Ethical Issues faced by Physical Therapists: A case scenario.


Hello friends,

How are you all? I know its been such a long I haven’t posted. I was so busy with my school and work. But Yay! I am going to graduate on May 19th! At last a relief! I hope you are all doing very well. I always get notification of you all liking my posts and still visiting my blog daily. I am very thankful to all of you guys for keeping my blog alive during my absence. Thank you so much!

In my today’s post I am going to write about a case-scenario of a woman with postpartum depression disorder. I know some of you are quite aware of the depression faced by women after child-birth and during child-bearing stages. Postpartum depression disorder is a part of my last thesis work and here I am going to highlight some main points along with the case-study using the RIPS model. If you guys need more clarification on the RIPS model please find the link attached below to read what a RIPS model is. Thank you all once again and I will be catching up with you guys hopefully very soon!!

I narrated the incident of a woman suffering from post-partum depression in my first discussion post. The patient is an Asian female. The patient complains of post-partum depression secondary to financial condition and stress between her husband. The patient also reported that she was so depressed that she tried to kill herself. The patient also told me that she has never felt so depressed before. In my 1stdiscussion post, I did not mention that I saw red bruises of blades on her right forearm. The patient reported me that the bruises were her attempts to commit suicide after her second delivery. The patient was taking some sleep medications, however, the patient reported that the medications did not produce any prolong effects. The patient also told that due to depression her second delivery was not a normal delivery.

After talking with her, she requested me that I should not include the following content in her chart. The patient also requested not to tell anyone about her depressive condition as she feared that she might not be able to get involved in her Asian society secondary to stigmatization.

US Navy 090527-A-4455C-005 Capt. Samantha Wige...

US Navy 090527-A-4455C-005 Capt. Samantha Wigeand smiles at her patient, Yimana Garcia, before Garcia’s surgery aboard the Military Sealift Command hospital ship USNS Comfort (T-AH 20) to remove a cyst in her ovaries (Photo credit: Wikipedia)

When I saw this patient and heard about her request I felt sorry for her. However, there were various questions in my mind, whether to accept the patient’s request or do what is good for her and the society she is living in. The other side of my mind continuously told me that I should report about her to decrease the incidents of harm to her kids or her family, although I felt sorry for the patient.

Kirch (2006), states the RIPS model of ethical and decision-making. Kirch (2006), divides the model based upon the Realm which constitutes of the Individual/Institutional or Organization/societal. According to my case, I did not include her depressive condition in the chart which can be said as Realm Individual (Kirch, 2006). I did that to help the patient/client relationship that we shared and trust that she laid upon me.

The second phase according to Kirch (2006):

a)     Moral Sensitivity: I tried to recognize the sensitivity of the situation; however, I was more biased and leaned towards the patient’s side due to the patient’s emotional attachment with her society and her fear of stigmatization.

b)    Moral Judgment: I was thinking about both the aspects, if I report about the patient she might get emotional breakdown, on the other side If I didn’t report she might do harm to her kids and family secondary to depression.

c)     Moral Motivation: After looking at her kids (older one 10 years old and younger one 1 ½ year old) I thought off taking a stand and reporting about her and in that way not only helping her but helping her family too..

d)    Moral Courage: I took the stand and reported about her to the Physician onboard so that proper action about her depressive condition can be taken as soon as possible. However, I was highly discouraged to note down regarding her condition on the chart. Instead I noted it down in my personal PT system (I did that because we do have high amount of Asian staff and I did not want the patient’s confidentiality to get exposed).

Ethical Situation: Kirch (2006), states that Ethical situation includes Problem or Issue, Temptation, Distress, Dilemma and Silence. As mentioned above, I faced dilemma and temptation of not reporting about the patient and a thought to keep silence about her condition.

Do you think I did right? Should I have noted down about her condition in the chart? What do you suggest I should have done in this situation?

Thanks

Sweta

Links: Rips Model pdf 1

Links: RIPS model pdf 2

Reference:

Kirsch, N. (2006). Ethical Decision Making: Terminology. PT: Magazine of Physical Therapy, 14(2), 38-40.

8 comments

  1. My spouse and I absolutely love your blog and find nearly all of your post’s to be just what I’m looking
    for. Do you offer guest writers to write content available
    for you? I wouldn’t mind writing a post or elaborating on most of the subjects you write related to here. Again, awesome web site!

    1. Hello my dear.. Thank you for appreciating my blog. I appreciate your efforts and time to go over my blog.. Thank you once again.. Yes I would love to offer you the opportunity to write your content on my blog. That would be my privilege. I saw your website of wellness and chiropractic care. I would love to see you share your content on my site of physical therapy. Please contact me or drop me an email at sweta.schristian@gmail.com. I am also available through skype at swetac25.

      Thank you once again!
      Sweta

  2. Definitely have to note that in the chart and speak with her physician. Not doing so will put you at legal risk

    1. Yes Zach.. I did note that in her chart later and I have also reported it to the physician, however, I have just kept her chart in lock and key as I don’t want her confidentiality to be exposed.

  3. I think you were right to report the condition and to keep it out of the charts, since there was a danger of leaking the information to people who had no right to the information. Good job!

    1. Thank You Barbara.. nice to see your response on my long waited post after so many days!@!!!! I want to interact on wordpress like before.. just 2 more weeks to go for my final sem before graduation.. Yuppiieee. how are you by the way my dear?

      1. I am doing well, Sweta. I am so proud of your accomplishment! I know you probably need a good rest. It is good to see you posting again. Take some time just for you. You deserve it.

  4. Good day I am so glad I found your site, I really found you by error, while
    I was researching on Aol for something else, Nonetheless I am here
    now and would just like to say thanks for a marvelous post and a all round
    thrilling blog (I also love the theme/design),
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    I have bookmarked it and also included your RSS feeds, so when I have time
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