D5: It's Ethical For PTs To Treat Family And Friends Flashcards
Affirmative opening statement
PTs are trained to be objective, and with long waitlists and limited access, treating family is a logical, ethical option.
According to WHO, there is a Global need for rehabilitation (ratio is 1 in 3 + increasing demand)
Opposition opening statement:
Emotional bias and blurred boundaries make treating family/friends unethical and risky.
- Compromised objectivity
- Potential conflicts of interest
What are the 3 affirmative arguments ?
- SAFE: PT is non-invasive and low risk
- LEGAL: No laws prohibit this
- LOGIC: It makes sense
What are the 3 opposition arguments?
- Lack of professional objectivity
- Difficulty in setting professional boundaries
- Increased emotional burden on PT
Evidence used for this affirmative argument:
SAFE - PT is non-invasive and low risk
- Structured referral system
• so PT is well aware of the patient’s medical history and needs - Extended Treatment Duration Allows for Objective Assessment
- 2 sessions for diagnosis and 6 or more sessions for treatment - Non-invasive techniques (no surgery or drugs etc) = lower risks
• “How Safe is Physical Therapy for Critically Ill Patients?” (Sricharoenchai, 2014) → PT is safe even in critical care - Treatment plan is designed for each patient
- tailored to patient’s needs regardless of who they are so boundaries are clear and no ethical concerns
Evidence used for this affirmative argument:
LEGAL: No laws prohibit this
No rule in Kuwaiti law or APTA ethics that bans it
Article (14) :
• A doctor cannot refuse to treat a patient without a valid reason, unless it’s outside their scope.
• Even then, they must document the case and refer the patient properly.
Article (26)
• Every patient has the right to receive comprehensive medical care, including prevention, diagnosis, treatment, rehab, and counseling—based on medical standards.
Evidence used for this affirmative argument:
LOGIC: It makes sense
• If untrained caregivers assist, why can’t trained PTs treat their own family?
• Home programs are part of recovery—why exclude qualified PTs from helping?
Evidence used for this opposition argument:
Lack of professional objectivity
• Emotions may lead to BIASED evaluation (Overestimating/underestimating condition severity)
• May fail to probe sensitive areas : avoiding personal/uncomfortable questions or movements
• Giving suboptimal treatment because they know they will not adhere to it
They referenced these:
• “AMA Code of Medical Ethics” → Emotions can interfere with medical judgment
• “Treating Self or Family” (AMA Ethics) → Over/under-treating due to emotional ties
Evidence for this opposition argument:
Difficulty in setting professional boundaries
• Patients may not take treatment seriously
• PTs may avoid strict or uncomfortable guidelines
• “AccessPhysiotherapy” → Difficult to maintain authority with loved ones
Evidence for this opposition argument:
Increased Emotional burden on PT
• Guilt or stress if the patient doesn’t improve
• Affects both personal and professional sides
• “FSBPT Position Statement” → Conflicts and emotional stress risks increase
Opposition rebuttal against :
SAFE - PT is non-invasive and low risk
• Some PT procedures (dry needling, mesotherapy) are invasive
• Stroke/post-op rehab are high-stakes
• Even non-invasive treatment can still cause have bad effects if ineffective (e.g. inability to treat cancer pain is heartbreaking)
Opposition rebuttal against :
LEGAL - No laws prohibit this
Legal ≠ Ethical
• FSMB: treating family creates ethical concerns
• AMA : personal feelings can compromise professional objectivity and patient care
• We’re not talking emergencies—this is about routine care
Opposition rebuttal against:
LOGIC - it makes sense
• Caregivers assist, PTs treat and take responsibility.
• Relatives may be too emotionally involved to make clear decisions
• Missteps by family PTs can damage relationships and trust
Affirmative rebuttal against:
Lack of professional objectivity
• Strong communication = better adherence
• “Physician-Patient Communication & Adherence” (Zolnierek & DiMatteo, 2009) → Good rapport = 19% higher treatment adherence
• PTs can maintain professionalism through boundaries
Affirmative rebuttals against:
Difficulty in setting professional boundaries
• Non-compliance happens with all patients—not just family. This doesn’t reflect PT’s competence nor professionalism.
• Adherence depends on personal motivation, external support system, and individual health—not relationship
• PTs are trained to educate and motivate effectively and design effective treatment plans
Affirmative rebuttals against:
Increased Emotional burden on PT
• Emotional stress is part of healthcare regardless
• “Managing Clinician Emotions” (Kolehmainen, 2014) → All clinicians face guilt/stress when care doesn’t meet expectations
• Following evidence-based practice helps to stay objective
• Training helps PTs manage emotions and stick to guidelines
Affirmative closing statement
PTs can treat objectively with proper boundaries, ensuring patient-centered care. Limiting this creates unnecessary stress and delays in care. No law prohibits it, and ethical safeguards already exist.
Opposition closing statement
Just because you can treat loved ones doesn’t mean you should. Professionalism requires objectivity, and referring out is the ethical choice to protect the patient and the therapist.
Which side used a survey gathered from physical therapists to support their position?
Affirmative
Which side used a survey gathered from physical therapists to support their position?
Affirmative
