The aim of the study was to investigate the type and frequency of ethical situations experienced by physiotherapists in Spain, Portugal and the South American countries.
An online study was conducted in both languages using a questionnaire based on the work of Fryer et al. (2021), and 13 additional items, comprising 4 scales: (A) Physiotherapist and patient interaction, (B) Physiotherapist and other health professionals including other physiotherapists, (C) Physiotherapists and the system, and (D) Professional and economic ethical situations. Participants were asked about socio-demographic, work-related and educational aspects.
607 participants (380 female, 214 male, 5 diverse, 8 without specification), with an age range from 22 to 76 years (M=39.64 [SD=9.66]) responded to socio-demographic, work-related and educational aspects. 333 respondents (215 female, 118 male) completed the entire questionnaire.
The five most frequently encountered ethical situations by physiotherapists in South America, Spain and Portugal were “Lack of recognition of the role of physiotherapists in healthcare”, “Scarcity of resources and time affecting quality of physiotherapy treatment”, “Lack of knowledge about the scope of physiotherapy by other health professionals”, “Lack of access to physiotherapy for all people in society who need it” and “Lack of accreditation infrastructure and policies”, experienced by participants in a frequency between weekly and monthly. Scales showed very good Cronbach Alphas between 0.864 and 0.916.
Seven in ten respondents (N=424) learned about codes of ethics, and 36.7% (N=223) learned about ethical decision-making frameworks during their entry level education. Linear regression analysis showed that higher age, knowledge about ethical decision-making frameworks and private funding for physiotherapy in the respective countries predicted higher scores in all 4 scales. A higher frequency of experiencing ethical situations in scale (A) was predicted by higher education, country areas (rural, urban, both), and working in less different fields of physiotherapy and types of workplaces. Country areas that physiotherapists worked in predicted a higher frequency in scale (B) and (C), but not in scale (D). Experiencing more frequent ethical situations in scale (D) was predicted by higher age, knowledge about ethical decision-making frameworks, private funding of physiotherapy and less different types of workplaces, particularly in South America.
The recognition of and knowledge about physiotherapy by other health professions and equal access of the population to physiotherapy services are still insufficient in South American countries, Spain and Portugal, compromising quality of healthcare and just provision of physiotherapy services. The frequency of experiencing ethical situations in these countries is related to the source of funding of physiotherapy services, as well as age and knowledge of physiotherapists about ethical decision-making frameworks.
Physiotherapists need practical and structural support from professional associations to be capable moral agents within their health systems and workplaces in Spanish and Portuguese-speaking countries in Europe and South America, to address existing inequities in access to physiotherapy and educating societies about the profession’s scope. Knowledge about ethical decision-making should be fostered in physiotherapy entry level education.
Professionalism
South America
