15-1 Physical Therapy, Evidence-Based-Practice and Ethics
Physical Therapy, Evidence-Based-Practice and Ethics / Ilana Zilberstein, PT,Ph.D, Geriatric Department, Ministry of Health, Israel Zvulun, PT, MAppSc
Shifts in healthcare policies have challenged the belief that health budgets should be prioritized based on economic standards nd scientific research. This was also the principle underlying the development of the Evidence Based Medicine (EBM) approach. There are also ethical aspects to EBM, chief among them the confidence that evidence based treatments are more likely to benefit than harm the patient. The Physical Therapy (PT) profession is constantly developing in the areas of research, technological diversity and professional skills and attitudes. As a health profession, it is influenced by social changes and national healthcare trends. As a result, health and allied-health professions, PT included, have adapted the EBM approach and recast it as Evidence Based Practice (EBP).
Sackett (2000), the founder of the approach, included in the definition of EBM three elements: research, clinical experience and the patients' set of values. However, as the discussion in the professional literature reveals, there is a tendency among professionals, funding agents and healthcare organizations to view the approach as based primarily, if not solely, on research evidence. After a thorough examination of research methodologies in PT and a critical reading of numerous studies, it appears that sometimes there are conflicts between ethical principles and the implementation of research results. Every physiotherapist should examine these issues carefully when considering the application of research conclusions in the clinical setting. Practicall, physical therapists must balance between basing their practice on research findings, educating about usage of their clinical experience, and considerations of their patients' needs and values. Employing a broad approach to EBP, by taking all its aspects into account, justifies offering PT treatment to a wider population, thus extending the reach of PT beyond its current boundaries.
Keywords: Physical Therapy, Evidence Based Practice (EBP), ethics.