Physiotherapists’ experiences about ethical dilemmas and ethical reflections in their word with elderly, frail stroke patients

Scientific article in Fysioterapeuten 3/2015.


Kristin Fiskaa, spesialfysioterapeut, MSc., Naustdal kommune.


Purpose: Working with elderly, frail stroke patients may provide complex professional challenges. This article is based upon a thesis about physiotherapists’ experiences with ethical dilemmas and ethical reflections in their work with these patients and its impact on clinical practice. The purpose of the article is to contribute to increased knowledge about the topic.

Material and method: In-depth interviews were conducted with 5 physiotherapists in hospital stroke units and rehabilitation wards, concerning their experience with the topic. All interviews were transcribed and analyzed using systematic analysis of content following qualitative methods and theory.

Results: The ethical dilemmas identified were within two main categories: «Ethical dilemmas concerning systemic factors» and «Ethical dilemmas concerning the meeting between the physiotherapists and the elderly, frail stroke patients». In their work with elderly, frail stroke patients, physiotherapists choose a relational ethical approach whereas the system emphasizes a consequential ethical approach. This may lead to ethical dilemmas and the experience of moral distress.

Conclusion: Focus on ethics and ethical reflection at individual and group level at work, supported by the leaders, may contribute that physiotherapists develop ethical competence and reduce their experience of moral distress in their patient work with complex professional challenges.

Key words: Ethical dilemma, physiotherapy, relational ethics, consequential ethics, moral distress.

Fulltext article in Norwegian