Ethics and Patient Safety
Ethics and Patient Safety
This domain tests applied ethics, confidentiality, consent and capacity, safeguarding, incident reporting, infection control and manual handling in physiotherapy practice.
Core rules
- Four principles: beneficence, non-maleficence, autonomy and justice. When they conflict, justify and document your reasoning.
- Confidentiality: share only on a need-to-know basis, avoid corridor and social-media discussion, and secure written and electronic records.
- Capacity: presume capacity unless evidence suggests otherwise. Assess understanding, retention, ability to weigh information, and communication of choice. If capacity is absent, act in the patient's best interests, involve family where culturally and legally appropriate, and seek senior advice.
- Safeguarding: act on suspected abuse or neglect of children, older adults or vulnerable persons through the designated pathway.
- Incident reporting covers near misses, not only harms; reporting is blame-free and separate from disciplinary processes.
- Infection control follows the WHO five moments of hand hygiene; manual handling follows assessed risk, not individual strength.
Worked example
A patient two days after abdominal surgery with intact capacity refuses mobilisation because of pain and fear. Reasoning: autonomy prevails over the therapist's view of benefit. Explore the concern, offer analgesia timing and a seated alternative, explain the risks of immobility, then document the discussion, the refusal, and the risk accepted, and inform the team. Coercion is not permissible.
Traps
- Paternalism - deciding that the patient "must" comply.
- Casual confidentiality breaches in corridors or messaging groups.
- Treating consent as a one-off signature rather than a process.
- Failing to report a near miss because no harm occurred.