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Making 100% ethical decisions with 0% internal conflicts would be easy if it weren't for … well, just about everything.

This month's "Ethics in Practice" column in PT in Motion magazine uses a fairly uncommon setting to get at a fairly common issue: namely, the ways in which external pressures can cloud the ability of a physical therapist (PT) or physical therapist assistant (PTA) to stay true to professional ethics.

The scenario involves a PT for a pro football team—not exactly a common gig—but the larger issues will be all-too-familiar to readers, who, for example, may receive pressure from parents of a pediatric patient, or feel conflicted over a working patient who believes he or she must return to the job as soon as possible.

The PT in Motion column presents a PT for a pro team who is charged with overseeing rehab for a high-value player after meniscal surgery. The player is progressing in a fairly normal way, but as a big playoff game looms, the PT starts experiencing pressure to hurry things along and make a positive return-to-play decision.

Some of the pressure is overt, coming from the team's coach and even the player in question. But some of that pressure comes from within the PT. The work with the team is rewarding, both personally and financially, and the PT feels the pull to make everyone—maybe even himself included—happy with a process that will get the star player on the field in time for the crucial game.

While the particulars involve a setting most PTs will never experience, the conflicts are familiar. Column author Nancy Kirsch, PT, DPT, PhD, and guest coauthor Bruce Greenfield, PT, PhD, ask readers, "Have you faced similar situations, in which you have questioned your own clinical judgments and motives? What did you do about it? How did you subsequently feel about your action—or lack of action—as the case might be?"

"A Game-Time Decision" is featured in the March issue of PT in Motion magazine, and is open to all viewers—pass it along to nonmember colleagues to show them one of the benefits of belonging to APTA. Printed editions of the magazine are mailed to all members who have not opted out; digital versions are available online to members.

Also open for public access: "Beyond Rest: Physical Therapists and Concussion Management." Check it out!


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