Patterns of ethical issues and decision-making challenges in clinical practice among Ghanaian physiotherapists

Objectives: To determine the patterns of ethical issues and decision-making challenges encountered by practicing physiotherapists in Ghana. Design: This is a cross-sectional study in which the stratified sampling technique was adopted to sample the participants. Setting: The study involved physiotherapists at the private healthcare setting and from different levels of public healthcare facilities. Participants: Eighty-two duly registered physiotherapists who were practising in Ghana participated in the study. Interventions: Participants completed a 30-item questionnaire related to ethical issues and challenges encountered in making ethical decisions. Data analysis was premised on the frequency of occurrence of ethical tensions and difficulty in decision making which were dichotomized as 'high' and 'low' issues, and 'extreme' and 'low' difficult decisions, respectively. Results: The age range of the participants was 21-49 years (mean 31.5 ± 1.4years). 18 (22%), 31 (37.8%) and 33 (40.2%) physiotherapists practice in the primary, secondary and tertiary healthcare settings respectively. 56 (68.3%) and 43 (52.4%) of the participants affirmed that 'establishing priorities for patient's treatment amidst limited time resources' was the most frequently encountered and the most extremely difficult ethical issue to make a decision on respectively. Whereas, limiting physical therapy services for personal or organizational gains sub-theme was the least occurred issue which was also the least difficult to make a decision on as indicated by the respective 16 (19.5%) and 18 (22.0%) physiotherapists. Conclusion: A wide range of primary and secondary ethical issues were reported by the sampled physiotherapists, which tend to pose difficulty during the decision-making process in practice.