Authors:Marie Goulet, Marie-Josée Drolet Pages: 9 - 21 Abstract: In rehabilitation, there is a growing interest in ethics. That said, few meta-ethical reflections have been conducted to date. Therefore, a review and critical analysis of the use of the concept of “ethical issue” is warranted. To this end, a systematic and critical review of the literature discussing ethical issues in rehabilitation was conducted. This review, based on the method developed by McCullough and colleagues, identified and analyzed 80 articles. Several characteristics and gaps in the conceptualization of the ethical issue concept were noted. Three main findings emerge from the study: 1) the corpus of texts studied is dominated by descriptive ethics; 2) ethical conceptualisation is marginal, in that ethical concepts are generally stated without being defined; and 3) the corpus is characterized by the use of amalgams and by the multiplication of imprecise ethical concepts that are often used as synonyms while referring to distinct phenomena. These conceptual gaps create conceptual confusion and imprecision that can undermine ethics research, teaching and clinical ethics, and discredit the discipline of ethics. PubDate: 2018-12-14 Issue No:Vol. 1, No. 3 (2018)
Authors:Kevin Reel, Sylvia Davidson Pages: 35 - 48 Abstract: This article explores the many dimensions of sex which result in very strong moral and ethical responses. In support of practitioners who wish to feel more comfortable and competent discussing sexual matters, the article then introduces a hybrid conceptual model of practice. Combining one model originally from sexology and another from occupational therapy, the Ex-PLISSIT Enablement Model offers a flexible, progressively-staged framework to guide practitioners toward a plan to better understand and work within their own scope while also assessing if clients are ready and willing to engage with the subject to varying degrees. PubDate: 2018-12-14 Issue No:Vol. 1, No. 3 (2018)
Authors:Simon Deslauriers, Marie-Hélène Raymond, Maude Laliberté, Anne Hudon, François Desmeules, Debbie E. Feldman, Kadija Perreault Pages: 49 - 60 Abstract: In the context of long waiting time to access rehabilitation services, a large majority of settings use referral prioritization to help manage waiting lists. Prioritization practices vary greatly between settings and there is little consensus on how best to prioritize referrals. This paper describes the prioritization processes for physiotherapy services in Québec and its potential implications in terms of equity in access to services. This is a secondary analysis of a survey of outpatient physiotherapy departments (n=98; proportion of participation was 99%) conducted in 2015 across publicly funded hospitals in Québec. In many settings, persons with acute orthopaedic conditions were prioritized while chronic conditions were given a lower priority. There were 72 different combinations of prioritization criteria used in outpatient physiotherapy departments. Variability was also observed in the type of personnel involved in the prioritization process, the number of priority levels used to rank the referrals and the source of information used to prioritize referrals. These results highlight potential issues regarding equity in access to physiotherapy services: the prioritization of persons with acute conditions to the detriment of those with chronic conditions, the lack of consensus on a fair prioritization process and the importance to adequately assess patients’ needs for treatment. Further research and interventions on prioritization criteria and processes are needed to ensure equitable access to physiotherapy services, especially in the public sector. PubDate: 2018-12-14 Issue No:Vol. 1, No. 3 (2018)
Authors:Marie-Ève Caty, Marie-Dominique Lessard, Annie-Kim Robertson Pages: 61 - 70 Abstract: Professional ethics is an important skill for professionals who work in the area of health. For speech-language pathologists specifically, the constant widening of the field of practice and the increasing complexity of the needs of the aging population expose professionals to more ethical questioning. Yet, the scientific literature demonstrates that speech-language pathologists do not feel properly prepared to solve ethical issues. The main objective of this study was to examine the situation of ethics training in all Canadian programs that offer speech language pathology training. In order to meet this objective, a survey was sent to the directors of the eleven Canadian university programs in speech-language pathology. Three programs responded to the survey. The main results obtained suggest that professional ethics is a subject taught within different courses in Canadian university speech-language programs. Nevertheless, the percentage dedicated to ethics inside the courses is low and difficult to clearly estimate. These results shed light on the quantity and quality of professional ethics courses offered in the various Canadian speech-language programs, as well as on the teaching methods used. PubDate: 2018-12-14 Issue No:Vol. 1, No. 3 (2018)
Authors:Kevin Reel Pages: 71 - 81 Abstract: The recent change in Canadian law to allow access to medical assistance in dying restricts eligibility, among its other criteria, to those for whom “natural death has become reasonably foreseeable.” A recent review of certain aspects of the law examined the evidence pertaining to extending access to assisted dying in three particular request situations currently denied: requests by mature minors, advance requests, and requests where mental illness is the sole underlying medical condition [1]. The requirement for this review was included in the legislation that introduced medical assistance in dying in Canada. Both the original change in the law and the review itself neglected to consider those with intolerable suffering for whom natural death is not reasonably foreseeable. This paper explores the possibility that access to assisted dying should be extended by removing this limiting criterion. It also considers the ethical challenges this might present for those who work in rehabilitation. PubDate: 2018-12-14 Issue No:Vol. 1, No. 3 (2018)
Open Access journal
