Question

Case Study:

Linda is a student in training to become a physical therapist. Dr. B., who is the head of the Physical Therapy Department, has told Linda that she helps the patients too much. Many times he has said, "You can't go home with the patients. They must learn to take care of themselves." Nearing the end of her program, Linda is doing very well in all her studies, but she fears Dr. B. will not give her a good performance evaluation unless she can better prepare her patients for independence.

One of her patients, a 72-year old woman recovering from a stroke, is adamant in her refusal to walk with either a cane or a walker. She insists on remaining in her wheelchair because she is afraid of falling, and Linda is sympathetic to her fears.

In addition, a statement that Linda heard in one of her classes, "First of all, do no harm," has always influenced her behavior. Linda is very reluctant to force her patient to do something she does not want to do.

Please answer the following Case Questions (20 points):

1. How can Linda balance the benefits and harm of encouraging her patients to do something they do not want to do?

2. In your opinion, is Dr. B. placing too much pressure on the student?

3. Is this a legal problem, ethical problem, or both? Explain your answer.

4. Who should Linda talk to about her dilemma?

Answer 1

1. How can Linda balance the benefits and harm of encouraging her patients to do something they do not want to do?

Answer - First of all, Linda is doing nothing wrong by worrying about her patient’s safety. Dr. B. is also quite correct in his wish for patients to be able to become as independent as they can. But there is help for Linda.

2. In your opinion, is Dr. B. placing too much pressure on the student?

Answer - Physical therapy is a discipline that prepares patients to return home as independent as possible. This is good time for Linda to better understand the career that she has chosen. She needs to learn as much as she can from Dr.B.—but never forget that her first responsibility is to the patient. She must talk with her instructor about her concerns.

3. Is this a legal or ethical problem or both?

Answer - It would be both illegal and unethical if Dr. B were asking Linda to do something that would cause injury to the patient. As far as we know from this case, this doesn’t seem to be the problem. If the patient is too frail or ill to perform the exercises, then Linda would have to report this to both the doctor and her supervisor.

4. Who should Linda talk to about her dilemma?

Answer - Students must always be aware that they are not acting independently of their supervisor—in this case, that would be her instructor. Students can always seek out the advice of their faculty member.