overview !!!!!!

To start with, i Have joined the course to experience how the physios from all over the world learns and to analyse whether am at par with them or not.

To be frank,the topics were not seemed to be interesting (because i have no answers for many of the questions) initially, then i realized that my thoughts are influenced by what i believe, where am from and where i live. since all the above three varies from person to person , the ideas, thoughts  of various sensitive topics had varied widely. 

As a professional i learnt that when you encounter a controversial thing, analyse the situation in point of view from yours as well as your opponent. 

above all the best thing i learnt is FIrst am a Human and next am a professional/ Physiotherapist ………….

happy learning !!!!!!!

Euthanasia- to agree or not ????

hmmmmmm. quite a controversial topic.

if we believe that we have right to live and right to die, then Euthanasia seems to be justifiable.

in my country (INDIA) where suicide of able-bodied and disabled is an offence , Euthanasia is not accepted. I ,myself being a religious person have one query.

Euthanasia or assisted suicide is solely based on result of human interpretation. where a group of specialised doctors/health care professionals agree that there is no/very minimal chance of recovery.

there are many instances where the medical team believe there is no chance of survival yet the person lives so long. this is not to emphasize the presence of supreme power (eventhough i believe it) but to emphasize the  lack of human knowledge on death and life issues.

if we accept that the humans cannot judge 100% then how can we go for euthanasia on the basis of medical team interpretation?????

on the other hand, if euthanasia or assisted suicide is legalised on the grounds of burden to the soceity and family , wont the threshold of burden wil reduce????

on the long run even a bearable burden will be seen as unbearable and provision of assisted suicide may be enforced.

wont they?????

torture (better understood)

Torture can be defined as the deliberate or systematic infliction of physical or mental suffering to force another person to yield information, as a punishment or to destroy a person’s identity.

The aim of the physiotherapy treatment for persons who have undergone torture is to relieve or reduce pain, correct musculoskeletal dysfunctions, teach the client to cope with pain, and regain body awareness.

A good interaction and communication with  persons who have undergone torture is needed to optimize the treatment
Gard G. (2007) emphsasized factors important for good interaction in physiotherapy treatment of persons who have undergone torture in a qualitative study as: Personal characteristics, Professional and therapeutic competence and support, Language Factors, Time, and Frames.

Five factors in the interaction situation were important for a good interaction: cultural factors, treatments tailored to the patient’s needs, to develop confidence and trust, religious factors, and capacity to handle negative emotions.

All these factors have to be considered to improve the interaction between PTs and persons who have undergone torture.

this is quite clear where my professional duty is to treat a torture victim.

when my treatment can  be misused as a torture technique ,the actual problem arises.

as tony lowe’s example scenario where you are asked to examine a prisoner to determine whether they could weight bear on an injured leg, where you suspect that enforced standing could then be utilised as a torture technique. In such circumstances what would you do?  Do you diagnose that the prisoner could not weight bear even when your professional opinion would be that they could?

i may give the benefit to the victim and may advise not to bear weight because whomever the patient, my technique is to improve the well-being and not to inflict pain.

torture redefined


My religion says alcohol is probihited,

am i going to treat differently if my patient is alcoholic, why not even if  he/she suffers from alcoholic neuropathy ?????

am i going to see it as a punishment for his wrongdoing(as per my belief)?????

definitely no………….

then what if the patient is gay,lesbian,bisexual, alcoholic,drug addict.

i may hate these stuffs personally but this wont affect my treatment behavior.

Week 3 :Are we really all equal?

on seeing the question my immediate reaction was ‘yah! ofcourse all humans are equal. i felt there’s nothing great to talk about this. 

once i read the posts, i felt its not so. 

Unfortunately in health care setting, the lack of diversity among care providers and the lack of culturally competent policies within healthcare delivery settings makes this not so feasible.

 Although developing and implementing a diversity plan and culturally competent policies is very complex practically, politically, and programmatically for traditional institutional care providers, it must be done.

Providers must embrace the diversity that is a part of any society and must not let race or ethnicity be a determining factor in offering treatment options.

Ethics Vs Morality – only Religious ?????

Hi everyone,

After going through the posts I think for a while, what are the ethical /moral dilemmas I face as a Physio. Most of my thoughts ended up with dilemmas related to religious stuffs of the therapist / patient.

For example:

  1. What will I do when am rushing for a prayer and my patient came for his/her treatment?
  2. What will I do when my patient requested to adjust my busy schedule for his/her religious stuffs?

Does ethics vs morality issue arise only pertaining to religion? If there were no conflicts with respect to religion, everything is okay?????

I did a quick review on PUBMED to search about the documentation of these issues in Physiotherapy. I came across an excellent article (Guiccone,1980) which describes various situations where ethical dilemmas may arise.

Listing a few:

  1. Establishing priorities for patient treatment when time or resources are limited.
  2. Discontinuing treatment for patients who habitually disregard instructions such as for home programs, treatment regimens, and safety instructions.
  3. Continuing treatment with a terminally ill patient.
  4. Continuing treatment to provide psychological support after physical therapy treatment goals has been reached.
  5. Determining professional responsibilities when a patient’ needs or goals conflict with the family’s needs or goals.
  6. Defining the limits of the physical therapist’s role in the initial education of a patient/family regarding diagnosis or prognosis.
  7. Deciding whether to represent certain necessary patient services in a way that would meet third party- payer limitations.
  8. Withholding or limiting physical therapy services in order to improve work conditions, salaries, staff/ patient ratios, etc.
  9. Reporting questionable practices of another physical therapist/ physician to the appropriate person.
  10.  Deciding what to do when two of my ethical principles or values are in conflict?             

How to Tackle Clinical Empathy ????

Medical educators and professional bodies increasingly recognize the importance of empathy, but they define empathy in a special way to be consistent with the overarching norm of detachment. Outside the field of medicine, empathy is an essentially affective mode of understanding. Empathy involves being moved by another’s experiences. In contrast, a leading group from the Society for General Internal Medicine defines empathy as “the act of correctly acknowledging the emotional state of another without experiencing that state oneself.” (Jodi Halpern, 2003)

The whole point of empathy is to focus attention on the patient.A listener who was busy having his or her own parallel emotions and introspecting about them would have the wrong focus.

For Example is a patient says that he / she has stopped doing his/her exercise empathy involves taking cues from his/her tone.Because he/she doesn’t feel unwell, or he/ she may see the exercise program as useless because of  hopeless feel about getting well.

The skeptic might ask why it matters whether physicians respond emotionally if they just behave empathically. Jodi halpern suggests,

1)The observational studies mentioned above show that patients sense whether physicians are emotionally attuned.

 2) Patients trust physicians who respond to their anxiety with their own responsive worry. Trust has been associated with better treatment adherence.

3) It matters when and how physicians ask patients about their feelings, and empathic attunement guides physicians about when to ask questions, when to stay silent, and when to repeat important words.

Another example an be quoted from the case study of a GBS patient cited by Ann Hallum. The patient reported that she was terrified during the time she was totally paralysed (including eyelid movement) and on a respirator.

She said that nurse,doctors and hospital staff seemed to assume she could not hear because she was unable to respond in any manner.

In her word ” they acted like I was already dead”

Needless to say , Evidence is increasing that patients treated in acute trauma rooms or ICUs can have POST-TRAUMATIC STRESS SYNDROME.


Hi friends,

Am done with my Post Graduation Exams (M.P.Th-Neuroscience)

waiting for my results……….

Going home after a long back.

catch you soon. keep in touch.