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INTRODUCTION

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Ethical decision making evolves as medicine evolves. The choices that we have expand, but the basic parameters by which we make these changes are a constant, providing a frame of reference and stability in an exciting and ever-evolving healthcare landscape.

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Consider for example end-of-life issues. When medicine had no options to offer, there were few ethical choices to make. As medicine progressed and there were options available to keep people alive, we were faced with the ethical questions not only whether we should keep people alive but how and when we should allow people to die.

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For every improvement in healthcare, there are hopefully concurrent improvements in quality of life, which of course is an area that physical therapists become actively engaged in. The exciting thing about this topic is the lists of new medical advances and technological improvement are always evolving. Not every new advancement is appropriate or in the best interest of the patient. The challenge for us as healthcare providers is to choose wisely when embracing new techniques and technology. Rehabilitation is considered the downstream recipient of new developments as we translate the advancements into function. We are still concerned with the same issues, such as fairness in access, justice in resource allocation. We have to be mindful that we don’t expend more time and resources on a patient or technology just because of the novelty of a new process or intervention. Technology also demands of us responsible research and responsible care.

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Each of the topics below when revisited will have developed more fully or will have evolved off of this list into main stream therapeutics. By no means is this a complete listing either; it is meant to be a start, a jumping off point for you to begin to think of the many other things that while in development should be considered as to their impact on the delivery of physical therapy and the future of physical therapy treatment. To fully assess the value of new techniques and technology, the patient must remain the central focus. Each new technique or technology must be evaluated based on its risk–benefit ratio, its worth, a function of cost and value, and the possible positive and negative consequences.

  • New techniques in physical therapy

  • Access and allocation

  • Genomics and gene therapy

  • Therapeutic procedures in utero

  • Stem cell therapy

  • Consideration of non-opioid treatment options

  • Using exercise with serious illnesses

  • Telehealthcare at a distance

  • Robotics

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New Techniques in Physical Therapy:

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New techniques in physical therapy are constantly evolving. PTs have an ethical obligation to remain current with changes in the field. Principle 6: “Physical therapists shall enhance their expertise through the lifelong acquisition and refinement of knowledge, skills, abilities, and professional behaviors.” PTs also have the obligation to evaluate new techniques and determine the value of that technique for their practice. Principle 6C: “Physical therapists shall evaluate the strength ...

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