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Physical therapy in the United States evolved from its technical roots in the early 20th century to its current level of development, it is expected that a critical mass of practicing clinicians will have a Doctor of Physical Therapy degree by 2025 (APTA, 2014). The demands on the physical therapist to collaborate and practice as part of the inter-professional team continue to grow requiring further development and refinement of clinical skills. These clinical skills include the skills in ethical decision making that we will concentrate on in this text.

The roots of physical therapy go all the way back to 400 BC when Hippocrates and Galen advocated for treatment that included massage, manual therapy, and hydrotherapy. In the 18th century, orthopedists employed exercise as part of their treatment. In 1813, the Royal Central Institute of Gymnastics was founded in Sweden and therapeutic exercise became part of medical practice. In 1887, Sweden started registering practitioners of “physiotherapy.” In 1894, four nurses founded the Chartered Society of Physiotherapists. In 1913, the New Zealand School of Physiotherapy was founded, and in 1914, the first cohort of Reconstruction Aides, the precursors to physical therapists graduated from Reed College in the United States. In December 1921 several visionary women met in New York City recognizing the importance of establishing the nascent profession of physical therapy in the United States. This group of leaders established the 238-member strong, “American Women’s Physical Therapeutic Association.” A year later, in the first effort to be inclusive, not excluding their male colleague, the organization changed the name to the American Physiotherapy Association.

Physical therapy grew rapidly as a result of two world wars, and Polio, a major pandemic. Both events threatened the lives of many, yet lives were spared with the help of major medical advancements, including the development of antibiotics, safer blood transfusions, improvements in infection control, and surgical innovations, which saved people on the battlefield, and at home, leaving them alive but with disabilities to conquer. Medicine further evolved through the 1950’s, though still physician-centric during that period, physical therapy continued to evolve.

In the 1960s, the culture was to question and distrust authority, and medicine was not immune to that mentality, resulting in the further development of ancillary services and alternative healthcare treatments. People began to take more responsibility for their own healthcare needs. The relationship of provider and patient/client continues to evolve as information available to individuals to manage their own healthcare continues to grow in quantity and availability.

While physical therapy started as a technical field it has evolved into a profession. The Australian Council of Professions defines a profession as a, “disciplined group of individuals who adhere to ethical standards and who hold themselves out as, and are accepted by the public as possessing special knowledge and skills in a widely recognized body of learning derived from research, education, and training at a high level, and who are prepared ...

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