<- Home <- Arhive <- Vol. 25, Issue 3, September 2017



Rom J Leg Med25(3)309-313(2017)
DOI:10.4323/rjlm.2017.309
© Romanian Society of Legal Medicine


Ethical issues in rehabilitation of the post-traumatic patient

A. S. Nica, M. Constantinovici, R. Miclaus


Abstract: Physical Medicine and Rehabilitation is a relatively young specialty developed after 1947 based on the needs of patients with functional locomotor sequelae of infectious pathologies (poliomyelitis epidemics) or of various posttraumatic pathologies - interpreted as public health issues related to impairments and disabilities. Restoring maximum locomotor functioning is the main therapeutic objective, thus increasing the degree of physical and psycho-behavioral independence of the post-traumatic patient referred to rehabilitation. Patients are extremely physically and mentally vulnerable most of the time. They may not be psychologically prepared for the long-term therapeutic program and must be informed and motivated to follow a medical routine involving many healthcare professionals. The trauma patient needs empathy and communication for reaching coping, adapting and complying to the rehabilitation program. Patients with dysfunctional locomotor pathologies and disabilities (reffered from orthopedics, neurology or rheumatology) in post-traumatic context, must reasonably understand the goals of the rehabilitation program Also, they must carry out its different sequences by following the given recommendations based on experience and professional competence of the rehabilitation team. In many situations developing conflicts and ethical dilemmas related to the communication and information process, patient monitoring, quality of the relationships and communication in the rehabilitation team. Also, may be related to the presence of specific equipment and infrastructure (for example the hydrokinesiotherapy infrastructure) or the access to specific assistive devices (eg. orthotics, wheelchair). The particular elements of ethics in Rehabilitation were progressively structured starting from other models such as the US bioethical model and the general principles of medical ethics. To address the specific issues of Ethics in Rehabilitation there might be analyzed various challenging situations related to compliance of physician-patient and patient-family relationship.
Keywords: rehabilitation ethics, post-traumatic patient.



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