Honest patient communication?

I have an ethical question about honest communication style:

Given the example of an elderly patient with a painful strongly deformed joint of one toe of her foot who wishes therefore massage/mobilisation. How honest can I be in telling the truth that massage/mobilisation and even exercise will probably not help to reduce the pain because the point of time for therapy is already too late? I am in a dilemma. What shall I do? Making massage even knowing it won’t help or telling her the truth and confront her?

Can I use the principles of the WCPT ethical principles (World Confederation for Physiotherapie) where it says we should provide honest, competent and accountable professional services? Is it about the communication style?

Please post me!

I am very interested what you think about honest communication!




3 Replies to “Honest patient communication?”

  1. Hi there. I think that in this case there really isn’t very much of a dilemma. If you know that the therapy the patient wants is of little value, then there doesn’t seem to be any point in providing it. I’m not sure how it is in Switzerland but in South Africa physiotherapists are first line practitioners, which means that we make the decision about the most appropriate management for patients, regardless of what anyone else on the team thinks. We obviously work with patients where possible to try and make sure that their wishes are integrated with treatment, but ultimately it is the therapist who must decide.

    At the end of the day, it’s essential that we are honest with our patients.


  2. I think to solve this problem it is important to use good communication skills. If you want to be honest, you should tell the patient the truth. I think it is better he knows in the begining that your expectation is low, so he is not disappointet in the end. Good luck!


  3. Good Day
    Touching on what Michael has said, in South Africa we are to be honest with or patients and treat them the best way we know how. We have the responsibility to educate them on their current condition and sate and discuss the best plan forward using our clinical knowledge and practice. In this case, where you know such techniques would not be beneficial to the patient maybe advice on alternative pain management strategies or even referral to another professional to identify why the toe is deformed? Would this not allow you to treat the impairment rather than symptoms? I would feel that if massage and mobilisation is what they want then they should be educated on such techniques to perform themselves, however at the end of the day during your treatment sessions you the therapist should prioritise what is best for the patient.
    Kind regards


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