A speaker examines whether independence should always be the goal in healthcare. They explore the ethics of dependency in active care and rehabilitation, drawing on conversations with practitioners about what patients actually want versus what treatment demands.
But I think it's important that we actually look at these because these have been shied away from a lot and creating problems. First one, create loads of pension over treat and stuff. Bear with me. If you've seen a few of my videos, you'll probably know that's not it. If you don't, I'm going to ask you to trust me here for a minute. But let's deal with that first one, is it unethical to give active care? I would argue that there are certain situations where we shouldn't be doing that and we may actually be better embracing the idea of dependency or if not embracing, at least certainly allowing for it. Now this came off the back of a conversation I had two of my newer associates fairly recently. We were talking about when should you give rehab, how much rehab should you give, how aggressive should you be in trying to wean the patient off treatment and onto rehab versus the other way around, saying what's wrong if somebody wants to pay you more money and have more treatment so that they can do less work themselves if they know that that's the option. And what was interesting is both of these associates had slightly different preferences. One would, all things being equal, prefer to do more rehab and have less treatment. They want to do as much as they could themselves. The other was quite happy to pay a bit more money, have a bit more treatment if it meant they had to do less work. In this, they were quite happy to outsource some of that problem to somebody else. And it came up because they both had these preferences there. They were both trying to navigate what was right for the patient in front of them. But I pointed out to them that yes, the guidelines and stuff are pushing us down the active care side a bit more, trying to correct the fact that we never did that. It's actually a pendulum swinging, I would argue, but that's one of the things that's going on. But also both of them were approaching this from a subtly doctor centered way and that they were going, well, this is what I want. And I'm going to argue that. And I'm going to argue what I would want and why my preferences should be taken account of. But then that was influencing their recommendations, their patients. They were essentially putting their values and preferences on onto the patient instead of doing what would be actually patient centered, which is finding out what the patient wants. But a lot of us don't do this because we have this automatic assumption that, you know, more rehab and less manual therapy is good, that's better. You know, we're being more ethical. We're not trying to make money out of them, we're not creating dependency, all that sort of stuff. Plus, surely patients would want to save a good bit of money and need.
