Faculty of Health and Social Sciences, Department of Health and Function, Western Norway University of Applied Sciences (HVL), Bergen, Norway.
Faculty of Health Studies, VID Specialized University, Bergen, Norway.
Physiother Theory Pract. 2022 Jan;38(1):1-13. doi: 10.1080/09593985.2020.1741051. Epub 2020 Mar 13.
Ethics is ever-present in all aspects of human interaction and, in any physiotherapy situation there is an inherent claim to act and care for the patient in the best possible way. The physiotherapy profession is provided with rules, guidelines and codes to support and ensure ethical professional conduct. In recent decades however, physiotherapy literature has emphasized how ethical agency is immersed in clinical reasoning in each particular situation, in the doing of physiotherapy. The Danish philosopher and theologian Knud E. Løgstrup offers a bottom-up approach to ethics, which may augment the philosophical underpinning of this development in ethical thinking. Løgstrup departs from the given pre-conditions of life; a point of departure where the ethical claim emerges from sensation in the concrete situations. This paper introduces Løgstrup's situational ethics and its ontological framing, with four foci: how we can tune in to sensation and sense the ethical claim of the other; how human interdependence can be heard in what Løgstrup calls sovereign life utterances; relational responsibility and ethical norms; and the metaphorical importance of poetic understandings of the world. In four themes we reflect on how these ethical issues are at stake in physiotherapy practice with regards to: (1) uncertainty, tuned sensation and therapeutic attitude in physiotherapy; (2) sensuous, narrative and poetic meaning-making in physiotherapy; (3) physiotherapy and coming to oneself in new embodied experiences; and (4) ethical claims and codes of conduct in physiotherapy.
伦理学存在于人类互动的各个方面，在任何物理治疗情况下，都有一个内在的要求，即尽可能以最好的方式为患者采取行动和提供护理。物理治疗专业有规则、准则和规范来支持和确保其专业道德行为。然而，近几十年来，物理治疗文献强调了伦理代理如何沉浸在每个特定情况下的临床推理中，即物理治疗的实践中。丹麦哲学家和神学家 Knud E. Løgstrup 提供了一种自下而上的伦理学方法，这可能会增强这一伦理思维发展的哲学基础。Løgstrup 从生活的既定前提条件出发；从这个起点出发，伦理诉求从具体情境中的感觉中产生。本文介绍了 Løgstrup 的情境伦理学及其本体论框架，重点关注以下四个方面：我们如何能够调谐感觉并感知他人的伦理诉求；人类相互依存如何在 Løgstrup 所谓的主权生命话语中被听到；关系责任和伦理规范；以及对世界的诗意理解的隐喻重要性。在四个主题中，我们反思了这些伦理问题在物理治疗实践中是如何存在的：（1）物理治疗中的不确定性、调谐感觉和治疗态度；（2）物理治疗中的感性、叙事和诗意意义建构；（3）物理治疗和新的具身体验中的自我认同；以及（4）物理治疗中的伦理诉求和行为准则。
