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Critical Reviews™ in Physical and Rehabilitation Medicine
SJR: 0.121 SNIP: 0.228 CiteScore™: 0.17

ISSN Print: 0896-2960
ISSN Online: 2162-6553

Critical Reviews™ in Physical and Rehabilitation Medicine

DOI: 10.1615/CritRevPhysRehabilMed.v17.i1.20
pages 31-52

Ethical Issues in Physical Medicine and Rehabilitation: Treatment Decision Making with Adult Patients

Mark G. Kuczewski
Neiswanger Institute for Bioethics & Health Policy, Loyola University Chicago, Stritch School of Medicine, 2160 S. First Avenue, Bldg. 120, Rm. 280, Maywood, IL 60153
Irma Fiedler
Department of Physical Medicine and Rehabilitation, Medical College of Wisconsin


In the bioethics, medical, and disability studies literature, ethical issues in the rehabilitation care of adult patients have received sporadic interest over the last 20 years. This overview of the literature focuses on the cornerstone of contemporary bioethics—the doctrine of informed consent. Problems in applying this doctrine to patients whose values and personal identity may be challenged by disease or injury, as well as radically altered life options, are addressed. Practical guidance regarding informed consent and decision-making capacity in the clinical setting is offered, highlighting the issues raised by evolving reimbursement structures, as well as the ethical issues involved in the quest for objective measures of quality of life.