Ethical and Medico-Legal Issues in Amputee Prosthetic Rehabilitation

Abstract

This chapter focuses on ethical and medico-legal issues in amputee prosthetic rehabilitation. Ethics is a critical evaluation of assumptions and arguments and is the study of what we “ought” to do. One ethical cluster of principles includes respect for autonomy, non malefience, beneficence and justice. Health care professionals “think” that they always do what is right for the patient, however in amputee rehabilitation and prosthetics with contracts with private companies there can be business pressures and resultant conflicts.

The primary duty of the clinician is to act in the best interests of the patient. Clinicians make better ethical decisions if they have a chance to think about them. It is only recently that we have begun to address ethical issues in amputee rehabilitation, with such attention previously focusing on acute care issues. Ethical dilemmas relate to goal setting, patient selection, resource allocation, teamwork issues and expectations of patients. There is an element of rationing in health service owing to a lack of resources and doctors are pushed into the role of gatekeepers. This chapter discusses a range of such issues as implicated in amputee prosthetic rehabilitation.