Abstract:
An understanding of the client, his/her needs, emotions and circumstances is
fundamental to an effective therapeutic relationship. This holistic focus of the
relationship and service excellence are, together with ethical sensitivity, important
pillars for effective and competent practice. Since there are currently no measures
available to evaluate ethical sensitivity in the therapeutic sciences, this study aimed
at developing, implementing and evaluating a multidisciplinary measure of ethical
sensitivity for healthcare professionals in the therapeutic sciences. The focus was
specifically on four professions – audiology, occupational therapy, physiotherapy and
speech-language therapy – within the South African context. The study followed a
two-phase, sequential mixed-methods research approach. Phase 1, the qualitative
exploration of ethical sensitivity, focused on developing a measuring instrument by
means of a systematic review of the following: ethical codes of conduct; focus group
discussions; individual in-depth interviews; an expert panel review; and public
complaints websites. Phase 2, the quantitative stage, focused on implementing and
evaluating the measuring instrument. One hundred participants – i.e. final-year
students who represented the four professions included in this study – completed the
measuring instrument. Participants’ overall scores on the Measuring Instrument for
Ethical Sensitivity in the Therapeutic sciences (MIEST) were comparable for all four
professions, which confirmed the multidisciplinary usability of the instrument. All
participants tended to make decisions based on the principle of Beneficence.
Participants were particularly sensitive about the impact of the therapist’s actions on
the individual client (individualistic culture), and sometimes overlooked their duty to
the community (collectivistic culture). Overall, participants selected an alternative
response for the target principle of Non-Maleficence. The MIEST can be used to assess the ethical sensitivity of student therapists (and possibly qualified therapists
as defined in this study) and describe the stage of their ethical sensitivity
development throughout the course of their professional development. The
constructed vignettes make the MIEST appropriate for use in problem-based
learning programmes. Further research could focus on testing and refining the
vignettes and items included in the MIEST to enhance reliability and validity.
