Ethical Dilemma

When I was on my country placement, one of my patients was a 70 years old male who had a head injury (subdural haematoma) secondary to a fall in the community.

When I took over his case (in a restorative ward), he was already 38 weeks down the track. From his previous medical entries, this patient had been documented as ‘unfriendly’, ‘uncooperative’, ‘stubborn’ and ‘verbally expressive’.

In his first physiotherapy session with me, he was unwilling to participate and the only thing he wanted was to kick or punch me. I wasn’t quite sure what to do so I went back to consult my supervisor.

My supervisor went to see the patient with me and she suggested since patient was not doing anything apart from kicking or punching, I might have to integrate these two movements into his session. For example: If I want him to do active knee extension in sitting, I have to ask him to ‘kick my hand’.

To be honest, this method worked for that patient yet I was thinking: Would this encourage patient to develop an aggressive manner towards other medical staff? Is it an appropriate method to treat your patient while hospital has emphasized on the importance of ‘zero-tolerance’ policy.