In private practice, informed consent is interpreted as providing explanations rather than offering choices: a qualitative study.

QUESTION How do physiotherapists working in private practice understand and interpret the meaning and significance of informed consent in everyday clinical practice? DESIGN Qualitative study using semi-structured interviews. PARTICIPANTS Seventeen physiotherapists purposefully recruited from metropolitan private practices where treatment was on a one-on-one basis. RESULTS Therapists defined informed consent as an implicit component of their routine clinical explanations, rather than a process of providing explicit patient choices. Therapists' primary concern was to provide information that led to a (therapist-determined) beneficial therapeutic outcome, rather than to enhance autonomous patient choice. Explicit patient choice and explicit informed consent were defined as important only if patients requested information or therapists recognised risks associated with the treatment. CONCLUSION Physiotherapists defined informed consent within a context of achieving therapeutic outcomes rather than a context of respect for patient autonomy and autonomous choice. Physiotherapy practice guidelines developed to ensure compliance with ethical and legal obligations may therefore be followed only if they fit with therapists' understanding and interpretation of a desired therapeutic outcome.