by Debra Gorman-Badar, APTA Montana, Chair of Ethics Committee

The Golden Rule is commonly invoked in ethics discussions and seems to be thrown out on the table like a trump card. While some have touted it for its simplicity because it is easy to remember, easy to understand, and easy to apply; it is a much more complex concept that lends itself to confusion and, thus, to critique.

First, let’s define what we are talking about. The Golden Rule can be stated in a positive and directive form as, “Do unto others as you would have them do unto you,” or “Treat others as you would like others to treat you.” It can also be stated in a negative or prohibitive form as, “Do not do to others what you would not want them to do to you,” or “Do not treat others in ways that you would not like to be treated.” It is thought to reflect empathy and reciprocity in human interactions.

Both forms are generally accepted to come from almost every religious tradition including humanist/atheist traditions. Some traditions use the positive form as an expression of the concept of beneficence: do good. Other traditions use the negative form expressing the concept of non-maleficence: do no harm. People living within specific traditions or communities have deep explicit and implicit assumptions that particularize their conceptions of doing good and doing no harm. They share many of the same beliefs, values, and customs that undergird their “Golden Rule.”

In our pluralistic society, where there are many traditions and communities with differing beliefs, values, and customs, applying the Golden Rule becomes problematic. My interpretation of the Golden Rule may not be yours. Critiques of the Golden Rule point out that it does not take into consideration differences in preferences, situations, contexts, or relationships. Let’s look at the following case:

A 63-year-old man who is s/p a CVA is your patient. Because he has plateaued in his physical therapy progress, his insurance company decides they will no longer pay for your services. To continue his recovery, he wants to keep coming for therapy, but does not have the financial resources to pay for your services. What do you do?

Either the directive or prohibitive forms of the Golden Rule would require you to continue treating this patient without being paid because you would want to recover as much as possible from a stroke even if you didn’t have the financial resources. The Golden Rule is too abstract to be of use and becomes a cliché. Using the Golden Rule to think about your actions in this case may highlight which features are morally relevant to your decision; however, now an easy rule to remember is not so easy to understand and apply.

Ethics involves the study of and reflection on the collective and individual values, beliefs, traditions, and customs that we live by. At the Montana APTA’s Spring Conference 2020, we will spend time examining, deliberating about, and discussing Current Topics and Issues in PT Ethics. I hope to see you there.

Debra Gorman-Badar, PT, MA, PhD(c)

Chair, Montana APTA Ethics Committee