Ethics and Community-Based Rehabilitation: Eight Ethical Questions from a Review of the Literature

Abstract

Purpose: This article reviews the literature regarding ethics and community-based rehabilitation (CBR) with the goal of identifying and analyzing ethical considerations associated with this approach. Method: We conducted a critical interpretive review of the academic literature related to CBR in low- and middle-income countries and to indigenous communities in high-income countries. Using an inductive analysis of the collected articles, we identified five key topic areas related to ethical considerations. We then critically appraised this literature and developed eight questions that reflect areas of ethical tension, uncertainty, or debate. Results: The five key topic areas are partnerships among stakeholders, respect for culture and local experience, empowerment, accountability, and fairness in programme design. The eight ethical questions are linked to these topics and associated with how CBR practices reflect commitments to equity, respect, inclusion, participation, and social justice. Conclusion: Continued engagement with ethical considerations associated with CBR can help to strengthen the foundations of this important and influential approach. It is crucial that all those involved in CBR projects, including physiotherapists, pay careful attention to the development of partnerships that, despite asymmetries among stakeholders, are respectful and effective.