Contracting Compliance: A Discussion of the Ethical Implications of Behavioural Contracts in the Rehabilitation Setting

  • Jane Cooper Department of Arts and Sciences, Queen’s University, Kingston, Canada; Bioethics Program, University Health Network, Toronto, Canada; Department of Bioethics, Harvard Medical School, Boston, United States of America
  • Ann Heesters Bioethics Program, University Health Network; Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
  • Andria Bianchi Bioethics Program, University Health Network; Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
  • Kevin Rodrigues Bioethics Program, University Health Network, Toronto, Canada
  • Nathalie Brown Brain Program of Toronto Rehab, University Health Network, Toronto; Department of Education, Western University, London, Canada
Keywords: contracts, patient contracts, behaviours, rehabilitation, ethics

Abstract

The pervasive use of contracts in healthcare is a source of unease for many healthcare ethicists and patient advocates. This commentary examines the use of such contracts with individuals in rehabilitation settings who have complex medical and behavioural issues. The goals of this paper are to examine the many factors that can lead to contract use, to discuss some legal and ethical implications of contract use, and to assess contract use in light of concerns about health equity. The paper concludes with some practical alternatives to the use of such contracts, and refers specifically to tools that might be borrowed from the field of behavioural therapy.

Published
2019-10-23
How to Cite
1.
Cooper J, Heesters A, Bianchi A, Rodrigues K, Brown N. Contracting Compliance: A Discussion of the Ethical Implications of Behavioural Contracts in the Rehabilitation Setting. Can. J. Bioeth. [Internet]. 2019Oct.23 [cited 2020Jun.6];2(2):97-101. Available from: https://cjb-rcb.ca/index.php/cjb-rcb/article/view/173
Section
Critical commentaries