IntroductionFor over 75 years, the physical therapy profession has required its members to adhere to a standard of ethical behavior.1 The first code of ethics adopted by the American Physiotherapy Association in 1935 was focused primarily on the relationship between the physical therapist (PT), the referring physician, and disciplinary action when this relationship is violated.2(p.4) Since then, the code of ethics has evolved into what the American Physical Therapy Association (APTA) calls the Code of Ethics for the Physical Therapist (PT Code) and Standards of Ethical Conduct for the Physical Therapist Assistant (PTA Standards).2(p.5),3,4 Today, the Code and standards are designed around the core set of the association. of values ​​to help define the ethical standards and obligations of the physiotherapist and the physiotherapist assistant (PTA), and to serve as a reference in ethical dilemma situations.3,4 The ethical dilemma is defined as “a conflict of values ​​where every action of value is considered equally good or bad, and acting on one value cancels out the other, so you can't have it both ways. »5 (p. 1333) In the United States, a common cause of ethical dilemma is health care rationing and forced allocation of resources.6 Health care rationing is often seen as the withholding of necessary care or the use of lower quality health care in place of more expensive but superior alternatives. However, health care rationing is best defined as the equitable and conscious disbursement of a limited supply of necessary resources.7 (p. 151) I am of the opinion that to achieve the best outcome in ethical dilemmas involving rationing health care, one must apply needs-based justice distribution reasoning and consider the middle of the document...... K. Understanding health policy: a clinical approach. 5th ed. New York, NY: McGraw-Hill; 20098. Nalette E. Constrained practice of the physiotherapist: an ethical case analysis of the recommendation of placement upon discharge from an acute care establishment. Physical. 2010;90(6):939-952. doi:10.2522/ptj.20050399.9. Swisher LL, Arslanian LE, Davis CM. The kingdom-individual process-situation (RIPS) model of ethical decision making. Published by: APTA Section on Health Policy and Administration. Flight. 5 No. 3. October 2005. Available at: http://www.apta.org/uploadedFiles/APTAorg/Practice_and_Patient_Care/Ethics/Tools/RIPS_DecisionMaking.pdf. Accessed: March 22, 2014.10. Edwards I, Delany CM, Townsend AF, Swisher LL. New perspectives on justice theory: implications for physical therapy ethics and clinical practice. Physical. 2011; 91: 1642-1652. doi:10.2522/ptj.20100351.10