Lucy faces an ethical dilemma. While the ethical principle of autonomy dictates that Mr. Smith has the right to accept or reject occupational therapy interventions, Lucy is concerned that continuing to miss therapy sessions may result in a poorer overall functional outcome for Mr. Smith in the long term. This would contradict the ethical principle of charity or act clinically, which would have a positive effect on a patient`s well-being. 2L. Identify and take appropriate action to address personal problems and limitations of occupational therapy staff that could cause harm to service recipients. (Principle: Non-maleficence; Keywords: relationships, customers, beneficiaries, staff, security) 2I. Do not get involved in dual relationships or situations where an occupational therapist or student is unable to maintain clear professional boundaries or objectivity. (Principle: Non-maleficence; Keywords: relationships, clients, beneficiaries, colleagues, professional boundaries, objectivity, social media) 5I. Do not participate in any activity that results in unauthorized access to educational content or exams, screening and assessment tools, websites, and other copyrighted information, including, but not limited to, plagiarism, copyright infringement, and illegal sharing of resources in any form. (Principle: Justice; Keywords: plagiarism, students, copyright, fraud) 2B.
Do not harm occupational therapy recipients, students, research participants or staff. (Principle: Non-maleficence; Keywords: relationships, customers, beneficiaries, students, research, employers, employees) The terms law and ethics are different from each other, although some people mistakenly assume they mean the same thing. In the United States, the law refers to any rule that, if broken, „subjects the person or persons violating the rule to criminal sanction or civil liability“ (The Free Dictionary, n.o.a.). Occupational therapists and occupational therapy assistants must practise in accordance with the laws governing their society and their occupational therapy practice. Ethics refers to a system or set of moral principles that govern behaviour, including job performance. Ethics includes beliefs about the „rightness“ and „falsehood“ of actions, as well as the „goodness“ and „wickedness“ of motives and results (The Free Dictionary, n.d.). Occupational therapists and occupational therapy assistants must practise according to the ethical principles of their profession as described in the AOTA Code of Ethics in Occupational Therapy (see below). Using the methodology of the group case study, we examined the ethical tensions reported by seven occupational therapists practising in different settings in southwestern Ontario. While occupational therapy practice laws vary from state to state, they include similar grounds for complaint, such as: The Code is an official AOTA document and a public statement tailored to the most common ethical concerns of the occupational therapy profession. It outlines the standards of conduct that the public can expect from professionals.
It should be applied to all areas of occupational therapy and shared with relevant stakeholders to promote ethical behavior. The Code has two objectives: principles guide ethical decisions and inspire occupational therapists to act according to the highest ideals. These principles are not hierarchically organized. Sometimes conflicts between competing principles must be taken into account in order to make ethical decisions. These principles may need to be carefully weighed and weighed against professional values, individual and cultural beliefs, and organizational policies. Following the principle of non-malice, the 3D standard states that occupational therapy personnel „shall not follow arbitrary instructions that interfere with the rights or welfare of others, including unrealistic expectations of productivity, falsification, falsification, plagiarism of documentation, or inaccurate coding.“ 4I. Reassess and reassess recipients in a timely manner to determine whether objectives are being met and whether case plans should be revised. (Principle: charity; Keywords: occupational therapy process, reassessment, reassessment, intervention) The results of this study reflect the results of previous work on ethical tensions in occupational therapy practice. The first theme reflects the tensions between preserving clients` autonomy and concern for their safety, and the second reflects the tensions between the values of the client and the therapist. Similarly, in an exploratory study examining ethical tensions in occupational therapy practice (2015), Bushby et al. identified challenges related to adherence to various ethical principles, including client autonomy, particularly when this could put the client at risk of harm.
Similarly, two values that Drolet and Maclure (2016) identified as impaired in occupational therapy practice were respect for patient autonomy and respect for patient dignity, which they felt sometimes conflicted with patient safety or the values of therapists, employers or organizations. In addition, these first two subjects are consistent with the results of a study that examined ethical tensions in the private practice of occupational therapy and reported tensions between maintaining client autonomy and pursuing the conduct and protecting the safety of clients or the public (Goulet and Drolet, 2017). The findings related to tensions between loyalties to colleagues, clients, and the regulatory college mirror the findings of other studies, such as issues of interpersonal conflict and practice management, conducted by Bushby et al. have been identified. (2015), the discussions on professional autonomy addressed by Drolet and Maclure (2016), the challenges of competition between obligations to patients and third-party payers or employers described by Goulet and Drolet (2017), and the question of professional life identified by Kassberg and Skar (2008) in their study on ethical tensions in occupational therapy practice in Sweden. Finally, some of the tensions identified between respect for client and therapist values, and between loyalty to therapist values and employer policies, were consistent with the findings of Kinsella et al. (2008) in a study examining the ethical tensions experienced and observed by occupational therapy students, as well as in the work of Kassberg and Skar (2008) and Drolet and Maclure (2016). One excerpt states: „It is unethical to physically force or force a patient to undergo treatment against their will if they are of sound mind and mentally capable of making an informed decision“ and discusses in more detail the denial of patients` rights.
In contemporary practice settings, occupational therapists work to meet the needs of clients, but also aim to achieve employers` goals and work within the limits of their role or context, while fulfilling their obligations to regulatory colleges. Sometimes loyalties to different stakeholders and/or perceived professional commitments may conflict, and therapists may feel compelled to act in ways that compromise values, creating ethical tensions. An important point highlighted in the results is whether the issue is ethical or whether it is simply a difficult situation related to personal conflicts, difficult employment circumstances or complex role requirements. Admittedly, a myriad of circumstances related to the role or job requirements can be challenging; Why, then, should it be important that the challenges be ethical? While unethical struggles can contribute to countless negative circumstances, ethical tensions have been linked to moral stress (Kälvemark et al., 2004; Ulrich & Grady, 2018), which, as noted above, was associated with a low sense of accomplishment, decreases job satisfaction (Ando & Kawano, 2018; Pauly et al., 2012), burnout and fluctuation (Fumis et al., 2017; Penny et al., 2014; Ulrich and Grady, 2018) and professional alienation (Durocher et al., 2016).