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The Ethical Mandate of

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Occupational Therapy ... to demonstrate independence, ... OT Ethical Mandate We are entrusted with promoting health and participation through engagement in occupation. – PowerPoint PPT presentation

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Title: The Ethical Mandate of


1
The Ethical Mandate of
  • Occupational Therapy

2
Always do right. This will gratify some people,
and astonish the rest. Mark Twain
3
Never let your sense of morals get in the way of
doing whats right. Isaac Asimov
4
Morality, like art, means drawing a line
someplace. Oscar Wilde
5
Those are my principles, and if you dont like
them well, I have others. Groucho Marx
6
Learning Objectives
  • Explain the ethical mandate for occupational
    therapy services.
  • Discuss the relationship of the occupational
    therapist to society.
  • Describe some of the more prominent approaches to
    addressing ethical issues.
  • Describe ways to raise ones awareness of ethics
    in practice.
  • Identify ethical issues and pose potential
    solutions to case materials.

7
What are Ethics?
  • Concerned with what is right and good
  • Emanate from values
  • Norms or methods for conducting human affairs
  • Held both internally and externally
  • Universal and particular

8
What are Ethics?
  • Manifested in the moral imperative, What ought I
    to do?
  • Ethics ? laws
  • Ethics are complex
  • Ethical dilemmas
  • Taking one action precludes taking another
    ethically mandated action
  • Lack of clear rules or rules need specification
    and balancing
  • Each situation is unique
  • Emotional involvement complicates situations

9
Major Ethical Approaches
  • Utilitarianism seeks greatest good for all
    individuals affected
  • Ends justify means
  • Case-based approach
  • Do the right thing based on what is best for each
    individual affected
  • Deontology based on universal principles and
    rules
  • Morality is grounded on reason
  • Need to act according to moral obligation
  • Do the right thing for the right reason

10
Major Ethical Approaches
  • Rights Theory focuses on rights of individuals
    affected
  • Each individual has basic rights that must be
    protected and upheld
  • My right assumes anothers obligation to do
    something for me
  • Do the right thing out of obligation to the
    individuals rights
  • Communitarianism concerned about the common
    good
  • Good of society, or the common good, trumps
    individual rights
  • Seeks to build the good society
  • Do the right thing out of obligation to society

11
Case Example
  • Should the federal government require all
    employers to include birth control in their
    healthcare coverage for their employees?

12
Utilitarianism
  • What is the greatest good for each party involved
    in this decision?
  • Who are the parties?
  • What is good for each?
  • Individual women exert autonomy get needed
    resources control their own health be treated
    as equals avoid undue financial, emotional, and
    familial stress
  • Employer healthier workforce support values and
    mission sustain business enterprise control
    costs
  • Society fewer unwanted pregnancies seen as
    caring for the needs of citizens keeping people
    healthy

13
Deontology
  • What universal principles need to be implemented
    here?
  • Religious rules about life and the need not to
    infringe on it
  • Governments laws about treating everyone equally
  • Laws about not intruding on the lives of
    individuals and institutions
  • Principle of having to balance our federal and
    state budgets
  • Principle of individual responsibilities

14
Rights Theory
  • Whose rights need to be met and how do we
    prioritize them?
  • Womens rights to equal, relevant healthcare
  • Societys right to less burden for unwanted
    children
  • Institutions right to decide what interferes
    with their values and mission
  • Individuals right to choose

15
Communitarianism
  • What is the common good?
  • Healthy communities
  • Undue burden on some for the sake of others
  • Fiscal solvency
  • Individual rights are subordinate to the good of
    all

16
OT Code of Ethics
  • Purpose
  • Identity and describe the principles supported by
    the occupational therapy profession
  • Educate the general public and members regarding
    established principles to which occupational
    therapy personnel are accountable
  • Socialize occupational therapy personnel new to
    the practice to expected standards of conduct
  • Assist occupational therapy personnel in
    recognition and resolution of ethical dilemmas
  • (AOTA, 2010, p. 2)

17
Core Values of OT Profession
  • Codifies the beliefs and ideals of the group
  • Lays the foundation to guide actions
  • Ideally all members embrace (voted)
  • Reflected in interactions with clients,
    colleagues, society at large
  • Actions and attitudes of members are a reflection
    of the values
  • AOTA, 1993

18
Core Values Attitudes of Occupational Therapy
Practice
  • Altruism - unselfish concern for others
  • Equality - perceiving all individuals as having
    same fundamental human rights and opportunities
  • Freedom allowing the individual to exercise
    choice, to demonstrate independence, initiative,
    and self-direction

19
Core Values Attitudes of Occupational Therapy
Practice
  • Justice - value of upholding moral and legal
    principles, such as fairness, equity,
    truthfulness, and objectivity
  • Dignity - valuing the inherent worth and
    uniqueness of each person
  • Truth - requires that we be faithful to facts and
    reality
  • Prudence - ability to govern and discipline
    oneself through the use of reason

20
OT Ethical Mandate
  • Over-arching goal of occupational therapy
    services - supporting health and participation in
    life through engagement in occupation (OT
    Practice Framework, 2008)
  • View humans as occupational beings
  • Role of OT use occupations to support health
    and participation
  • Unique role in promoting health
  • Goal of services participation
  • Applies to all people occupational justice

21
OT Ethical Mandate
  • Adolph Meyer
  • Described a pattern of life for all humans
    following rhythms of life work, play, rest, and
    sleep
  • Occupational therapy needs to apply the
    principles of establishing and maintaining
    balance by engaging patients in routines of
    occupation.
  • The role of the occupational therapist is to
    provide opportunities rather than prescriptions.

22
OT Ethical Mandate
  • William Rush Dunton
  • We believe that occupation is as necessary to
    life as food and drink. That every human being
    should have both physical and mental occupation.
    That all should have occupations which they
    enjoy That sick minds, sick bodies, sick souls,
    may be healed through occupation.

23
OT Ethical Mandate
  • Mary Reilly
  • My reexamination of our early history revealed
    that our profession emerged from a common belief
    held by a small group of people. This common
    belief is the hypothesis upon which our
    profession was founded. It was, and indeed still
    is, one of the truly great and even magnificent
    hypothesis sic of medicine today. I have dared
    to state this hypothesis That man, through the
    use of his hands as they are energized by mind
    and will, can influence the state of his own
    health.

24
OT Ethical Mandate
  • Elizabeth Yerxa
  • Human beings are meaning creators. One of the
    raw materials of such meaning is action in the
    form of satisfying occupation. Perhaps this was
    the great insight of Adolph Meyer (1922) when he
    proposed that occupational therapists provide
    opportunities (I, we) rather than prescriptions
    (it, they).

25
OT Ethical Mandate
  • Suzanne Peloquin
  • We are pathfinders. We enable occupations that
    heal. We cocreate daily lives. We reach for
    hearts as well as hands. We are artists and
    scientists at once. If we discern this in
    ourselves, if we act on this understanding every
    day, we will advance into the future embracing
    our ethos of engagement.

26
OT Ethical Mandate
  • OT Centennial Vision Statement -
  • By the year 2017 we envision that occupational
    therapy is a
  • powerful,
  • widely recognized,
  • science-driven, and
  • evidence-based profession with a
  • globally connected and diverse workforce
  • meeting societys occupational needs.

27
OT Ethical Mandate
  • We are entrusted with promoting health and
    participation through engagement in occupation.
  • Understand occupation beyond its common-sense
    meanings
  • Define occupation and occupational therapy to our
    stakeholders
  • Promote the role of engagement in occupation in
    health
  • Advocate for everyones right to occupation,
    health, and participation

28
Enacting the Mandate
  • Appreciate our unique role and its
    responsibilities.
  • Embody the ethos of occupational therapy.
  • Recognize our ethical mandate with every client
    practice occupation-based, client-centered care.
  • Care deeply about the welfare of those we serve.
  • Work with our teams.
  • Educate and advocate.
  • Use best available evidence to support practice.
  • Recognize ethical issues.
  • Address ethical issues using available resources.
  • Support and participate in our professional
    organizations.

29
Questions about Ethics
  • How do we decide the merits of the Patient
    Protection and Affordable Care Act?
  • By accepting the current healthcare restrictions
    on OT practice, are we complicit in denying the
    care they need and that will allow them to lead
    fuller, more productive lives?
  • How do we work in environments that restrict our
    scope of practice?
  • Should occupational therapists address societal
    issues such as obesity, teenage pregnancy,
    suicide, mass killings?
  • Should we allow others to not understand OT?

30
Ethics Resources
  • Ethics committees
  • Institutional review boards (IRBs)
  • AOTA
  • NBCOT
  • Ohio OT, PT, AT Licensure Board

31
References
  • American Occupational Therapy Association.
    (2010). Occupational therapy code of ethics and
    ethics standards. American Journal of
    Occupational Therapy, 64, 17-26.
  • American Occupational Therapy Association.
    (2008). Occupational therapy practice framework
    Domain and process, 2nd ed. American Journal of
    Occupational Therapy, 62, 625-683.
  • American Occupational Therapy Association.
    (2007). Centennial Vision and executive summary.
    AJOT, 61, 613-614
  • American Occupational Therapy Association.
    (1993). Core values and attitudes of occupational
    therapy practice. American Journal of
    Occupational Therapy, 47, 10851086.
  • Beauchamp, T.L. Childress, J.F. (2009).
    Principles of bioethics, 6th ed. New York Oxford
    University Press.

32
References
  • Doherty, R.F. (2009). Ethical decision making in
    occupational therapy practice. In Crepeau, E.B.,
    Cohn, E.S., Schell, B.A. Willard and
    Spackmans occupational therapy, 11th ed.
    Philadelphia Lippincott Williams and Wilkins.
  • Dunton, W.R. (1919). Reconstruction therapy.
    Philadelphia Saunders.
  • Meyer, A. (1977). The philosophy of
    occupational therapy. American Journal of
    Occupational Therapy, 51, 639-642.
  • Peloquin, S.M. (2005). Embracing our ethos,
    reclaiming our heart. American Journal of
    Occupational Therapy, 59, 611-625.
  • Reilly, M. (1962). Occupational therapy can be
    one of the great ideas of 20th Century medicine.
    American Journal of Occupational Therapy, 16,
    2-9.
  • Yerxa, E.J. (1967). Infinite distance between
    the I and the It. American Journal of
    Occupational Therapy, 63, 490-497.

33
Model for Ethical Decision-Making
  • Identify the ethical question.
  • Gather the relevant data.
  • Formulate a moral diagnosis.
  • Problem-solve practical alternatives and decide
    on an option for action.
  • Act on the choice and evaluate the results.
  • Doherty, p. 280

34
Enforcement Procedures for the OT Code of Ethics
  • Overview
  • Apply to all occupational therapy personnel
  • Designed to protect the public
  • Established and maintained by the AOTA Commission
    on Standards and Ethics (SEC)

35
Steps for Dealing with a Breach of Ethics
Notify Regulatory Board
Talk to a confidant.
Witness a potential breach of ethics
Confront the offender.
Verify a breach occurred
Handled locally
Notify NBCOT
Go to a supervisor.
Notify AOTA
36
Principles Governing Review of Breach of Ethics
  1. Complaint brought
  2. Evidence gathered and reviewed
  3. Complainant notified
  4. Preliminary decision made on grounds for breach
  5. Formal hearing held includes evidence,
    witnesses, and rebuttal
  6. Decision made
  7. Sanction levied
  8. Appeals made
  9. Final determination
  10. Sanctions publicized
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