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Occupational Therapy Code of Ethics

Standards of Conduct

Core Values

&

Principles

………….. .. ….
The Occupational Therapy Code of Ethics was developed by the American Occupational Therapy Association (AOTA) to document the core values and ethical principles that govern occupational therapy practice in the United States.
This document is maintained by AOTA and updated periodically. The Occupational Therapy Code of Ethics is proprietary information and the full document can be viewed through the AOTA website.

These charts provide the main points and examples from the Code of Ethics for study purposes.

Core Values

The occupational therapy profession is grounded in seven longstanding Core Values: Altruism, Equality, Freedom, Justice, Dignity, Truth, and Prudence. The seven Core Values provide a foundation to guide occupational therapy personnel in their interactions with others. These Core Values should be considered when determining the most ethical course of action.

Value	Description	Example
Altruism (Think about the welfare of others)	Altruism is the unselfish concern for the welfare of others. This concept is reflected in actions and attitudes of commitment, caring, dedication, responsiveness, and understanding. – Demonstrating concern for the welfare of others.	1. An OT asks her patient how the patient is feeling during the OT session. 2. An OTA helps a patient make a card for his wife on her birthday and buys flowers for the patient to give to his wife.
Equality (Treat all patients objectively)	Equality requires that all individuals be perceived as having the same fundamental human rights and opportunities. This value is demonstrated by an attitude of fairness and impartiality. We believe that we should respect all individuals, keeping in mind that they may have values, beliefs, or life styles that are different from our own. Equality is practiced in the broad professional arena, but is particularly important in day-to-day interactions with those individuals receiving occupational therapy services. – Treating all people impartially and free of bias.	1. An OT clinic accepts all patients who have a physician’s referral for OT regardless of race, gender, ethnic background, lifestyle, etc. 2. An OT running a group ,has a personality clash with one of the patients. Despite her personal feelings about this patient, the OT treats him as she would, another patient – with respect.
Freedom (Patients have choices)	Freedom allows the individual to exercise choice and to demonstrate independence, initiative, and self-direction. Purposeful activity plays a major role in developing and exercising self-direction, initiative, interdependence, and relatedness to the world. Activities verify the individual’s ability to adapt, and they establish a satisfying balance between autonomy and societal membership. As professionals, we affirm the freedom of choice for each individual to pursue goals that have personal and social meaning. – Patients are given personal choices based on their values and desires.	1. An OTA agrees to set up a home exercise program for an outpatient who prefers to complete her therapy at home as she has young children. 2. An OTA working with a male patient is told by that patient that he does not want to participate in a cooking activity as it is a “woman’s job!” The OTA gives the patient choices of other activities which could be used instead of cooking, and would achieve the same treatment goals.
Justice (Every person is included)	Justice places value on the upholding of such moral and legal principles as fairness, equity, truthfulness, and objectivity. This means we aspire to provide occupational therapy services for all individuals who are in need of these services and that we will maintain a goal-directed and objective relationship with all those served. Practitioners must be knowledgeable about and have respect for the legal rights of individuals receiving occupational therapy services. In addition, the occupational therapy practitioner must understand and abide by the local, state, and federal laws governing professional practice. – Diverse communities are inclusive, structured, and organized so that all members can function, flourish, and live satisfactory lives.	1. An OT facilitates a multiple sclerosis support group, making sure each member has time to tell his or her story without monopolizing more group time than the other members. 2. An OTA working in a long term care facility is given an expensive gift by a patient. The OTA does not accept the gift as it would unduly influence the therapeutic relationship or have the potential to blur professional boundaries. 3. An OTA notices a disabled homeless man struggling to walk, and establishes that he would benefit from OT intervention. The OTA approaches the man and offers to help him obtain a referral for OT Services at the local clinic, where she works. The clinic offers pro-bono services to those in need.
Dignity (Respect your patients)	Dignity emphasizes the importance of valuing the inherent worth and uniqueness of each person. This value is demonstrated by an attitude of empathy and respect for self and others. We view human beings holistically, respecting the unique interaction of the mind, body, and physical and social environment. We believe that dignity is nurtured and grows from the sense of competence and self-worth that is integrally linked to the person’s ability to perform valued and relevant activities. In occupational therapy we emphasize the importance of dignity by helping the individual build on his or her unique attributes and resources. – Treat all patients with respect at all times.	1. An OTA escorts a woman with Alzheimer’s disease back to her room, patiently answering the same question 5 times and addressing the patient by her name. 2. While working with a patient on bed-wheelchair transfers, the OTA draws the curtain around the patient’s bed / ensures that the patient is fully covered, so that she does not expose herself to other patients in the ward.

Value

Description

Example

Altruism

(Think about the welfare of others)

Altruism is the unselfish concern for the welfare of others. This concept is reflected in actions and attitudes of commitment, caring, dedication, responsiveness, and understanding.

– Demonstrating concern for the welfare of others.

1. An OT asks her patient how the patient is feeling during the OT session.

2. An OTA helps a patient make a card for his wife on her birthday and buys flowers for the patient to give to his wife.

Equality

(Treat all patients objectively)

Equality requires that all individuals be perceived as having the same fundamental human rights and opportunities. This value is demonstrated by an attitude of fairness and impartiality. We believe that we should respect all individuals, keeping in mind that they may have values, beliefs, or life styles that are different from our own. Equality is practiced in the broad professional arena, but is particularly important in day-to-day interactions with those individuals receiving occupational therapy services.

– Treating all people impartially and free of bias.

1. An OT clinic accepts all patients who have a physician’s referral for OT regardless of race, gender, ethnic background, lifestyle, etc.

2. An OT running a group ,has a personality clash with one of the patients. Despite her personal feelings about this patient, the OT treats him as she would, another patient – with respect.

Freedom

(Patients have choices)

Freedom allows the individual to exercise choice and to demonstrate independence, initiative, and self-direction. Purposeful activity plays a major role in developing and exercising self-direction, initiative, interdependence, and relatedness to the world. Activities verify the individual’s ability to adapt, and they establish a satisfying balance between autonomy and societal membership. As professionals, we affirm the freedom of choice for each individual to pursue goals that have personal and social meaning.

– Patients are given personal choices based on their values and desires.

1. An OTA agrees to set up a home exercise program for an outpatient who prefers to complete her therapy at home as she has young children.

2. An OTA working with a male patient is told by that patient that he does not want to participate in a cooking activity as it is a “woman’s job!” The OTA gives the patient choices of other activities which could be used instead of cooking, and would achieve the same treatment goals.

Justice

(Every person is included)

Justice places value on the upholding of such moral and legal principles as fairness, equity, truthfulness, and objectivity. This means we aspire to provide occupational therapy services for all individuals who are in need of these services and that we will maintain a goal-directed and objective relationship with all those served. Practitioners must be knowledgeable about and have respect for the legal rights of individuals receiving occupational therapy services. In addition, the occupational therapy practitioner must understand and abide by the local, state, and federal laws governing professional practice.

– Diverse communities are inclusive, structured, and organized so that all members can function, flourish, and live satisfactory lives.

1. An OT facilitates a multiple sclerosis support group, making sure each member has time to tell his or her story without monopolizing more group time than the other members.

2. An OTA working in a long term care facility is given an expensive gift by a patient. The OTA does not accept the gift as it would unduly influence the therapeutic relationship or have the potential to blur professional boundaries.

3. An OTA notices a disabled homeless man struggling to walk, and establishes that he would benefit from OT intervention. The OTA approaches the man and offers to help him obtain a referral for OT Services at the local clinic, where she works. The clinic offers pro-bono services to those in need.

Dignity

(Respect your patients)

Dignity emphasizes the importance of valuing the inherent worth and uniqueness of each person. This value is demonstrated by an attitude of empathy and respect for self and others. We view human beings holistically, respecting the unique interaction of the mind, body, and physical and social environment. We believe that dignity is nurtured and grows from the sense of competence and self-worth that is integrally linked to the person’s ability to perform valued and relevant activities. In occupational therapy we emphasize the importance of dignity by helping the individual build on his or her unique attributes and resources.

– Treat all patients with respect at all times.

1. An OTA escorts a woman with Alzheimer’s disease back to her room, patiently answering the same question 5 times and addressing the patient by her name.

2. While working with a patient on bed-wheelchair transfers, the OTA draws the curtain around the patient’s bed / ensures that the patient is fully covered, so that she does not expose herself to other patients in the ward.

Truth

(Provide accurate information)

Truth requires that we be faithful to facts and reality. Truthfulness or veracity is demonstrated by being accountable, honest, forthright, accurate, and authentic in our attitudes and actions. There is an obligation to be truthful with ourselves, those who receive services, colleagues, and society. One way that this is exhibited is through maintaining and upgrading professional competence. This happens, in part, through an unfaltering commitment to inquiry and learning, to self-understanding and to the development of an interpersonal competence.

– Provide accurate information in oral, written and electronic forms in all situations.

1. While writing an initial evaluation report, an OT documents that she did not test cognitive skills, rather than writing that cognition appeared normal.

2. When the director of the facility in which an OT is employed is asked if her OT license is valid, for that state, the OT answers honestly even if she has forgotten to renew her license.

Prudence

(Use good judgement)

Prudence is the ability to govern and discipline oneself through the use of reason. To be prudent is to value judiciousness, discretion, vigilance, moderation, care, and circumspection in the management of one’s affairs, to temper extremes, make judgments and respond on the basis of intelligent reflection and rational thought.

– Use clinical and ethical reasoning skills, sound judgement, and reflection to make decisions in professional and volunteer roles.

1. An OTA determines that a patient is not yet ready to complete ADL tasks without supervision after observing the patient retrieving ADL items in an unsafe manner.

2. An OT has achieved her goals with a patient’s intervention. The following day, as the patient is about to be discharged from the hospital, she notices that he is struggling to negotiate stairs. The OT asks the patient to wait for her while she speaks to the physician about her concerns.The patient is at risk for injuring himself, especially when using public transport.

Principles and Standards of Conduct

The Principles guide ethical decision making and inspire occupational therapy personnel to act in accordance with the highest ideals. These Principles are not hierarchically organized

Principle	Description	Examples
1. Beneficence (Benefit your patients)	Occupational therapy practitioners shall demonstrate concern for occupational therapy patients.	-Provide appropriate evaluation and treatment to patients (to benefit patient). Ensure treatment is provided in a timely manner. -Revise treatment goals when necessary. -Use therapeutic treatment approaches that are evidence based and consistent with occupational therapy practice. -Provide treatment that is consistent with the therapist’s education, background and knowledge. -Demonstrate service competency to ensure therapeutic standards are met and gain knowledge of evidence-based approaches through continuing education, review of research, and other methods. -Terminate occupational therapy services when a patient’s goals are met or when insurance coverage is no longer available. -Refer patients to other practitioners when the patient’s symptoms and functional limitations warrants.
2. Nonmaleficence (Do no harm)	Occupational therapy practitioners shall take reasonable precautions to avoid inflicting harm on others or their property. Treatment goals should outweigh any risks.	-Consider the benefit of the treatment technique vs. any discomfort the patient experiences. A patient may complain that passive range of motion is uncomfortable, but the treatment is necessary to prevent contractures. -Never inflict harm to a patient during treatment. -Never abandon a patient during treatment. -Therapists should minimize their own personal problems while providing treatment to not burden patients. -Insure that influences that might compromise a treatment session are eliminated, such as removing another patient who is behaving inappropriately from the therapy clinic. -Set boundaries with patients and avoid personal or sexual relationships. -Never exploit patients for personal gain.
3. Autonomy (Patients have rights)	Occupational therapy practitioners shall treat patients according to their wishes and shall keep patient information confidential.	-Respect patients’ views and wishes for treatment. If a patient prefers to receive treatment in his hospital room, attempt to accommodate that request. -Establish a therapeutic relationship with a patient to promote shared decision making. -Respect a patient’s right to refuse occupational therapy services, even if that decision is not in the patient’s best interests. -Comply with all applicable rights and privacy acts, including the Health Insurance Portability Accountability Act (HIPAA) and the Family Educational Rights and Privacy Act (FERPA). -Protect patients’ privacy and refrain from discussing patients in public areas and/or with people who are not involved in a patient’s treatment. -Address communication barriers with patients, such as language differences, illiteracy or aphasia.
4. Justice (Treat every patient equally)	Occupational therapy practitioners shall provide occupational therapy services in a fair and objective manner. The principle of ‘Social Justice’ was removed and replaced with a more generic term – ‘Justice’, which focuses on the procedural aspects of the Justice construct. http://abctherapeutics.blogspot.com/2015/05/social-justice-in-occupational-therapy.html	-Respond to occupational therapy referrals or requests for referrals in a timely manner. -Assist patients in obtaining access to occupational therapy services by requesting referrals, assisting to solve problems with insurance coverage, helping patients obtain services on sliding fee scales, and similar efforts. -Work to change policies that unfairly limit access to occupational therapy services. -Maintain awareness of current laws and policies related to occupational therapy practice and keep facilities up to date on such laws and policies. -Obtain and renew the proper credentials necessary for a particular area of practice, such as a state license or a department of public instruction certification. -Refrain from accepting gifts that might adversely influence therapeutic relationships with patients. -Report any unethical or illegal activities to the proper authorities according to state and federal laws.
5. Veracity (Represent the profession authentically)	Occupational therapy practitioners shall represent the profession in a thorough, objective and accurate manner.	-Be truthful regarding occupational therapy credentials, education, experience, and competence in specific areas of treatment. -Refrain from using false, misleading, or unfair statements or claims. -Complete documentation of occupational therapy services in an accurate and timely manner. -Report any incidents that may adversely affect occupational therapy treatment, i.e. injuries during or resulting from treatment, to the appropriate people. -Ensure that all advertising of occupational therapy services is truthful and accurate. -Give the proper credit when using the work of others to produce oral, written, or digital information about occupational therapy services. -Be honest and fair when completing employee performance or student evaluations.
6. Fidelity (Respect all professionals)	Occupational therapy practitioners shall treat patients and other healthcare professionals with respect.	-Respect the privacy of other professionals unless required to report unethical or illegal actions. -Never attempt to use a position within an organization to control other employees. -Never misuse employer resources, such as billing an employer for more hours than were actually worked. -Keep communication with colleagues professional and respectful. -Do not harass other employees verbally, physically, sexually, or emotionally. -Represent a facility or organization accurately and follow the facility’s policies and procedures when acting on its behalf. -Avoid behaviors that would lead to the public’s mistrust of the profession. -Encourage collaborative efforts between professionals, including holding case conferences with all disciplines present. -Recognize when differences in personal, cultural, or religious values may interfere with the provision of services.

AOTA 2020 OCCUPATIONAL THERAPY CODE OF ETHICS

Standards of Conduct the public can expect from those in the profession.

The AOTA Ethics Commission, under the Enforcement Procedures for the AOTA Occupational Therapy Code of Ethics (AOTA, 2019), enforces the Standards of Conduct listed in this table:

Section	Standards of Conduct
1. Professional Integrity, Responsibility, and Accountability: Occupational therapy personnel maintain awareness and comply with AOTA policies and Official Documents, current laws and regulations that are relevant to the profession of occupational therapy, and employer policies and procedures.	1A. Comply with current federal and state laws, state scope of practice guidelines, and AOTA policies and Official Documents that apply to the profession of occupational therapy. (Principle: Justice; key words: policy, procedures, rules, law, roles, scope of practice) 1B. Abide by policies, procedures, and protocols when serving or acting on behalf of a professional organization or employer to fully and accurately represent the organization’s official and authorized positions. (Principle: Fidelity; key words: policy, procedures, rules, law, roles, scope of practice) 1C. Inform employers, employees, colleagues, students, and researchers of applicable policies, laws, and Official Documents. (Principle: Justice; key words: policy, procedures, rules, law, roles, scope of practice) 1D. Ensure transparency when participating in a business arrangement as owner, stockholder, partner, or employee. (Principle: Justice; key words: policy, procedures, rules, law, roles, scope of practice) 1E. Respect the practices, competencies, roles, and responsibilities of one’s own and other professions to promote a collaborative environment reflective of interprofessional teams. (Principle: Fidelity; key words: policy, procedures, rules, law, roles, scope of practice, collaboration, service delivery) 1F. Do not engage in illegal actions, whether directly or indirectly harming stakeholders in occupational therapy practice. (Principle: Justice; key words: illegal, unethical practice) 1G. Do not engage in actions that reduce the public’s trust in occupational therapy. (Principle: Fidelity; key words: illegal, unethical practice) 1H. Report potential or known unethical or illegal actions in practice, education, or research to appropriate authorities. (Principle: Justice; key words: illegal, unethical practice) 1I. Report impaired practice to the appropriate authorities. (Principle: Nonmaleficence; key words: illegal, unethical practice) 1J. Do not exploit human, financial, or material resources of employers for personal gain. (Principle: Fidelity; key words: exploitation, employee) 1K. Do not exploit any relationship established as an occupational therapy practitioner, educator, or researcher to further one’s own physical, emotional, financial, political, or business interests. (Principle: Nonmaleficence; key words: exploitation, academic, research) 1L. Do not engage in conflicts of interest or conflicts of commitment in employment, volunteer roles, or research. (Principle: Fidelity; key words: conflict of interest) 1M. Do not use one’s position (e.g., employee, consultant, volunteer) or knowledge gained from that position in such a manner as to give rise to real or perceived conflict of interest among the person, the employer, other AOTA members, or other organizations. (Principle: Fidelity; key words: conflict of interest) 1N. Do not barter for services when there is the potential for exploitation and conflict of interest. (Principle: Nonmaleficence; key words: conflict of interest) 1O. Conduct and disseminate research in accordance with currently accepted ethical guidelines and standards for the protection of research participants, including informed consent and disclosure of potential risks and benefits. (Principle: Beneficence; key words: research)
2. Therapeutic Relationships: Occupational therapy personnel develop therapeutic relationships to promote occupational well-being in all persons, groups, organizations, and society, regardless of age, gender identity, sexual orientation, race, religion, origin, socioeconomic status, degree of ability, or any other status or attributes.	2A. Respect and honor the expressed wishes of recipients of service. (Principle: Autonomy; key words: relationships, clients, service recipients) 2B. Do not inflict harm or injury to recipients of occupational therapy services, students, research participants, or employees. (Principle: Nonmaleficence; key words: relationships, clients, service recipients, students, research, employer, employee) 2C. Do not threaten, manipulate, coerce, or deceive clients to promote compliance with occupational therapy recommendations. (Principle: Autonomy; key words: relationships, clients, service recipients) 2D. Do not engage in sexual activity with a recipient of service, including the client’s family or significant other, while a professional relationship exists. (Principle: Nonmaleficence; key words: relationships, clients, service recipients, sex) 2E. Do not accept gifts that would unduly influence the therapeutic relationship or have the potential to blur professional boundaries, and adhere to employer policies when offered gifts. (Principle: Justice; key words: relationships, gifts, employer) 2F. Establish a collaborative relationship with recipients of service and relevant stakeholders to promote shared decision making. (Principle: Autonomy; key words: relationships, clients, service recipients, collaboration) 2G. Do not abandon the service recipient, and attempt to facilitate appropriate transitions when unable to provide services for any reason. (Principle: Nonmaleficence; key words: relationships, client, service recipients, abandonment) 2H. Adhere to organizational policies when requesting an exemption from service to an individual or group because of self-identified conflict with personal, cultural, or religious values. (Principle: Fidelity; key words: relationships, client, service recipients, conflict, cultural, religious, values) 2I. Do not engage in dual relationships or situations in which an occupational therapy professional or student is unable to maintain clear professional boundaries or objectivity. (Principle: Nonmaleficence; key words: relationships, clients, service recipients, colleagues, professional boundaries, objectivity, social media) 2J. Proactively address workplace conflict that affects or can potentially affect professional relationships and the provision of services. (Principle: Fidelity; key words: relationships, conflict, clients, service recipients, colleagues) 2K. Do not engage in any undue influences that may impair practice or compromise the ability to safely and competently provide occupational therapy services, education, or research. (Principle: Nonmaleficence; key words: relationships, colleagues, impair, safety, competence, client, service recipients, education, research) 2L. Recognize and take appropriate action to remedy occupational therapy personnel’s personal problems and limitations that might cause harm to recipients of service. (Principle: Nonmaleficence; key words: relationships, clients, service recipients, personal, safety) 2M. Do not engage in actions or inactions that jeopardize the safety or well-being of others or team effectiveness. (Principle: Fidelity; key words: relationships, clients, service recipients, colleagues, safety, law, unethical, impaired, competence)
3. Documentation, Reimbursement, and Financial Matters: Occupational therapy personnel maintain complete, accurate, and timely records of all client encounters.	3A. Bill and collect fees justly and legally in a manner that is fair, reasonable, and commensurate with services delivered. (Principle: Justice; key words: billing, fees) 3B. Ensure that documentation for reimbursement purposes is done in accordance with applicable laws, guidelines, and regulations. (Principle: Justice; key words: documentation, reimbursement, law) 3C. Record and report in an accurate and timely manner and in accordance with applicable regulations all information related to professional or academic documentation and activities. (Principle: Veracity; key words: documentation, timely, accurate, law, fraud) 3D. Do not follow arbitrary directives that compromise the rights or well-being of others, including unrealistic productivity expectations, fabrication, falsification, plagiarism of documentation, or inaccurate coding. (Principle: Nonmaleficence; key words: productivity, documentation, coding, fraud)
4. Service Delivery: Occupational therapy personnel strive to deliver quality services that are occupation based, client centered, safe, interactive, culturally sensitive, evidence based, and consistent with occupational therapy’s values and philosophies.	4A. Respond to requests for occupational therapy services (e.g., referrals) in a timely manner as determined by law, regulation, or policy. (Principle: Justice; key words: occupational therapy process, referral, law) 4B. Provide appropriate evaluation and a plan of intervention for recipients of occupational therapy services specific to their needs. (Principle: Beneficence; key words: occupational therapy process, evaluation, intervention) 4C. Use, to the extent possible, evaluation, planning, intervention techniques, assessments, and therapeutic equipment that are evidence based, current, and within the recognized scope of occupational therapy practice. (Principle: Beneficence; key words: occupational therapy process, evaluation, intervention, evidence, scope of practice) 4D. Obtain informed consent (written, verbal, electronic, or implied) after disclosing appropriate information and answering any questions posed by the recipient of service, qualified family member or caregiver, or research participant to ensure voluntary participation. (Principle: Autonomy; key words: occupational therapy process, informed consent) 4E. Fully disclose the benefits, risks, and potential outcomes of any intervention; the occupational therapy personnel who will be providing the intervention; and any reasonable alternatives to the proposed intervention. (Principle: Autonomy; key words: occupational therapy process, intervention, communication, disclose, informed consent) 4G. Respect the client’s right to refuse occupational therapy services temporarily or permanently, even when that refusal has potential to result in poor outcomes. (Principle: Autonomy; key words: occupational therapy process, refusal, intervention, service recipients) 4H. Provide occupational therapy services, including education and training, that are within each practitioner’s level of competence and scope of practice. (Principle: Beneficence; key words: occupational therapy process, services, competence, scope of practice) 4I. Reevaluate and reassess recipients of service in a timely manner to determine whether goals are being achieved and whether intervention plans should be revised. (Principle: Beneficence; key words: occupational therapy process, reevaluation, reassess, intervention) 4J. Terminate occupational therapy services in collaboration with the service recipient or responsible party when the services are no longer beneficial. (Principle: Beneficence; key words: occupational therapy process, termination, collaboration) 4K. Refer to other providers when indicated by the needs of the client. (Principle: Beneficence; key words: occupational therapy process, referral, service recipients) 4L. Provide information and resources to address barriers to access for persons in need of occupational therapy services. (Principle: Justice; key words: beneficence, advocate, access) 4M. Report systems and policies that are discriminatory or unfairly limit or prevent access to occupational therapy. (Principle: Justice; key words: discrimination, unfair, access, social justice) 4N. Provide professional services within the scope of occupational therapy practice during community-wide public health emergencies as directed by federal, state, and local agencies. (Principle: Beneficence; key words: disasters, emergency)
5. Professional Competence, Education, Supervision, and Training: Occupational therapy personnel maintain credentials, degrees, licenses, and other certifications to demonstrate their commitment to develop and maintain competent, evidence-based practice.	5A. Hold requisite credentials for the occupational therapy services one provides in academic, research, physical, or virtual work settings. (Principle: Justice; key words: credentials, competence) 5B. Represent credentials, qualifications, education, experience, training, roles, duties, competence, contributions, and findings accurately in all forms of communication. (Principle: Veracity; key words: credentials, competence) 5C. Take steps (e.g., professional development, research, supervision, training) to ensure proficiency, use careful judgment, and weigh potential for harm when generally recognized standards do not exist in emerging technology or areas of practice. (Principle: Beneficence; key words: credentials, competence) 5D. Maintain competence by ongoing participation in professional development relevant to one’s practice area. (Principle: Beneficence; key words: credentials, competence) 5E. Take action to resolve incompetent, disruptive, unethical, illegal, or impaired practice in self or others. (Principle: Fidelity; key words: competence, law) 5F. Ensure that all duties delegated to other occupational therapy personnel are congruent with their credentials, qualifications, experience, competencies, and scope of practice with respect to service delivery, supervision, fieldwork education, and research. (Principle: Beneficence; key words: supervisor, fieldwork, supervision, student) 5G. Provide appropriate supervision in accordance with AOTA Official Documents and relevant laws, regulations, policies, procedures, standards, and guidelines. (Principle: Justice; key words: supervisor, fieldwork, supervision, student) 5H. Be honest, fair, accurate, respectful, and timely in gathering and reporting fact-based information regarding employee job performance and student performance. (Principle: Veracity; key words: supervisor, supervision, fieldwork, performance) 5I. Do not participate in any action resulting in unauthorized access to educational content or exams, screening and assessment tools, websites, and other copyrighted information, including but not limited to plagiarism, violation of copyright laws, and illegal sharing of resources in any form. (Principle: Justice; key words: plagiarize, student, copyright, cheating) 5J. Provide students with access to accurate information regarding educational requirements and academic policies and procedures relative to the occupational therapy program or educational institution. (Principle: Veracity; key words: education, student)
6. Communication: Whether in written, verbal, electronic, or virtual communication, occupational therapy personnel uphold the highest standards of confidentiality, informed consent, autonomy, accuracy, timeliness, and record management.	6A. Maintain the confidentiality of all verbal, written, electronic, augmentative, and nonverbal communications in compliance with applicable laws, including all aspects of privacy laws and exceptions thereto (e.g., Health Insurance Portability and Accountability Act, Family Educational Rights and Privacy Act). (Principle: Autonomy; key words: law, autonomy, confidentiality, communication, justice) 6B. Maintain privacy and truthfulness in delivery of occupational therapy services, whether in person or virtually. (Principle: Veracity; key words: telecommunication, telehealth, confidentiality, autonomy) 6C. Preserve, respect, and safeguard private information about employees, colleagues, and students unless otherwise mandated or permitted by relevant laws. (Principle: Fidelity; key words: communication, confidentiality, autonomy) 6D. Demonstrate responsible conduct, respect, and discretion when engaging in digital media and social networking, including but not limited to refraining from posting protected health or other identifying information. (Principle: Autonomy; key words: communication, confidentiality, autonomy, social media) 6E. Facilitate comprehension and address barriers to communication (e.g., aphasia; differences in language, literacy, health literacy, or culture) with the recipient of service (or responsible party), student, or research participant. (Principle: Autonomy; key words: communication, barriers) 6F. Do not use or participate in any form of communication that contains false, fraudulent, deceptive, misleading, or unfair statements or claims. (Principle: Veracity; key words: fraud, communication) 6G. Identify and fully disclose to all appropriate persons any errors or adverse events that compromise the safety of service recipients. (Principle: Veracity; key words: truthfulness, communication, safety, clients, service recipients) 6H. Ensure that all marketing and advertising are truthful, accurate, and carefully presented to avoid misleading recipients of service, research participants, or the public. (Principle: Veracity; key words: truthfulness, communication) 6I. Give credit and recognition when using the ideas and work of others in written, oral, or electronic media (i.e., do not plagiarize). (Principle: Veracity; key words: truthfulness, communication, plagiarism, students) 6J. Do not engage in verbal, physical, emotional, or sexual harassment of any individual or group. (Principle: Fidelity; key words: inappropriate communication, harassment, digital media, social media, social networking, professional civility) 6K. Do not engage in communication that is discriminatory, derogatory, biased, intimidating, insensitive, or disrespectful or that unduly discourages others from participating in professional dialogue. (Principle: Fidelity; key words: inappropriate communication, professionalism, professional civility) 6L. Engage in collaborative actions and communication as a member of interprofessional teams to facilitate quality care and safety for clients. (Principle: Fidelity; key words: communication, collaboration, interprofessional, professional civility, service recipients)
7. Professional Civility: Occupational therapy personnel conduct themselves in a civil manner during all discourse. Civility entails honoring one’s personal values, while simultaneously listening to disparate points of view. These values include cultural sensitivity and humility.	7A. Treat all stakeholders professionally and equitably through constructive engagement and dialogue that is inclusive, collaborative, and respectful of diversity of thought. (Principle: Justice; key words: civility, diversity, inclusivity, equitability, respect) 7B. Demonstrate courtesy, civility, value, and respect to persons, groups, organizations, and populations when engaging in personal, professional, or electronic communications, including all forms of social media or networking, especially when that discourse involves disagreement of opinion, disparate points of view, or differing values. (Principle: Fidelity; key words: values, respect, opinion, points of view, social media, civility) 7C. Demonstrate a level of cultural humility, sensitivity, and agility within professional practice that promotes inclusivity and does not result in harmful actions or inactions with persons, groups, organizations, and populations from diverse backgrounds including age, gender identity, sexual orientation, race, religion, origin, socioeconomic status, degree of ability, or any other status or attributes. (Principle: Fidelity; key words: civility, cultural competence, diversity, cultural humility, cultural sensitivity) 7D. Do not engage in actions that are uncivil, intimidating, or bullying or that contribute to violence. (Principle: Fidelity; key words: civility, intimidation, hate, violence, bullying) 7E. Conduct professional and personal communication with colleagues, including electronic communication and social media and networking, in a manner that is free from personal attacks, threats, and attempts to defame character and credibility directed toward an individual, group, organization, or population without basis or through manipulation of information. (Principle: Fidelity; key words: civility, culture, communication, social media, social networking, respect)

Section

Standards of Conduct

1. Professional Integrity, Responsibility, and Accountability:

Occupational therapy personnel maintain awareness and comply with AOTA policies and Official Documents, current laws and regulations that are relevant to the profession of occupational therapy, and employer policies and procedures.

1A. Comply with current federal and state laws, state scope of practice guidelines, and AOTA policies and Official Documents that apply to the profession of occupational therapy. (Principle: Justice; key words: policy, procedures, rules, law, roles, scope of practice)

1B. Abide by policies, procedures, and protocols when serving or acting on behalf of a professional organization or employer to fully and accurately represent the organization’s official and authorized positions. (Principle: Fidelity; key words: policy, procedures, rules, law, roles, scope of practice)

1C. Inform employers, employees, colleagues, students, and researchers of applicable policies, laws, and Official Documents. (Principle: Justice; key words: policy, procedures, rules, law, roles, scope of practice)

1D. Ensure transparency when participating in a business arrangement as owner, stockholder, partner, or employee. (Principle: Justice; key words: policy, procedures, rules, law, roles, scope of practice)

1E. Respect the practices, competencies, roles, and responsibilities of one’s own and other professions to promote a collaborative environment reflective of interprofessional teams. (Principle: Fidelity; key words: policy, procedures, rules, law, roles, scope of practice, collaboration, service delivery)

1F. Do not engage in illegal actions, whether directly or indirectly harming stakeholders in occupational therapy practice. (Principle: Justice; key words: illegal, unethical practice)

1G. Do not engage in actions that reduce the public’s trust in occupational therapy. (Principle: Fidelity; key words: illegal, unethical practice)

1H. Report potential or known unethical or illegal actions in practice, education, or research to appropriate authorities. (Principle: Justice; key words: illegal, unethical practice)

1I. Report impaired practice to the appropriate authorities. (Principle: Nonmaleficence; key words: illegal, unethical practice)

1J. Do not exploit human, financial, or material resources of employers for personal gain. (Principle: Fidelity; key words: exploitation, employee)

1K. Do not exploit any relationship established as an occupational therapy practitioner, educator, or researcher to further one’s own physical, emotional, financial, political, or business interests. (Principle: Nonmaleficence; key words: exploitation, academic, research)

1L. Do not engage in conflicts of interest or conflicts of commitment in employment, volunteer roles, or research. (Principle: Fidelity; key words: conflict of interest)

1M. Do not use one’s position (e.g., employee, consultant, volunteer) or knowledge gained from that position in such a manner as to give rise to real or perceived conflict of interest among the person, the employer, other AOTA members, or other organizations. (Principle: Fidelity; key words: conflict of interest)

1N. Do not barter for services when there is the potential for exploitation and conflict of interest. (Principle: Nonmaleficence; key words: conflict of interest)

1O. Conduct and disseminate research in accordance with currently accepted ethical guidelines and standards for the protection of research participants, including informed consent and disclosure of potential risks and benefits. (Principle: Beneficence; key words: research)

2. Therapeutic Relationships:

Occupational therapy personnel develop therapeutic relationships to promote occupational well-being in all persons, groups, organizations, and society, regardless of age, gender identity, sexual orientation, race, religion, origin, socioeconomic status, degree of ability, or any other status or attributes.

2A. Respect and honor the expressed wishes of recipients of service. (Principle: Autonomy; key words: relationships, clients, service recipients)

2B. Do not inflict harm or injury to recipients of occupational therapy services, students, research participants, or employees. (Principle: Nonmaleficence; key words: relationships, clients, service recipients, students, research, employer, employee)

2C. Do not threaten, manipulate, coerce, or deceive clients to promote compliance with occupational therapy recommendations. (Principle: Autonomy; key words: relationships, clients, service recipients)

2D. Do not engage in sexual activity with a recipient of service, including the client’s family or significant other, while a professional relationship exists. (Principle: Nonmaleficence; key words: relationships, clients, service recipients, sex)

2E. Do not accept gifts that would unduly influence the therapeutic relationship or have the potential to blur professional boundaries, and adhere to employer policies when offered gifts. (Principle: Justice; key words: relationships, gifts, employer)

2F. Establish a collaborative relationship with recipients of service and relevant stakeholders to promote shared decision making. (Principle: Autonomy; key words: relationships, clients, service recipients, collaboration)

2G. Do not abandon the service recipient, and attempt to facilitate appropriate transitions when unable to provide services for any reason. (Principle: Nonmaleficence; key words: relationships, client, service recipients, abandonment)

2H. Adhere to organizational policies when requesting an exemption from service to an individual or group because of self-identified conflict with personal, cultural, or religious values. (Principle: Fidelity; key words: relationships, client, service recipients, conflict, cultural, religious, values)

2I. Do not engage in dual relationships or situations in which an occupational therapy professional or student is unable to maintain clear professional boundaries or objectivity. (Principle: Nonmaleficence; key words: relationships, clients, service recipients, colleagues, professional boundaries, objectivity, social media)

2J. Proactively address workplace conflict that affects or can potentially affect professional relationships and the provision of services. (Principle: Fidelity; key words: relationships, conflict, clients, service recipients, colleagues)

2K. Do not engage in any undue influences that may impair practice or compromise the ability to safely and competently provide occupational therapy services, education, or research. (Principle: Nonmaleficence; key words: relationships, colleagues, impair, safety, competence, client, service recipients, education, research)

2L. Recognize and take appropriate action to remedy occupational therapy personnel’s personal problems and limitations that might cause harm to recipients of service. (Principle: Nonmaleficence; key words: relationships, clients, service recipients, personal, safety)

2M. Do not engage in actions or inactions that jeopardize the safety or well-being of others or team effectiveness. (Principle: Fidelity; key words: relationships, clients, service recipients, colleagues, safety, law, unethical, impaired, competence)

3. Documentation, Reimbursement, and Financial Matters:

Occupational therapy personnel maintain complete, accurate, and timely records of all client encounters.

3A. Bill and collect fees justly and legally in a manner that is fair, reasonable, and commensurate with services delivered. (Principle: Justice; key words: billing, fees)

3B. Ensure that documentation for reimbursement purposes is done in accordance with applicable laws, guidelines, and regulations. (Principle: Justice; key words: documentation, reimbursement, law)

3C. Record and report in an accurate and timely manner and in accordance with applicable regulations all information related to professional or academic documentation and activities. (Principle: Veracity; key words: documentation, timely, accurate, law, fraud)

3D. Do not follow arbitrary directives that compromise the rights or well-being of others, including unrealistic productivity expectations, fabrication, falsification, plagiarism of documentation, or inaccurate coding. (Principle: Nonmaleficence; key words: productivity, documentation, coding, fraud)

4. Service Delivery:

Occupational therapy personnel strive to deliver quality services that are occupation based, client centered, safe, interactive, culturally sensitive, evidence based, and consistent with occupational therapy’s values and philosophies.

4A. Respond to requests for occupational therapy services (e.g., referrals) in a timely manner as determined by law, regulation, or policy. (Principle: Justice; key words: occupational therapy process, referral, law)

4B. Provide appropriate evaluation and a plan of intervention for recipients of occupational therapy services specific to their needs. (Principle: Beneficence; key words: occupational therapy process, evaluation, intervention)

4C. Use, to the extent possible, evaluation, planning, intervention techniques, assessments, and therapeutic equipment that are evidence based, current, and within the recognized scope of occupational therapy practice. (Principle: Beneficence; key words: occupational therapy process, evaluation, intervention, evidence, scope of practice)

4D. Obtain informed consent (written, verbal, electronic, or implied) after disclosing appropriate information and answering any questions posed by the recipient of service, qualified family member or caregiver, or research participant to ensure voluntary participation. (Principle: Autonomy; key words: occupational therapy process, informed consent)

4E. Fully disclose the benefits, risks, and potential outcomes of any intervention; the occupational therapy personnel who will be providing the intervention; and any reasonable alternatives to the proposed intervention. (Principle: Autonomy; key words: occupational therapy process, intervention, communication, disclose, informed consent)

4G. Respect the client’s right to refuse occupational therapy services temporarily or permanently, even when that refusal has potential to result in poor outcomes. (Principle: Autonomy; key words: occupational therapy process, refusal, intervention, service recipients)

4H. Provide occupational therapy services, including education and training, that are within each practitioner’s level of competence and scope of practice. (Principle: Beneficence; key words: occupational therapy process, services, competence, scope of practice)

4I. Reevaluate and reassess recipients of service in a timely manner to determine whether goals are being achieved and whether intervention plans should be revised. (Principle: Beneficence; key words: occupational therapy process, reevaluation, reassess, intervention)

4J. Terminate occupational therapy services in collaboration with the service recipient or responsible party when the services are no longer beneficial. (Principle: Beneficence; key words: occupational therapy process, termination, collaboration)

4K. Refer to other providers when indicated by the needs of the client. (Principle: Beneficence; key words: occupational therapy process, referral, service recipients)

4L. Provide information and resources to address barriers to access for persons in need of occupational therapy services. (Principle: Justice; key words: beneficence, advocate, access)

4M. Report systems and policies that are discriminatory or unfairly limit or prevent access to occupational therapy. (Principle: Justice; key words: discrimination, unfair, access, social justice)

4N. Provide professional services within the scope of occupational therapy practice during community-wide public health emergencies as directed by federal, state, and local agencies. (Principle: Beneficence; key words: disasters, emergency)

5. Professional Competence, Education, Supervision, and Training:

Occupational therapy personnel maintain credentials, degrees, licenses, and other certifications to demonstrate their commitment to develop and maintain competent, evidence-based practice.

5A. Hold requisite credentials for the occupational therapy services one provides in academic, research, physical, or virtual work settings. (Principle: Justice; key words: credentials, competence)

5B. Represent credentials, qualifications, education, experience, training, roles, duties, competence, contributions, and findings accurately in all forms of communication. (Principle: Veracity; key words: credentials, competence)

5C. Take steps (e.g., professional development, research, supervision, training) to ensure proficiency, use careful judgment, and weigh potential for harm when generally recognized standards do not exist in emerging technology or areas of practice. (Principle: Beneficence; key words: credentials, competence)

5D. Maintain competence by ongoing participation in professional development relevant to one’s practice area. (Principle: Beneficence; key words: credentials, competence)

5E. Take action to resolve incompetent, disruptive, unethical, illegal, or impaired practice in self or others. (Principle: Fidelity; key words: competence, law)

5F. Ensure that all duties delegated to other occupational therapy personnel are congruent with their credentials, qualifications, experience, competencies, and scope of practice with respect to service delivery, supervision, fieldwork education, and research. (Principle: Beneficence; key words: supervisor, fieldwork, supervision, student)

5G. Provide appropriate supervision in accordance with AOTA Official Documents and relevant laws, regulations, policies, procedures, standards, and guidelines. (Principle: Justice; key words: supervisor, fieldwork, supervision, student)

5H. Be honest, fair, accurate, respectful, and timely in gathering and reporting fact-based information regarding employee job performance and student performance. (Principle: Veracity; key words: supervisor, supervision, fieldwork, performance)

5I. Do not participate in any action resulting in unauthorized access to educational content or exams, screening and assessment tools, websites, and other copyrighted information, including but not limited to plagiarism, violation of copyright laws, and illegal sharing of resources in any form. (Principle: Justice; key words: plagiarize, student, copyright, cheating)

5J. Provide students with access to accurate information regarding educational requirements and academic policies and procedures relative to the occupational therapy program or educational institution. (Principle: Veracity; key words: education, student)

6. Communication:

Whether in written, verbal, electronic, or virtual communication, occupational therapy personnel uphold the highest standards of confidentiality, informed consent, autonomy, accuracy, timeliness, and record management.

6A. Maintain the confidentiality of all verbal, written, electronic, augmentative, and nonverbal communications in compliance with applicable laws, including all aspects of privacy laws and exceptions thereto (e.g., Health Insurance Portability and Accountability Act, Family Educational Rights and Privacy Act). (Principle: Autonomy; key words: law, autonomy, confidentiality, communication, justice)

6B. Maintain privacy and truthfulness in delivery of occupational therapy services, whether in person or virtually. (Principle: Veracity; key words: telecommunication, telehealth, confidentiality, autonomy)

6C. Preserve, respect, and safeguard private information about employees, colleagues, and students unless otherwise mandated or permitted by relevant laws. (Principle: Fidelity; key words: communication, confidentiality, autonomy)

6D. Demonstrate responsible conduct, respect, and discretion when engaging in digital media and social networking, including but not limited to refraining from posting protected health or other identifying information. (Principle: Autonomy; key words: communication, confidentiality, autonomy, social media)

6E. Facilitate comprehension and address barriers to communication (e.g., aphasia; differences in language, literacy, health literacy, or culture) with the recipient of service (or responsible party), student, or research participant. (Principle: Autonomy; key words: communication, barriers)

6F. Do not use or participate in any form of communication that contains false, fraudulent, deceptive, misleading, or unfair statements or claims. (Principle: Veracity; key words: fraud, communication)

6G. Identify and fully disclose to all appropriate persons any errors or adverse events that compromise the safety of service recipients. (Principle: Veracity; key words: truthfulness, communication, safety, clients, service recipients)

6H. Ensure that all marketing and advertising are truthful, accurate, and carefully presented to avoid misleading recipients of service, research participants, or the public. (Principle: Veracity; key words: truthfulness, communication)

6I. Give credit and recognition when using the ideas and work of others in written, oral, or electronic media (i.e., do not plagiarize). (Principle: Veracity; key words: truthfulness, communication, plagiarism, students)

6J. Do not engage in verbal, physical, emotional, or sexual harassment of any individual or group. (Principle: Fidelity; key words: inappropriate communication, harassment, digital media, social media, social networking, professional civility)

6K. Do not engage in communication that is discriminatory, derogatory, biased, intimidating, insensitive, or disrespectful or that unduly discourages others from participating in professional dialogue. (Principle: Fidelity; key words: inappropriate communication, professionalism, professional civility)

6L. Engage in collaborative actions and communication as a member of interprofessional teams to facilitate quality care and safety for clients. (Principle: Fidelity; key words: communication, collaboration, interprofessional, professional civility, service recipients)

7. Professional Civility:

Occupational therapy personnel conduct themselves in a civil manner during all discourse. Civility entails honoring one’s personal values, while simultaneously listening to disparate points of view. These values include cultural sensitivity and humility.

7A. Treat all stakeholders professionally and equitably through constructive engagement and dialogue that is inclusive, collaborative, and respectful of diversity of thought. (Principle: Justice; key words: civility, diversity, inclusivity, equitability, respect)

7B. Demonstrate courtesy, civility, value, and respect to persons, groups, organizations, and populations when engaging in personal, professional, or electronic communications, including all forms of social media or networking, especially when that discourse involves disagreement of opinion, disparate points of view, or differing values. (Principle: Fidelity; key words: values, respect, opinion, points of view, social media, civility)

7C. Demonstrate a level of cultural humility, sensitivity, and agility within professional practice that promotes inclusivity and does not result in harmful actions or inactions with persons, groups, organizations, and populations from diverse backgrounds including age, gender identity, sexual orientation, race, religion, origin, socioeconomic status, degree of ability, or any other status or attributes. (Principle: Fidelity; key words: civility, cultural competence, diversity, cultural humility, cultural sensitivity)

7D. Do not engage in actions that are uncivil, intimidating, or bullying or that contribute to violence. (Principle: Fidelity; key words: civility, intimidation, hate, violence, bullying)

7E. Conduct professional and personal communication with colleagues, including electronic communication and social media and networking, in a manner that is free from personal attacks, threats, and attempts to defame character and credibility directed toward an individual, group, organization, or population without basis or through manipulation of information. (Principle: Fidelity; key words: civility, culture, communication, social media, social networking, respect)

The American Journal of Occupational Therapy, November/December 2020, Vol. 74, Suppl. 3
http://ajot.aota.org on 08/02/2021

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Occupational Therapy Code of Ethics

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Principles and Standards of Conduct

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THE MOST EFFECTIVE STUDY PREP FOR THE NBCOT® EXAM

Occupational Therapy Code of Ethics

Standards of Conduct

Core Values

&

Principles

Core Values

Principles and Standards of Conduct

Exam Prep

Student Resources

About Us

Follow Us on Social Media

I'm becoming an
OTR®

I'm becoming a
COTA®

I'm a Program
Director

I'm earning my
CEU's