Transcript Ethics of Occupational Therapy

Ethics of
Occupational Therapy
Alyssa Finn
Pacific Institute for Ethics and
Social Policy
Spring 2009
Overview
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Occupational Therapy Practice
Development of Ethical Standards
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AOTA Code of Ethics
Case Study
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Presentation
Discussion
OT Practice
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Human Occupation
 Activities of Daily Living
 “Directed use of energy, time, attention, & interest”
Broad Scope of Practice
Holistic Approach
 Psychological
 Physical
 Social
Quality of Life via Inclusion
 Education
 Prevention
 Screening
 Independence
Development of Ethical
Standards
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World Federation of Occupational Therapy (WFOT)
American Occupational Therapy Association
(AOTA)
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Licensure
Legal & Ethical Standards
Occupational Therapy Association of Oregon
(OTAO)
AOTA Code of Ethics
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Public Statement of values and principles
AOTA Code of Ethics
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7 Principles
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Beneficence
Nonmaleficence
Autonomy/ confidentiality
Duty
Procedural Justice
Veracity
Fidelity
Current Ethical Issues
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Colleague Interactions
Quality/Standards of Care
Professional vs Personal Relationships
Deception
Scope of Practice
Insurance Coverage
Service Continuation
Autonomy vs Beneficence
Case Presentation
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3rd year OT student
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Local School District
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Low in funding/resources – High Case Loads
Single FT OT
6 year old girl with High Functioning Autism
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Currently in special education programs for OT,
Speech Pathology, and Adapted Physical
Education
Regular classroom setting with teaching aide
Case Presentation
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Satisfactory Academic Progress
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District suggests removal of student from special
programs
OT student recently had discussion with
teaching aide
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Socially, she should stay in special programs
Case Presentation
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IEP Meeting and Assessments
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Qualifies for services
Because of case loads and academic
performance, APE and Speech Pathologist
changed scores
Suggest that district OT do same
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Student reveals conversation with aide
Discounted by other members of IEP Team
OT changes score
Family consents based on info presented
Ethical Questions
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Should the student address the family of the
false documentation?
Is the student’s education jeopardized from
the actions taken?
Were the APE, Speech Pathologist, and OT
justified in their decision?
What institutional changes can be made to
prevent this situation?
Legal Process
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Individuals with Disabilities Educational Act
(2004)
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Special education and related services provided
to students with designated disabilities
“Free Appropriate Education”
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Designed specifically to child’s need
Future employment, education, independence
Should the student address the
family of the false documentation?
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Veracity
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Autonomy
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False documentation
Family not able to make fully informed decision
Fidelity
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Respecting professional opinion of colleagues
Benefits of School Based OT
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Fine Motor Skills
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Linked to academic, social, emotional capability
Need for fine motor assistance only
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Not included within IDEA
Academic Performance
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Sensory Integration
Independent function
High Functioning Autism
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Children with HFA
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Generally on level academic performance
Lacking in social capabilities
Autistic behaviors
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Isolation
Repetitive behavior
Is the student’s education
jeopardized from the actions
taken?
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Yes
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Education more than academic performance
Evaluation Standards
Sensory Integration and Academic
Performance
Were the APE, Speech
Pathologist, and OT justified in
their decision?
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Beneficnce
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Individual student vs Collective case load
Underlying lack in funding
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OT Advocacy
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True ‘Occupational Justice’
Increase in FT OT
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Decreased case load
Improved direct services
What institutional changes can be
made to prevent this situation?
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Brown (2003)
Multi-skilled & Cross Trained Practitioners
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Positives
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Practitioner trained in 2 or more disciplines
Single professional trained with skills of another
Decreased Costs
Decrease in health care providers with single patient
Negatives
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Lacked Specialization
Regulation/ Liability
References
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Barbara, A. & Curtin, M. (2008). Gatekeepers or advocates? Occupational
therapists and equipment funding schemes. Australian Occupational Therapy
Journal, 55, p. 57-60.
Brown, G.T. (2003). Integrated health human resource options: The impact on
occupational therapy professional practice. Scandinavian Journal of
Occupational Therapy, 10, 127-137.
Ericksen, J.B. (2010). Critical reflections on school-based occupational therapy.
Scandinavian Journal of Occupational Therapy, 17, 64-69.
Gal, E., et al. (2009). Enhancing social communication of children with highfunctioning autism through a co-located interface. Al & Soc, 24, 75-84.
Jackman, M., & Stagnitti, K. (2007). Fine motor difficulties: The need for
advocating for the role of occupational therapy in schools. Australian
Occupational Therapy Journal, 54, 168-173.
Schaaf, R.C. & Miller, Lucy, J. (2005). Occupational therapy using a sensory
integrative approach for children with developmental disabilities. Mental
Retardation & Developmental Disabilities Research Reviews, 11(2), p143-148.
AOTA Code of Ethics