Ethical Issues in Private Occupational Therapy Practice: Perceptions of Occupational Therapists

Abstract

In Quebec, 31% of occupational therapists work in the private sector, which is constantly growing. To date, no studies have specifically documented the ethical issues involved in this practice. The objective of this study was to explore these issues, that is, situations that could compromise the respect of an ethical value. Using a phenomenology-inspired research protocol, seven occupational therapists were interviewed in semi-directed individual interviews. Based on the conceptual framework of Swisher and colleagues, the interview questionnaire permitted the identification of different types of ethical issues. The results show that several values are likely to be compromised: patient well-being, patient autonomy, public safety, distributive justice, quality of interventions, competent practice, professional independence, honesty and professionalism. Although occupational therapists are concerned about the well-being of patients, there are a number of factors that appear to contribute to compromised values, including dual-loyalty situations experienced by occupational therapists, third-party interference in the clinical process, and the funding of clinics. Moreover, the ethical issues of private practice occupational therapy are mainly macroscopic. The ability of occupational therapists to perceive some of these issues seems to be related to some of their characteristics, that is, their ethical sensitivity and the fact that they are novices. The results of this study are generally in line with those documented in the physiotherapy literature and demonstrate the lack of support available to occupational therapists, notably novices, to help effectively overcome these issues.