A diversity of ethical tensions in practice: An examination of competing allegiances

Background: Ethical tensions inevitably arise in occupational therapy in light of the diversity of aims and agendas that are implicitly and explicitly embedded in practice contexts. Such tensions can have significant... [ view full abstract ]

Background: Ethical tensions inevitably arise in occupational therapy in light of the diversity of aims and agendas that are implicitly and explicitly embedded in practice contexts. Such tensions can have significant implications such as causing delays in service or promoting actions that may be useful in the short term or from one perspective but that are less than helpful in the longer term or from a different viewpoint, all of which can decrease the quality and effectiveness of services provided. Ethical challenges can furthermore result in professional burnout and attrition. Despite these potentially serious implications, little work has been done to examine ethical tensions in occupational therapy practice.
Methods: This paper presents findings of an exploratory study that responds to this gap. In this work we employed collective case study methodology (Stake, 2000, 2006), to examine ethical tensions reported by occupational therapists practising in different settings in Southern Ontario, Canada. Seven therapists participated in 60-90 minute semi-structured interviews, designed to elicit their accounts.
Results: Ethical tensions were seen to arise for participants in a manner that highlighted competing allegiances toward clients, employers, colleagues, regulatory colleges, and other individuals in the context.
Conclusion: The analysis offers new ways of interpreting the ethical tensions that occupational therapists encounter.
Application to Practice: The findings open a discussion informing how practice settings can better facilitate practice directed at responding to patient needs while also meeting the variety of demands imposed on occupational therapists.