ABC Therapeutics Occupational Therapy Weblog

During today’s AOTA Representative Assembly meeting, the vote to approve the consent agenda passed 55–0 . Included in that consent agenda was a substantial revision to our Code of Ethics —and not one representative moved to pull it for open discussion . Yes, the revisions were reviewed in a task group. Yes, there was a comment period. But those procedural steps, while technically fulfilled, do not substitute for meaningful public deliberation —especially on something so foundational. The Code of Ethics is not just a policy; it reflects the core of our professional identity . When we alter that framework—particularly in ways that introduce a distinct set of social or philosophical assumptions—we should do so through visible, intentional, and inclusive ethical dialogue . That did not happen here. Members reached out. Emails were sent. Concerns were raised. But nothing was pulled. No one spoke. In the lead-up to the vote, I publicly stated the following: “I invite those who helped shape...

Being in program development mode has given me both the time and headspace to think more deeply about some of the broader dynamics shaping our profession. The release of AOTA’s newly published Vision Statement and the proposed changes to the Code of Ethics have provided a catalyst for deeper reflection. Ethics in occupational therapy can feel distant or overly academic—something shaped by committees and frameworks rather than day-to-day practice. I’m someone who has worn both hats—a street-level OT who’s spent too much time in academia—and that gives me a particular vantage point for reflecting on where we’ve been and where we might be headed. I’m writing this for the lunch-bucket practitioners out there—the ones grounded in clinical realities—who have sensed that something in our professional dialogue feels increasingly unfamiliar or prescribed. But I think we need to bring these conversations down to earth. We need to pull chairs into a circle, metaphorically speaking, and talk thr...

Philosophical thinking has always had value in occupational therapy. It helps us understand the deeper meanings of occupation, the ethics of care, and the cultural assumptions that shape our practice. But philosophy becomes a problem when it detaches from the reality of patient care. Take one example: I once worked with a patient who was Native American and had diabetes complicated by years of substance abuse. He was blind and had bilateral above-knee amputations. His family had limited resources and limited support. They were doing the best they could. And so was I. My plan of care was entirely rooted in his problems—because that's what brought occupational therapy into the picture in the first place. Clinicians don’t have the luxury of deconstructing outcome measures when they’re in a cramped living space, trying to help someone who can’t get into a shower. Rather, they are working with families who are struggling to care for their loved ones under impossible conditions. Tha...

In my previous post, I raised concerns about the increasing use of politicized language in the AOTA Code of Ethics. I argued that terms like equity and justice—however well-intentioned—have taken on broad, contested meanings, and that their uncritical adoption into our profession’s foundational documents risks substituting moral clarity for ideological fashion. In further research, I’ve come across something worth examining in more detail: how the state of Maine handled two different versions of AOTA’s Code of Ethics—first in 2010, and then again in 2023. The difference between these two adoption events reveals a great deal about how professional ethics are evolving—not necessarily for the better. Maine in 2010: Ethical Caution In 2010, the Maine Board of Occupational Therapy adopted AOTA’s then-current Code of Ethics with exclusions. Specifically, they removed Principle 4: Social Justice, signaling that parts of the document were seen as extending beyond enforceable professional condu...

In light of the proposed 2025 revisions to the AOTA Code of Ethics, I feel compelled to respond—not just as a practitioner and educator, but as someone who has been observing and writing about the profession’s ethical evolution for over a decade. This post reflects on concerns raised in the new draft and situates them in a broader historical context drawn from earlier critiques I published in 2011, 2013, 2014, and 2015. When Ethics Become Ideology The proposed 2025 Code of Ethics contains well-meaning language that reflects cultural currents around equity, inclusion, and advocacy. However, the revised document appears to shift the Code away from its core purpose—guiding ethical behavior—and toward promoting a specific ideological framework. It contains language and assumptions that may unintentionally alienate practitioners, obscure clarity in enforcement, and conflate professional conduct with political conformity. A Critical Logic Problem The most serious concern is the...