Ethics Deserve Deliberation: A Petition for Transparent Governance in Occupational Therapy

In April 2025, the American Occupational Therapy Association Representative Assembly approved substantial revisions to the Occupational Therapy Code of Ethics as part of a bundled consent agenda — without open deliberation.

Ethics are not routine administrative matters. They define the values, boundaries, and identity of a profession.

This petition was submitted to respectfully challenge the process by which the new Code of Ethics was adopted, to call for greater transparency, and to reinforce the importance of meaningful member participation in shaping the standards that govern our work.

Members deserve transparency, deliberation, and stewardship. I encourage all colleagues to remain engaged in the governance of our profession.

Note: For purposes of this public posting, I have redacted personal information such as my address and AOTA member number, as well as removed the names of individual forum contributors cited in the original petition. These edits do not alter the substance of the petition but are made to respect privacy and maintain focus on the core issues raised.

Following AOTA's posted procedures for petition submission, the document was formally submitted to the AOTA Secretary on April 25, 2025 and was received in their office on April 28, 2025.

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Dr. Linda Struckmeyer
Secretary – AOTA Board of Directors
American Occupational Therapy Association
7501 Wisconsin Ave., Suite 510E
Bethesda, MD 20814-6519

Petition to Challenge Association Action
Date: April 25, 2025

Petitioner:
Christopher J. Alterio, DrOT, OTR/L
Member in Good Standing, AOTA
AOTA Member # REDACTED
ADDRESS REDACTED
chris@abctherapeutics.com

1. Specific Action Challenged

The approval of the revised AOTA Occupational Therapy Code of Ethics as part of the Representative Assembly’s consent agenda on April 24, 2025, without open deliberation or discussion of its contents.

2. Date of the Action

April 24, 2025

3. Description of How the Challenged Action Affected the Petitioner’s Rights

The Code of Ethics is a foundational document that governs the professional conduct of all AOTA members and is frequently referenced in regulatory contexts, employer policies, and academic instruction. As an AOTA member, educator, and program director, I am directly subject to the ethical expectations and professional obligations established by this Code.

The process by which the revised Code was adopted—through a bundled vote on the consent agenda with no opportunity for debate, amendment, or separate consideration— compromised my right to meaningful representation as a member and eroded the transparency and deliberative integrity of the Association’s governance.

4. Body That Took the Challenged Action

The Representative Assembly of the American Occupational Therapy Association.

5. Grounds for the Challenge

  • The decision to place substantial revisions to the Code of Ethics on the consent agenda violates the spirit and likely intent of AOTA’s Administrative SOPs, which emphasize transparency, deliberation, and informed member participation.
  • The action may violate the Association Bylaws Article VII (Representative Assembly), which charges the RA with responsibility for professional standards and policies—standards that require open discourse to ensure legitimacy.
  • The process used fails to meet principles of procedural due process, as defined in the Association's SOPs and policies governing professional standards review.
  • The action may contradict Policy A.6 (Open Meetings), which guarantees members access to deliberative processes and agendas, and presumes discussion of consequential items.

 

Clarification Regarding Procedural Claims by AOTA Leadership:
It is anticipated that AOTA leadership may respond to this petition by asserting that the revisions to the Code of Ethics were developed through a task group process and that member feedback was solicited and considered. Even if these steps were completed, they cannot substitute for meaningful, deliberative review by the full Representative Assembly. Task groups are advisory, not representative—they function as subcommittees, tasked with development—not approval—and are not empowered to act on behalf of the Assembly as a whole. They do not reflect the diverse perspectives of the full RA, nor are they empowered to act in its place. Public comment periods—though procedurally permissible—do not fulfill the Assembly’s obligation to publicly deliberate on foundational governance documents. The decision to include the revisions in a consent agenda vote effectively foreclosed that deliberative function, violating both the spirit and procedural intent of AOTA’s own governance policies. 

 

6. Provision of Law, Bylaw, or Document Violated

  • AOTA Bylaws Article VII, Section 1 – Establishes the RA as responsible for the creation and approval of professional standards. Approving sweeping ethical revisions without open discussion compromises this responsibility.
  • Administrative SOP VII(D) – Discourages controversial or significant issues from being bundled into consent agendas unless there is full agreement or clear non-controversy.
  • Policy Manual A.6 (Open Meetings) – Calls for prior notice and open deliberation on important matters; bundling controversial ethics changes short-circuits this expectation.

7. Requested Relief

  1. Rescind the April 24, 2025 adoption of the revised Code of Ethics.
  2. Remove the revisions from the consent agenda retroactively, and require that they be presented in full at the next available RA meeting for open deliberation and separate vote.
  3. Require the Ethics Commission to issue a public statement outlining the rationale for the proposed changes and to receive structured member feedback with opportunities for deliberation before further consideration.
  4. Establish a procedural safeguard requiring that core governance documents (such as the Code of Ethics) be excluded from future consent agendas unless there is documented, unanimous agreement for such inclusion.

8. Supporting Documentation

Attached:

  • Copy of the April 24, 2025 RA Consent Agenda
  • Publicly posted comments expressing concern about the process
  • Reference to AOTA’s own recording and/or transcript of the April 24, 2025 RA meeting, which confirms that no deliberation occurred on the Code of Ethics revisions prior to their inclusion and approval via the consent agenda
  • Statement from a current RA member acknowledging mistaken vote and procedural confusion

9. Illustrative Member Commentary (Non-Endorsing)

  • Lauren Jones, RA Representative (North Carolina) – Publicly posted under the name “Lau Ren” on Facebook, acknowledging a mistaken vote on the consent agenda, citing constituent concerns, and expressing intent to follow up with AOTA leadership. Her statement affirms that transparency and open deliberation were lacking during the decision-making process.
  • REDACTED, AOTA member – Submitted public comments raising procedural concerns, specifically criticizing the lack of transparency, the inaccessibility of the proposed changes, and the inappropriateness of using a consent agenda for foundational ethical revisions.
  • REDACTED, AOTA member – Submitted public comments outlining philosophical and practical objections to the revised Code language, particularly the conceptual shift from equality to equity, and the risk of ethical conflict and ambiguity in application.

    The individuals listed above reflect broader member concerns about the Code of Ethics revisions, both procedural and substantive. Their inclusion is based on publicly posted comments in professional forums and is intended to illustrate recurring themes—not to imply formal endorsement of this petition.

Respectfully submitted,



____________________________________________________
Christopher J. Alterio
April 25, 2025

  •  
  • 1.  Code of Ethics as a CONSENT AGENDA item?
  • 2 Like 

  • Christopher Alterio
  • Posted 2 days ago
  • ReplyOptions Dropdown
  • Proposed changes to the AOTA Code of Ethics are on the consent agenda.
  • What's a "consent agenda"?
  • A consent agenda is a meeting tool used to streamline decision-making by grouping together multiple items expected to pass without discussion-typically routine or non-controversial issues like approving minutes or minor updates.
  • When something is placed on the consent agenda, it's assumed there will be no debate. The entire group of items is approved in a single motion.
  • Here's the catch: any voting member can request to pull an item off the consent agenda for individual discussion. But if no one does, everything passes with a single yes vote-even items with major implications.
  • In this case, placing changes to the Code of Ethics on the consent agenda sends the wrong message. Ethics are not routine. They define how we practice, what we value, and how we hold ourselves accountable. They deserve the time and respect of open deliberation.
  • Regardless of one's position on the proposed changes, ethics are foundational to our professional identity. Bypassing discussion not only silences concerns-it undermines member engagement and weakens trust in the governance process.
  • If we want a profession where members feel empowered to participate, we must model transparency and welcome scrutiny-especially on matters this important.
  • I remain hopeful that someone will request this item be removed from the consent agenda and that a robust, respectful conversation will follow.
  • -Chris

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Christopher Alterio
NY
chris@abctherapeutics.com
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  • 3.  RE: Further Reflection: Philosophical Shifts Behind the Proposed Code of Ethics

 

0 Like 


MEMBER NAME REDACTED

Posted 3 hours ago

ReplyOptions Dropdown

The fact that so many members did not know what a consent agenda is until you raised this concern two days ago, could not locate the proposed changes on the website, and did not understand what would happen when the Code of Ethics changes were added to the consent agenda, suggests to me that those responsible for running the meeting the last night, as well as those voting without comment on including the Code of Ethics changes in the consent agenda, suggests an issue with the new Code of Ethics item 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) NOTE from meeting: Provide transparency through all written
communications and provide relevant disclosures when participating in business arrangements

In my opinion, using the consent agenda in this way, and given the minimal time allotted to submit changes, is a good example of an egregious lack of transparency. 

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AOTA MEMBER INFORMATION REDACTED
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 Original Message

 

8.  RE: Code of Ethics as a CONSENT AGENDA item?

2 Like 


MEMBER NAME REDACTED

Actions Options Dropdown

Posted 20 hours ago

ReplyOptions Dropdown

Thank you. Here is the executive summary that I submitted.  I also asked the RA to remove the proposed changes to the Code of Ethics from the consent agenda. 

Executive Summary

This statement outlines professional concerns regarding the revision in the 2025 Occupational Therapy Code of Ethics, which replaces equality with equity as a core value. While equity is an important ethical aspiration, this language shift introduces ambiguity that may conflict with the practical application of occupational therapy and with the diverse values of practicing clinicians. This document calls for clarification, safeguards, and additional guidance from AOTA to ensure ethical consistency and support for practitioner integrity.

Statement of Concern

1. Conceptual Shift: From Equality to Equity

In the 2015 Code of Ethics, Equality was defined as:

"Occupational therapy personnel shall promote fairness in interactions with others. They shall treat all people impartially and free of bias."
 (AOTA, 2015, Principle 4, Justice; Core Value: Equality)

In contrast, the 2025 Code introduces Equity with broader and more complex implications:

"Equity as a core value… includes ensuring all individuals, regardless of identity, background, or circumstances, are treated equitably and with respect; addressing systemic disparities; providing tailored support… and challenging bias and discrimination."
 (AOTA, 2025, Core Value: Equity)

This represents a significant conceptual departure. Where equality offered a clear and universally applicable ethical directive- fair, unbiased, and impartial treatment-equity introduces obligations that are contextual, subjective, and open to interpretation.

2. Ambiguity and Risk of Ethical Distress

The revised definition lacks precise operational guidance for therapists. Terms such as "tailored support," "systemic disparities," and "challenging bias" may lead to:

●      Interpretive conflict: Therapists may disagree on what counts as an inequity or how to rectify it.


●      Subjective prioritization: Equity may inadvertently favor some needs over others without transparent criteria.


●      Ethical distress: Clinicians who strongly value neutrality or universal fairness may feel professionally compromised by policies or pressures that conflict with their ethical or clinical reasoning.

These concerns align with Principle 1: Beneficence and Principle 3: Autonomy, which affirm the obligation to do good while respecting clients' values and right to self-determination. When equity mandates are perceived to override these principles, therapeutic relationships and ethical practice may be undermined.

3. Risk of Harm to Clients and Practitioners

Without guardrails, equity-driven policies could cause unintentional harm:

●      Clients may feel marginalized if resources are redistributed in ways they perceive as unfair or ideologically driven.


●      Therapists may be asked to prioritize social advocacy roles over their clinical scope, leading to burnout or loss of trust.


●      Institutions may face ethical inconsistencies when translating broad equity goals into applied standards of care.


This contradicts the Code's stated commitment to Dignity, which emphasizes respect for individual uniqueness, and Justice, which requires transparency and impartiality in service delivery.

Recommendations to the Ethics Commission

To uphold the ethical integrity of the profession while embracing inclusive values, I respectfully propose the following:

  1. Clarify the Operational Definition of Equity
     Provide a more structured framework for how equity should be ethically interpreted and applied across diverse clinical settings.


  2. Develop Ethical Decision-Making Tools
     Publish case scenarios and reflective tools to help clinicians navigate tensions between equity, fairness, autonomy, and beneficence.


  3. Support Diverse Practitioner Values
     Acknowledge that therapists bring a range of ethical perspectives, and ensure that equity language does not alienate or silence differing views within the profession.


  4. Facilitate Ongoing Professional Dialogue
     Create spaces for open discussion on the implications of this shift, encouraging feedback from clinicians in varied settings.


Conclusion

Equity is a noble and necessary aim-but its integration into the Code of Ethics must be clear, actionable, and inclusive of the profession's diverse ethical commitments. As it stands, the revised language invites confusion, potential harm, and ethical conflict. By addressing these concerns proactively, AOTA can lead with both compassion and clarity, reinforcing its ethical foundation in a way that unites rather than divides the occupational therapy community.

References

American Occupational Therapy Association. (2015). Occupational therapy code of ethics (2015). American Journal of Occupational Therapy, 69(Suppl. 3), 6913410030p1–6913410030p8. https://doi.org/10.5014/ajot.2015.696S03

American Occupational Therapy Association. (2025). Occupational therapy code of ethics (2025). [Unpublished document or forthcoming publication-update citation when finalized and publicly available].

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AOTA MEMBER INFORMATION REDACTED
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