Code of Ethics
Framework
The AOTA Code of Ethics supplies the professional standards the Board may use when evaluating unprofessional conduct. The exam tests the six principles and the standards for professional relationships, documentation, billing, competence, and supervision.
Six principles
- Beneficence: act for the client's good.
- Nonmaleficence: avoid harm.
- Autonomy: respect the client's right to choose and self-determine.
- Justice: treat people fairly and distribute services without bias.
- Veracity: be truthful, including in documentation and billing.
- Fidelity: keep promises, maintain loyalty, and manage conflicts.
Standards in practice
Maintain a therapeutic relationship; avoid sexual or exploitative relationships; protect confidentiality; obtain informed consent; practice only within competence; supervise responsibly; avoid fraud; and address impaired colleagues through proper channels.
Worked example
A payer denies an OT claim, and a supervisor asks the OT to change the treatment note to say the client received 45 minutes of skilled OT instead of the 30 minutes actually provided. Changing the note would violate veracity and justice and could constitute fraud. The OT should refuse, correct any error through a dated addendum that preserves the original, and escalate the billing concern. The ethical obligation is to the accurate record, not to the payer's preference.
Traps
Believing confidentiality is absolute when law requires disclosure; confusing a gift with a bribe without considering intent and policy; and assuming a supervisor's instruction excuses a false note.