Ethics, Professional Conduct, and Patient Rights
This domain tests the fiduciary and professional obligations that sit alongside clinical competence, including boundaries, conflicts, and patient autonomy.
Ethical foundation
ND OT practice is governed by the Practice Act, Board rules, and the profession’s ethical standards. Core duties include beneficence, nonmaleficence, respect for autonomy, justice, veracity, and fidelity. “Unprofessional conduct” is a broad disciplinary category; it can include boundary violations, exploitation, fraud, practicing while impaired, and failing to report required information.
Conduct and boundaries
The therapeutic relationship is fiduciary. Avoid dual relationships that impair judgment or exploit the patient. Gifts may be accepted only if refusal would harm the relationship and the gift is modest; cash or large gifts should be declined. Social media contact, romantic involvement, and business deals with current patients are high-risk. Conflicts of interest must be disclosed and managed, not hidden.
Patient rights
Patients have rights to dignity, privacy, information, informed choice, refusal, access to their records, and a grievance process. Consent must be voluntary and based on adequate information. Patients may revoke consent. Cultural, language, and decision-making needs must be accommodated.
Worked example
A long-term patient gives an OT a $500 gift card after discharge. The OT should decline or return it. A small thank-you card is different from a substantial gift; the size and timing create an appearance of exploitation. The OT should document the offer and response and consult a supervisor or the Board if unsure.
Traps
Do not discuss patients in public areas or on social media. Do not assume a patient’s consent to treatment covers billing disclosure or research. Do not treat “the patient gave it to me” as a defense to a boundary violation. Do not retaliate against a patient who files a grievance.