Professional Practice, Ethics, Regulation, and Jurisprudence
Domain 5 tests ethical and regulatory judgment: what you may do, what you must do, and how to reason when duties conflict. It is not a memory quiz on slogans.
Core rules
- Core principles include beneficence, nonmaleficence, autonomy, justice, veracity, and fidelity. Apply them to the facts, not in isolation.
- Informed consent requires capacity, adequate disclosure, understanding, voluntariness, and documentation. Respect refusal by a capable client, even when you disagree.
- Keep confidentiality except where law or safety requires disclosure. Share only the minimum necessary information.
- Practice within scope and competence. Obtain supervision or refer when a request exceeds your training; do not delegate unskilled tasks to aides without required oversight.
- Know jurisdiction-specific licensure, mandatory reporting, record retention, billing, and advertising rules. Ethical decision-making frameworks help when obligations collide.
Worked example
A client with a progressive condition refuses a recommended home modification and wants to remain alone. The OT confirms capacity, explains fall risk and alternatives, offers a personal alarm and follow-up, and documents the discussion. The plan respects autonomy while reducing foreseeable harm. The OT does not override the refusal or abandon the client.
Traps
Paternalism disguised as safety; breaching confidentiality in casual conversation; practicing outside scope because a supervisor is unavailable; falsifying or altering records; and accepting a referral that creates a conflict of interest without disclosure.