A European Standard of Practice
Ethics is as old as civilisation itself. The popular meaning of
ethics is that it is a code of behaviour considered correct, especially
to a particular group, profession or individual.
Ethics are mainly concerned with how people ought to act. Many
ethical principles are based on a combination of sensitivity, courtesy
The WFOT Code of Ethics is designed to offer broad guidelines
for the practice of occupational therapy. The COTEC Standard of Practice
is intended to refine ethics to more specific and detailed principles.
The Standard of Practice and the Code of Ethics for our profession are
therefore very closely linked.
Both the Code of Ethics and the Standard of Practice are the
established methods or sets of rules dealing with behaving etc.,
a particular situation (Chambers 20th Century Dictionary 1983). The
purposes of these are to provide a public statement of the principles
established for occupational therapists and students by the professional
body. They provide a specific set of guidelines for practice which help
occupational therapists make ethical decisions, having regard to the
rights of the client. The guidelines alone cannot be taken as absolute,
- they demand from occupational therapists a combination of ethical
standards, moral values and professional conduct.
The Standard of Practice developed by COTEC is a voluntary code
designed to assist the National Associations to establish and develop
national codes in line with European standards of practice for
occupational therapists. It is intended for general application but may
be modified for specialist areas of practice e.g. paediatrics, community
care, psychiatry etc. Should any such group wish to do this, each issue
dealth with in the Standard of Practice, should be given informed and
prudent consideration because they have been included for their
relevance to one or other activities of our professional practice. It is
imperative that issues included in any Standard of Practice must be
current and relevant to the members of the profession who are using it
or for whose use it is intended.
The COTEC Standard of Practice is a policy statement which helps to
set and maintain good standards of professional practice. In instances
where decisions must be made regarding the unprofessional behaviour of
an occupational therapist , the Code may be used as a guide to the
appropriate standards of professional conduct.
We are all now familiar with the Higher Directive on a General System
for the recognition of higher education diplomas (89/48/EEC). Article
6.1 of this Directive states that the competent authority of a host
Member State requires a person taking up a regulated profession to
"prohibit the persuit of that profession in the event of a serious
professional misconduct". This gives our professional group a very
good reason to set standards for our professional practice.
Representatives to COTEC are asked to ensure that, when the code is
being translated into other European languages, it is done so by a
native speaker. This is advisable as it has phrases and terms that are
sometimes difficult to translate. There are two main sections in this
conjunction with representatives of National Associations by
the Code of Ethics and Standard of Practice Document Committee :
Maria McGuinn (Chairperson & Secretary), Judith Marti, Dirk de
Code of Ethics :
The Code of Ethics of the World Federation of Occupational Therapists
describes the appropriate conduct of occupational therapists practising
in all fields of occupational therapy. As all National Associations of
Occupational Therapy in Europe are members or Associate members of WFOT
it is deemed fitting that COTEC should base its Standards of Practice on
Occupational therapists have personal integrity, reliability,
open mindedness and loyalty with regard to the consumer and the whole
Responsibility towards the recipient of
Occupational Therapy Services
Occupational therapists approach all consumers with respect and
having regard for their individual situations. Occupational therapists
shall not discriminate against consumers on the basis of race, colour,
handicap, disability, national origin, age, gender, sexual preference,
religion, political beliefs or status in society. The consumer’s
personal preferences and ability to participate will be taken into
account in the planning of service provision. Confidentiality of
consumer’s personal information is guaranteed and any personal details
are passed on only with their consent.
Conduct within the Occupational Therapy team
and within the multidisciplinary team
Occupational therapists co-operate and accept responsibility within
a team by supporting the medical and the psychosocial goals that have
been set. Occupational therapists provide reports on the progress of
their intervention and provide other members of the team with relevant
Developing professional knowledge
Occupational therapists participate in professional development
through life-long learning and subsequent apply their acquired knowledge
and skills in their professional work.
Promotion of the profession
Occupational therapists are committed to the improvement and
development of the profession in general. They are also concerned with
promoting occupational therapy to the public, other professional
organisations and governing bodies at regional, national and
World Federation of
Occupational Therapists: Professional Practice Committee; March 1990.
Standards of Practice :
Consumer : For the purpose of the COTEC Standards of
Practice the term consumer is used to describe patients, clients and/or
carers. It also includes those for whom the occupational therapist is
1. Responsibility towards the recipient of occupational therapy
- Consumers should be referred to the occupational therapist by a
doctor or any other agency, as required by the law or custom of the
- The occupational therapist should accept referrals considered
appropriate and for which they have the therapeutic resources.
- Referrals awaiting acceptance should be placed on a waiting list
or referred elsewhere. The consumer and referrer should be informed of
the action taken.
- The occupational therapist must give consideration to the need to
refer the consumer elsewhere. The occupational therapist should,
inform the consumer of appropriate services or facilities.
- The occupational therapist should be responsible for assessing
the consumer who has been accepted for treatment. Each episode of
treatment must be planned, carried out and completed with the consumer's
- The occupational therapist should frequently evaluate and review
treatments and modify the programme in response to reassessment.
- The occupational therapists must maintain professional integrity
and discretion throughout the intervention process.
- The occupational therapists should ensure that their
interventions are consumer centred.
- The occupational therapist must ensure that discrimination
against the consumer does not occur on the basis of race, colour,
handicap, disability, nationality origin, age, gender, sexual
preference, religion, political belief’s or status in society or any
- The occupational therapist must, with the informed consent of
the consumer, strive to establish realistic goals for intervention based
on a therapeutic co-operation. The consumer should be informed of the
nature and potential outcome of treatment.
A Quality Programme
- When developing an effective quality assurance programme the
occupational therapist should consider the five components of quality
assurance, namely- professional behaviour, effectiveness, resource use,
risk management, consumer satisfaction with the services provided.
- The occupational therapist should maintain goal-directed and
objective relationships with all consumers served.
- The occupational therapist should terminate services when the
consumer has achieved the goal or when maximum benefit has been derived
from occupational therapy services.
- The reason for terminating treatment should be explained
clearly to the consumer.
- The occupational therapist should make arrangements for the
follow-up or reassessment of the consumer and document this.
2. Records and Reports
- In regard to reporting and recording information related to the
consumer and access to the consumers' records, the provisions of
Health and other Acts and/or the guidelines of the employing authority
should be observed.
- The Data Protection Act imposes certain obligations on the
occupational therapist when keeping personal information on computer
regarding the client and confers rights to persons on whom such
information is kept.
- At all times occupational therapists should protect and respect
confidential material and ensure that it is only disclosed where
appropriate for the benefit of the consumer.
- The consent of the consumer should normally be sought
before - information concerning them is disclosed outside the
therapeutic context and in the case of legal compulsion.
- Reports and records should be securely stored according to the
laws of the country. They should provide factual data, record
information related to professional activity and be without emotional
bias. They should provide information for professional colleagues and
for legal purposes.
- Records should be kept to facilitate review and analysis of
procedures and to measure the effectiveness of treatment. The
occupational therapist should document the consumers' abilities and
treatment outcome. Reports should be made.
- The occupational therapy service should prepare a statement of
purpose for which computer information on the consumer is kept.
Information should only be used as outlined in the statement of purpose.
- In the occupational therapy service all computer held
information should be kept safe. Only authorised staff should have
access to it and all waste paper and printouts should be disposed of
- Information Procedures in the occupational therapy service
should be in place to ensure that information is accurate and
- The occupational therapist should not cause or do anything to
endanger the health and safety of the consumer.
- It is important that appropriate equipment is used by the
occupational therapist in treatment.
- The occupational therapist should take all reasonable
precautions and must wear appropriate clothing and footwear.
- The occupational therapist should be acquainted with and observe
provisions in Health and Safety Acts.
- Excessive behaviour that causes distress to the consumer should
be reported to the appropriate agents.
- Where employers have different standards of conduct than those
in this code the occupational therapist must be clear on these and their
implications. However it is preferable that all places of employment
recognise the Code.
- The occupational therapist shall comply with guidelines
established by the employer in so far as these are compatible with
5. Promotion of the Profession
- Occupational therapists should offer and/or provide a service
only within their competence. Occupational therapists should recognise
skills, knowledge and expertise needed for a competent service.
- Occupational therapists should assume personal responsibility
for their competency. In situations where additional knowledge and
expertise are required, they should:- refer the consumer to another
therapist and consult with colleagues.
- The occupational therapist should keep up to date with knowledge
relating to legislation, politics, social and cultural matters which
effect the profession.
6. Professional Relationships
- The need and/or responsibilities of colleagues should be
respected by the occupational therapist.
- The occupational therapist should consult, co-operate and
collaborate with professional colleagues regarding professional duties.
- The occupational therapist should understand the scope of
practice of support staff in the occupational therapy service.
- The occupational therapist should be loyal to fellow
occupational therapists but, where necessary, report and/or appeal
- In cases of a breach of the Code of Ethics a confidential report
should be made to the Professional Body or appropriate person in
the service management.
- Non-nationals should respect the habits and culture of the host
7. Research and Development
- The occupational therapist should give credit for published
material when used.
- The occupational therapist should protect the privacy of the
consumer in any written or visual material that might be used outside
the therapeutic context.
- The occupational therapist should respect the ethical
implications involved when doing research.
- Researchers should observe the provisions of Health Acts and/or
regulations of the employing authority.
- Occupational therapists should base their professional practice
on established research.
- The occupational therapist has the duty to update and review
professional knowledge regularly and be aware of current
legal issues affecting their practice.
8. Representing the Profession
- The profession should be accurately represented to the consumer,
professional colleagues, students and the public.
- The occupational therapist should endeavour to establish and
develop the quality of the profession.
- The occupational therapist should be committed to the education
of society, the consumer, as well as to the education of health
personnel on matters of health that are within the scope of the
- The occupational therapist should avoid excessive behaviour that
adversely affects performance as an occupational therapist or reflects
on the profession. This might include substance abuse or any criminal or
unlawful activity in the course of the practice of the profession.
- The occupational therapist may advertise in accordance with
accepted health care practice.
- The occupational therapist in promoting a private service may do
so in accordance with health care practice.
- The occupational therapist in private practice should establish
fees based on cost analyses that are related to the service rendered.
- The occupational therapist should use professional judgement
when providing and/or recommending commercial products or technical
- The occupational therapist must not request or accept commission
from any commercial firm as a reward/payment for recommending the
products of that firm to consumers.
10. Occupational Therapy Education
- Educators of occupational therapists should ensure that the
Minimum Education Standards of the World Federation of Occupational
Therapists are met.
- Educators should ensure that students obtain an acceptable
standard of professional competency.
- Educational standards should be validated by the National
- The Code of Ethics and Standard of Practice should be
promoted in the education of occupational therapists.