Belgian Association of Occupational Therapists
Code of ethics & standards of practice

Revised : september 1996

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 and ‘horse-sense’.

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 document :

Prepared in 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 Vylder.

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 this code.

Personal attributes
Occupational therapists have personal integrity, reliability, open mindedness and loyalty with regard to the consumer and the whole professional field.

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 information.

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 international levels.

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 responsible.

1. Responsibility towards the recipient of occupational therapy services


  1. Consumers should be referred to the occupational therapist by a doctor or any other agency, as required by the law or custom of the country.
  2. The occupational therapist should accept referrals considered appropriate and for which they have the therapeutic resources.
  3. Referrals awaiting acceptance should be placed on a waiting list or referred elsewhere. The consumer and referrer should be informed of the action taken.
  4. 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.


  1. 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 involvement.
  2. The occupational therapist should frequently evaluate and review treatments and modify the programme in response to reassessment.


  1. The occupational therapists must maintain professional integrity and discretion throughout the intervention process.
  2. The occupational therapists should ensure that their interventions are consumer centred.
  3. 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 other grounds.
  4. 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

  1. 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.
  2. The occupational therapist should maintain goal-directed and objective relationships with all consumers served.


  1. The occupational therapist should terminate services when the consumer has achieved the goal or when maximum benefit has been derived from occupational therapy services.
  2. The reason for terminating treatment should be explained clearly to the consumer.
  3. The occupational therapist should make arrangements for the follow-up or reassessment of the consumer and document this.

2. Records and Reports

  1. 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.
  2. 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.
  3. 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.
  4. 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.
  5. 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.
  6. 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.
  7. 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.
  8. 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 carefully.
  9. Information Procedures in the occupational therapy service should be in place to ensure that information is accurate and up-to-date.

3. Safety

  1. The occupational therapist should not cause or do anything to endanger the health and safety of the consumer.
  2. It is important that appropriate equipment is used by the occupational therapist in treatment.
  3. The occupational therapist should take all reasonable precautions and must wear appropriate clothing and footwear.
  4. The occupational therapist should be acquainted with and observe provisions in Health and Safety Acts.
  5. Excessive behaviour that causes distress to the consumer should be reported to the appropriate agents.

4. Employers

  1. 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.
  2. The occupational therapist shall comply with guidelines established by the employer in so far as these are compatible with professional ethics.

5. Promotion of the Profession

  1. 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.
  2. 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.
  3. 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

  1. The need and/or responsibilities of colleagues should be respected by the occupational therapist.
  2. The occupational therapist should consult, co-operate and collaborate with professional colleagues regarding professional duties.
  3. The occupational therapist should understand the scope of practice of support staff in the occupational therapy service.
  4. The occupational therapist should be loyal to fellow occupational therapists but, where necessary, report and/or appeal unprofessional behaviour.
  5. 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.
  6. Non-nationals should respect the habits and culture of the host country.

7. Research and Development

  1. The occupational therapist should give credit for published material when used.
  2. The occupational therapist should protect the privacy of the consumer in any written or visual material that might be used outside the therapeutic context.
  3. The occupational therapist should respect the ethical implications involved when doing research.
  4. Researchers should observe the provisions of Health Acts and/or regulations of the employing authority.
  5. Occupational therapists should base their professional practice on established research.
  6. 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

  1. The profession should be accurately represented to the consumer, professional colleagues, students and the public.
  2. The occupational therapist should endeavour to establish and develop the quality of the profession.
  3. 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 occupational therapist.
  4. 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.

9. Commercial

  1. The occupational therapist may advertise in accordance with accepted health care practice.
  2. The occupational therapist in promoting a private service may do so in accordance with health care practice.
  3. The occupational therapist in private practice should establish fees based on cost analyses that are related to the service rendered.
  4. The occupational therapist should use professional judgement when providing and/or recommending commercial products or technical appliances.
  5. 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

  1. Educators of occupational therapists should ensure that the Minimum Education Standards of the World Federation of Occupational Therapists are met.
  2. Educators should ensure that students obtain an acceptable standard of professional competency.
  3. Educational standards should be validated by the National Association.
  4. The Code of Ethics and Standard of Practice should be promoted in the education of occupational therapists.