The AOTA Ethics Commission Creates a Totalitarian Code of Ethics

The AOTA Ethics Commission Creates A Totalitarian Code of Ethics

              This year the AOTA Ethics Commission created a proposed draft of the 2015 Code of Ethics. Through two provisions in this proposed draft, the Ethics Commission is granted the power to (1) require members to advocate for the same political policies promoted by the AOTA leadership and (2) prohibit any online criticism of the leadership.

              First on the issue of prohibiting criticism. Subsection I of the Principle of Fidelity prohibits any “negative comments, which may have the effect of discouraging others from participating, when using electronic media.” This allows anyone who is truthfully and accurately criticized to claim that someone made negative comments about them that discouraged them from future participation.

              Then there is Subsection D of the Justice Principle, which requires therapists to:

               “Advocate for changes to systems and policies that limit or prevent access to occupational therapy services for the client.”

              What people vote for belongs to a personal and private sphere of their lives. Even though some people may be occupational therapists, their political beliefs may not be premised on that fact alone. Viewing people in this limited way is part of the reductionist view of the human being that the Ethics Commission embeds in the Code of Ethics. Another reductionist view is that of advocacy. We rarely get to vote on something that is part of its own discrete piece of legislation. Legislation is routinely packaged with many things. It could be, for example, that people may favor part of a piece of legislation that works to promote access to OT services, but includes provisions favorable to abortion. People who are against abortion will not likely support legislation that they otherwise agree with if it promotes something they find deeply immoral. But making a judgment based on their views on abortion puts them in violation of the Code in this case.

              All of this is made problematic because AOTA routinely takes positions on legislative issues. For example, it opposed Sequestration. This is from the AOTA website in 2013:

         “AOTA has opposed these across the board cuts because their impact on clients and practitioners may be significant and also are unknown”  www.aota.org/.../sequestration.aspx

              But what if you want to advocate for Sequestration because you see it as the only means of getting the government to curb its spending, even if the result is that it limits and prevents occupational therapy services through those budget cuts? You are clearly in violation of a provision in the Code that requires you to advocate in the opposing direction.

              The same is true for supporting the Therapy Cap on Medicare Part B. Patients who receive occupational therapy services through Medicare Part B are limited to roughly $2,000 in services, after which they must request an exception. AOTA opposes these therapy caps. (see: http://www.aota.org/-/media/Corporate/Files/ConferenceDocs/HillDay/Talking%20Points%20for%20Personal%20Use%20with%20Therapy%20Cap%20Fact%20Sheets.pdf). But some individuals support the cap even if it leads to limiting occupational therapy services because it would put the breaks on the overuse of therapy services and because it is believed people should take more responsibility in funding their own care.

              The bottom line is that AOTA pushes a legislative agenda premised on the idea that it is promoting policies that promote access to occupational therapy. Subsection D of the Justice Principle would make advocating against this agenda a Code of Ethics violation.

          We should note that it is acceptable for an occupational therapy organization such as AOTA to support legislation that promotes occupational therapy. But the members of the organization are individual human beings whose own values and beliefs are many, varied, and complex. These individuals may rank their support for policies that promote occupational therapy lower than other values that may be in conflict with some particular policy supported by AOTA. Therefore, it is understandable for AOTA to have a myopic view towards policies regarding occupational therapy, but human beings rarely have such a myopic view of their own moral and political identities. The current proposed draft of the 2015 Code of Ethics not only forbids the expression of such moral and political identities when they conflict with AOTA’s leadership, but requires members to act contrary to their own moral and political identities when AOTA pushes agendas that conflict with them.

          The proposed Draft for the 2015 Code of Ethics  is a totalitarian document that forbids criticism of AOTA leadership and requires members to advocate against their own moral and political beliefs when those beliefs conflict with AOTA's political agenda. Readers interested in sharing their views on the subject may contact the AOTA Ethics Commission here: ethics@aota.org

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