Occupational therapists claim to practise in a client-centred and needs-led manner, yet disabled people can perceive occupational therapists to be accountable not to their clients but to their employers. This opinion piece argues that the profession has failed to address the ethical implications of being gatekeepers to the resources that clients need while professing to be ‘needs-led’; and contends that we must choose either client-centred or therapist-centred practice (in which occupational therapists protect their own interests). Because therapist-centred practice contravenes the existing Code of Ethics and Professional Conduct, either appropriate censure or a rewriting of the Code is required.
Canadian Association of Occupational Therapists (2002) Enabling occupation: an occupational therapy perspective. 2nd ed.Ottawa, ON: CAOT.
4.
Canadian Association of Occupational Therapists and the Health Services Directorate (1983) Guidelines for the client-centred practice of occupational therapy. Ottawa, ON: Health Services Directorate.
5.
College of Occupational Therapists (2001) Code of ethics and professional conduct for occupational therapists. British Journal of Occupational Therapy, 64 (12), 612–17.
6.
College of Occupational Therapists (2005) College of Occupational Therapists: Code of ethics and professional conduct for occupational therapists. British Journal of Occupational Therapy, 68 (11), 527–32.
7.
DavisK (1993) The crafting of good clients. In: SwainJFinkelsteinVFrenchSOliverM, eds. Disabling barriers — enabling environments. London: Sage, 197–200.
FrenchSSwainJ (2001) The relationship between disabled people and health and welfare professionals. In: AlbrechtGLSeelmanKDBuryM, eds. Handbook of disability studies. London: Sage, 734–53.
10.
HammellKW (2003) Changing institutional environments to enable occupation among people with severe physical impairments. In: LettsLRigbyPStewartD, eds. Using environments to enable occupational performance. Thorofare, NJ: Slack, 35–53.
11.
HammellKW (2006) Perspectives on disability and rehabilitation. Contesting assumptions; challenging practice. Edinburgh: Churchill Livingstone.
12.
HasselkusBR (2002) The meaning of everyday occupation. Thorofare, NJ: Slack.
13.
JongbloedLCrichtonA (1990) A new definition of disability: implications for rehabilitation practice and social policy. Canadian Journal of Occupational Therapy, 57 (1), 32–38.
14.
McKnightJ (1981) Professionalised service and disabling help. In: BrechinALiddiardPSwainJ, eds. Handicap in a social world. Sevenoaks: Hodder and Stoughton, 24–33.
15.
RossiterAPrilletenskyIWalsh-BowersR (2000) A postmodern perspective on professional ethics. In: FawcettBFeatherstoneBFookJRossiterA, eds. Practice + research in social work. Postmodern feminist perspectives. London: Routledge, 83–103.
16.
SchrinerK (2001) A disability studies perspective on employment issues and policies for disabled people. In: AlbrechtGLSeelmanKDBuryM, eds. Handbook of disability studies. London: Sage, 642–62.
17.
SwainJFrenchSCameronC (2003) Controversial issues in a disabling society. Buckingham: Open University Press.
18.
TownsendE (1998) Good intentions overruled: a critique of empowerment in the routine organisation of mental health services. Toronto: University of Toronto Press.
