A study of Occupational Therapists’ ethical development as individuals and within communities of practice.
University of Southampton, School of Education,
Occupational Therapists (OTs) who recommend housing adaptations for people with disabilities, funded through public finance, must satisfy professional codes of practice and the employing local authority requirement to allocate finite resources effectively and fairly. At the same time they must also meet service user expectations. Ethical reasoning will be required to balance these demands whilst practising to a personally acceptable professional standard. This study investigates how OTs understand themselves to develop a sense of fairness and how they use their community of practice in developing professional ethical practice. This was a 2 part methodology. Firstly, OTs from 2 community services were invited to participate in small discussion groups. 3 group sessions, of different sizes ranging from 2-6 participants and duration of 2-3 hours, were recorded in which OTs discussed cases which posed ethical challenges with respect to fairness. All participants were female. Secondly, 4 individual interviews with volunteers from the groups were recorded to collect OT narratives of personal ethical development. Transcripts were analysed using a literary-critical approach focussing for transcripts of group sessions on dialogue in community of practice and ethical approaches used; focussing for interview transcripts on the process of ethical development. OTs were shown developing professional practice dialogically within their own community of practice groups. This finding confirms the importance for professional development of encouraging opportunities for dialogical interaction between OTs. Practical reasoning about justice as theorised by Sen (2009) better characterised OT ethical reasoning practices than biomedical-ethical approach applying universal, abstract ethical principles. OT narratives of ethical development fitted the Aristotelian model of growth in virtue as a whole, across both professional and personal aspects of life. Empathy was tentatively categorised as a virtue rather than a technical skill in this context. Empathy contributed to OT clinical reasoning processes as well as ethical reasoning.
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