Ethical Dilemmas in Occupational Therapy: Elderly Care
This paper examines moral and ethical dilemmas that arise in occupational therapy practice, using the case of an elderly stroke patient (Mrs. DN) as a central case study. Mrs. DN's devotion to her institutionalized husband conflicts with Medicare's homebound requirements, placing her occupational therapist in a difficult position between personal ethics, institutional regulations, and legal obligations. Drawing on ethical theories including utilitarianism, community ethics, and deontology, as well as scholarly perspectives from Nalette, Carroll, and others, the paper evaluates multiple courses of action and their potential outcomes, ultimately arguing that a compassionate compromise is both possible and necessary.
- Introduction: Aging populations create occupational therapy ethical conflicts
- Information Needed for Analysis and Resolution: Literature review of health care ethics and theory
- The Ethical Dilemma: Mrs. DN's Case: Stroke patient's hospital visits violate Medicare requirements
- Course of Action 1: Challenging Institutional Regulations: Revising rules to accommodate patient's unique circumstances
- Course of Action 2: Finding a Compromise Through Free Care: Pro bono or free clinic care as ethical alternative
- Conclusion: Balancing ethics, law, and compassionate care
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What makes this paper effective
- The paper grounds its ethical analysis in a concrete, relatable case study, making abstract theories accessible and practically relevant.
- It systematically considers multiple stakeholder perspectives — the patient, the institution, and the health care worker — before evaluating courses of action.
- By distinguishing between ethical codes and ethical theories, the paper demonstrates conceptual precision and avoids conflating the two.
Key academic technique demonstrated
The paper effectively uses applied ethical analysis, mapping multiple theoretical frameworks (utilitarianism, community ethics, deontology) onto a single real-world scenario. Rather than advocating for one theory, it uses them in combination to weigh competing obligations, which reflects sophisticated moral reasoning common in health professions literature.
Structure breakdown
The paper opens with context on aging populations and occupational therapy before introducing the case study. A literature review section synthesizes relevant scholarly sources on managed care ethics, resource constraints, and ethical theory. The dilemma section presents three stakeholder viewpoints, then evaluates two main courses of action, each with sub-outcomes. This problem–analysis–solution structure makes the argument easy to follow and mirrors professional case-study reporting conventions.
Introduction
It is a generally accepted fact that the aged population across the world is increasing as a result of better general health consciousness and technology to prevent, treat, and cure illnesses that would have caused death just a few years ago. The phenomenon of greater longevity is, however, not without inherent problems of its own. Indeed, it has created an increasing number of challenges, not least in terms of the burden placed upon national health care systems for those in need of care.
In more specific terms, the phenomenon of elderly care in occupational therapy is also not without its problems. Many ethical dilemmas arise where there is a sense of conflict between a carer's personal code of ethics and values, legal codes and requirements, and the institutional code of conduct. This is the case with Mrs. DN, the case study at the center of this discussion.
Although Mrs. DN is clearly in need of health care, her devoted visits to her husband's institution violate the Medicare requirement of being mostly homebound. It is also a fact that these visits place severe strain on her health, to the detriment of her own recovery process. Several alternatives therefore need to be considered before a final decision can be made regarding the continued provision of care to Mrs. DN.
In order to do this, several viewpoints regarding ethical theories will be considered, including utilitarianism, community ethics, and deontology. In order to provide Mrs. DN with the optimal care she needs, it may be not only possible, but also necessary, for the carer to revise her personal set of ethical and moral codes while attempting to bring these in line with institutional values — without abandoning Mrs. DN to her fate.
Ethical dilemmas are inherent in all caring professions. Sometimes legal issues and ethical issues simply cannot find any common ground, in which case a compromise by both sides becomes necessary. The argument remains, however, that it is indeed possible to provide optimal care to clients who need it while also adhering to a set of regulations that are put in place for the benefit of both clients and institutions.
References
Bevir, M. (2002). Sidney Webb: Utilitarianism, positivism, and social democracy. Journal of Modern History, 74. Retrieved from http://escholarship.org/uc/item/7vm01529.pdf
Bevir, M., & O'Brien, D. (2003, January 1). From idealism to communitarianism: The inheritance and legacy of John Macmurray. History of Political Thought, 24. Retrieved from http://escholarship.org/uc/item/95m6q13r.pdf
Carroll, M. J. (2007, December). Physical therapists' perception of risk of violating laws and rules governing the practice of physical therapy and/or their personal moral and ethical values when failing to provide treatment for an uninsured or underinsured patient. Graduate College. Retrieved from
De Sousa e Brito, J. (2008, August 8). From utilitarianism to Kantianism: Bentham's proof of utilitarianism, Mill and Kant. ISUS X, Tenth Conference of the International Society for Utilitarian Studies. Retrieved from http://escholarship.org/uc/item/4zn812s7.pdf
Kerridge, I., Lowe, M., & McPhee, J. (2009). Ethics and law for the health professions.
Nalette, E. (2010, June 1). Constrained physical therapist practice: An ethical case analysis of recommending discharge placement from the acute care setting. Physical Therapy. Retrieved from
Rice, D. P., & Fineman, N. (2004). Economic implications of increased longevity in the United States. Annual Review of Public Health, 25. Retrieved from http://escholarship.org/uc/item/4912f66t.pdf
Smead, R. (2009). Indirect reciprocity and the evolution of "moral signals." Biology & Philosophy, 25. Retrieved from http://escholarship.org/uc/item/1f85b66x.pdf
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