NBCOT Ethics and Professional Practice 4 — Questions and Answers
Question 1: An OT discovers a colleague is billing for services not rendered. What is the MOST appropriate first action?
- Confront the colleague privately and give them a chance to self-report
- Report immediately to the state licensing board without any internal steps
- Ignore it since it does not directly affect client care
- Document the observation and report through the facility's compliance chain (Correct answer)
Correct answer: Document the observation and report through the facility's compliance chain
The AOTA Code of Ethics requires OTs to address unethical conduct, and the appropriate first step is typically internal reporting through proper compliance channels while documenting the concern.
Question 2: Which AOTA ethical principle obligates an OT to keep client information confidential?
- Nonmaleficence
- Justice
- Fidelity (Correct answer)
- Veracity
Correct answer: Fidelity
Fidelity encompasses the duty to be loyal and keep commitments, including protecting confidential information shared within the therapeutic relationship.
Question 3: A client with cognitive impairment wants to discharge home alone against medical advice. How should the OT respond?
- Respect autonomy and discharge immediately per client's wishes
- Override the client's decision because safety is paramount
- Conduct a thorough capacity assessment and involve the care team and family as appropriate (Correct answer)
- Refuse to provide further services until the client agrees with the team's recommendation
Correct answer: Conduct a thorough capacity assessment and involve the care team and family as appropriate
The OT must assess decision-making capacity before overriding autonomy, and should engage the interdisciplinary team and appropriate surrogates when capacity is in question.
Question 4: An OT is asked by an employer to provide telehealth services to clients in a state where the OT is not licensed. What should the OT do?
- Provide services if the employer guarantees liability coverage
- Decline until proper licensure in that state is obtained (Correct answer)
- Provide services since telehealth is federally regulated and state licensure does not apply
- Provide services only if the client gives written consent
Correct answer: Decline until proper licensure in that state is obtained
Occupational therapy practice, including telehealth, is regulated by individual state licensure laws, and practicing without a valid license in the client's state is illegal and unethical.
Question 5: Which scenario BEST illustrates the ethical principle of justice in occupational therapy?
- Providing the same intervention to every client regardless of individual need
- Advocating for equitable access to OT services for underserved populations (Correct answer)
- Treating family members at a discounted rate
- Documenting services accurately to ensure proper reimbursement
Correct answer: Advocating for equitable access to OT services for underserved populations
Justice in the AOTA Code of Ethics includes advocating for fair and equitable access to occupational therapy services, particularly for vulnerable and underserved populations.
Question 6: An OT working in a school setting is approached by a parent who asks for the child's evaluation results. The child is 15 years old. What governs this situation?
- HIPAA exclusively, which gives all rights to the minor
- FERPA, which gives parents access rights to educational records for minor students (Correct answer)
- The AOTA Code of Ethics only, which requires parental consent for all disclosures
- State licensure law, which supersedes all federal regulations in school settings
Correct answer: FERPA, which gives parents access rights to educational records for minor students
In educational settings, FERPA governs student records, and parents generally retain rights to access educational records for students under 18.
Question 7: An OT receives a gift basket from a grateful client's family at the end of treatment. What is the MOST ethically sound response?
- Accept the gift graciously to avoid offending the family
- Accept only if the value is below a threshold set by facility policy
- Decline and explain the professional boundaries around accepting gifts (Correct answer)
- Accept and donate the contents to the therapy department
Correct answer: Decline and explain the professional boundaries around accepting gifts
The AOTA Code of Ethics cautions against accepting gifts that could create a conflict of interest or compromise the therapeutic relationship; declining while explaining professional boundaries is most appropriate.
NBCOT Ethics and Professional Practice 4
An OT discovers a colleague is billing for services not rendered.
What is the MOST appropriate first action?