COTBC Conflict of Interest (COI) Practice Standards

Date posted: May 3, 2016

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Statement of Purpose

The COTBC Code of Ethics outlines the obligations and responsibilities that occupational therapists have to their clients, the profession, and the general public. Occupational therapists are committed to providing safe, competent, and ethical care. A conflict of interest, whether perceived, potential, or actual, can jeopardize the occupational therapist’s ability to provide care, and the perception of the occupational therapist’s ability to provide care, in the client’s best interest. As such, the Code of Ethics addresses conflicts of interest in three of its occupational therapy values: Dignity and Worth, Accountability, and Honesty and Transparency.

A conflict of interest is a professional boundary issue, and occurs when the occupational therapist’s interests interfere or are perceived to interfere with the client’s best interests. A conflict of interest is deemed to arise where an occupational therapist has a personal interest in a matter that may be reasonably seen to influence his or her professional conduct in relation to a client. A conflict of interest can be perceived, potential, or actual, and can arise within personal, professional, or business relationships.  A conflict of interest can exist even if the occupational therapist does not benefit directly (e.g., a conflict of interest will still arise if the benefit accrues to a family member or the occupational therapist’s business). A personal interest can include but is not limited to personal, professional, family, political, academic, financial, or other material gain.

Conflicts of interest can compromise the profession’s values. Occupational therapists are in a fiduciary relationship with their clients and, as such, have an ethical and legal responsibility to act solely in their clients’ best interests. Client trust is delicate, and can be irrevocably compromised due to conflict of interest concerns. Confidence and respect for the occupational therapist’s organization can also be damaged, along with the public’s perception of the profession overall.

Given the varied risks that conflicts of interest pose, the College developed practice standards to assist occupational therapists in recognizing, preventing, and managing conflicts of interest. Used in conjunction with COTBC’s Code of Ethics and related practice standards, these standards clarify occupational therapists’ accountabilities and the College’s expectations.

COI Practice Standard #1: Recognizing Conflict of Interest

Principle Statement:
The occupational therapist will recognize proactively any perceived, potential, or actual conflict of interest.

Practice Expectations
The occupational therapist will do the following:

  1. Identify types of conflict of interest.
  2. Identify situations that may lead to conflicts of interest.
  3. Consider the implications that conflicts of interest have for clients and the public’s perception of the profession.
  4. Identify activities that may influence the occupational therapist’s ability to be impartial in a client–therapist relationship.
  5. Recognize if a situation involves any direct or indirect benefit (i.e., personal, professional, political, academic, financial, or material) to the occupational therapist that could affect his or her professional judgment.
  6. Recognize any personal beliefs or opinions which affect the occupational therapist’s ability to meet the client’s needs (e.g., beliefs about race, sexual orientation, or nationality).
  7. Consider whether others could potentially perceive a conflict of interest which could compromise the occupational therapist’s credibility and quality of client care.
  8. Seek proper advice when uncertain if a perceived, potential, or actual conflict of interest exists.
  9. Identify any conflict of interest–related policies and procedures of the occupational therapist’s organization.
  10. Consider feedback from others who may perceive a conflict of interest.

COI Practice Standard #2: Preventing Conflict of Interest

Principle Statement:
The occupational therapist will prevent or avoid any perceived, potential, or actual conflict of interest from occurring.

Practice Expectations
The occupational therapist will do the following:

  1. Avoid participating in activities or arrangements which may potentially compromise professional judgment.
  2. Manage professional boundaries.
  3. Avoid using status as an occupational therapist to receive benefits other than proper payment for professional services.
  4. Avoid preferential or discriminatory treatment towards particular clients or organizations.
  5. Apply any conflict of interest–related policies and procedures of the occupational therapist’s employer or organization.
  6. Maintain a relationship of trust and confidence by not taking advantage of his or her position, including access to privileged information or knowledge received in dealings with clients or organizations.
  7. Provide clients with alternative options for receiving occupational therapy services in circumstances where a perceived or actual conflict of interest exists or a potential conflict of interest may arise.

COI Practice Standard #3: Managing Conflict of Interest

Principle Statement:
The occupational therapist will manage and mitigate an unavoidable conflict of interest.

Practice Expectations
The occupational therapist will do the following:

  1. Seek appropriate assistance as required.
  2. Attempt to resolve a situation involving an actual or perceived conflict of interest or remove him or herself from that situation.
  3. Take action when a conflict of interest cannot be resolved. In these situations, the occupational therapist will do the following:
    a. Disclose to the client and/or stakeholders the perceived, potential, or actual conflict of interest.
    b. Provide the client with information about options available and allow the client to make an informed choice.
    c. Inform the client that he or she has the right to decline service at any time.
    d. Document the steps taken to address the conflict.