At the recent Australian occupational therapy education day (2021), there was a call to integrate ethics into the teaching of occupational therapy students. This is a subject that is dear to my heart and over the last few years I have developed an ethical reasoning framework to use with students. It is very well received by occupational therapy students and I believe that ethical reasoning is at least as important as any other framework that we use as occupational therapists.
In general, my ethical framing of context means that I am a pragmatic researcher with a professional commitment to issues of complex disability and care, and the education of occupational therapists. My national role in NZ was recognised in invitations to serve on policy groups for disability and low vision, and to embed ethics in the OT curriculum.
I use empirical data to develop ethical principles that elucidate everyday clinical practice. For example, I have written on third-party influences on practice (Butler,2012) and I have explored the effects of activity, such as dancing for people who have terminal cancer (Butler 2015). This ethical reasoning perspective is also integrated into my writing about the different levels of commitment demonstrated by formal and informal care (Barrett, Butler & Hale, 2016) and the debate about the uses and abuses of the ‘natural care’ concept (Barrett, Hale & Butler, 2014). I have further conceptualised Bourdieu’s notion of social capital to interpret the inequities that influence recovery from injury (Butler & Derrett,2017).
I believe that ethics is underpinned by knowledge in the same way as other anatomy and physiology are underpinning elements for practice. I have been grappling with the development of frameworks for care over the last couple of decades. I still feel that OT (and other health professions) have very little idea of what they are signing up for in terms of ‘care’. We need a practical ethics that is specific to each profession.
As an occupational therapist I have been part of the movement to re-integrate occupation as the primary focus of the profession. This has been a significant part of my teaching and research since the 1990s. My particular perspective on occupation is as an ethical process. I wrote my masters and PhD theses as an expression of this conviction. So, one of the areas where I believe I will be able to make a more significant impact over the coming five years is in ethics. I have been writing about ethics for decades, and it seems that this work has finally begun to ‘come of age’. I struggled in the past to find an audience for my work on ethics, but it seems that there is now an audience within my profession and further afield.