The Ethical Issues of School-Based Occupational Therapy Practice in Quebec-Canada

Abstract In Quebec-Canada, school-based occupational therapy has expanded over the last decade. This emerging practice context poses distinctive ethical issues for occupational therapists, but no empirical studies have documented them. Therefore, the purpose of this study was to describe the ethical issues faced by school-based occupational therapists in Quebec. Using a qualitative inductive research design, 19 school-based occupational therapists practicing in Quebec were interviewed individually. All participants reported experiencing ethical issues in their practice. Nine categories emerged from the analyzed data, covering ethical issues in the micro-environment (n?=?4), meso-environment (n?=?3), and macro-environment (n?=?2). In the micro-environment, occupational therapists face ethical issues relating to collaboration with school teams, management of restraints and seclusion, compliance with practice standards, and accessibility of services. In the meso-environment, they experience ethical issues linked to the cultural clash between healthcare and education, the inclusion of students with disabilities in schools, and the lack of understanding and recognition of occupational therapy. In the macro-environment, they encounter ethical issues arising from the lack of resources, and the lack of intersectoral collaboration between healthcare and education systems. Describing the ethical issues of occupational therapy school-based practice is a first step toward identifying ways of preventing and resolving them.