Posts

Don’t Just "Monitor" the Budget Bill — OTs Must Act Locally and Now

Image
The House-passed Budget Reconciliation Bill—nicknamed the "One Big Beautiful Bill" by its sponsors—has generated swift opposition from AOTA. The association’s article focuses on the very real concern that shifting Medicaid funding to block grants or per-capita caps could jeopardize occupational therapy (OT) services for vulnerable populations. That is correct analysis. But the AOTA messaging on this issue lacks depth and strategy. A pre-written form letter to Congress isn’t a serious response to a structural overhaul of one of OT’s largest funding streams. It’s time for clinicians and educators to stop outsourcing our critical thinking and advocacy. Here’s a deeper, more balanced look at what’s in this bill—and what OTs   need to be doing. The Real Structural Threat: Medicaid Block Grants Let’s start with the most important thing the bill proposes: a fundamental shift in Medicaid funding . Instead of Medicaid functioning as an open-ended federal match for state spending, ...
Post a Comment
Read more

The Emperor's New Ethics

Image
I just attended a professional development session on ethics, led by a prominent figure involved in ethics discussions within occupational therapy. The session was structured around a "socially responsive ethical decision-making model" that integrated themes of diversity, identity, power, and historical trauma. It was thoughtfully delivered, and the presenter was receptive and open to engagement. Yet by the end, I was left with a gnawing discomfort about the philosophical architecture beneath the model. It is not that I oppose reflection or the thoughtful inclusion of cultural context. Most clinicians I know already approach their work with thoughtfulness and recognize that each patient brings a unique context worthy of consideration. But what I encountered during this session was not a pluralistic ethics framework. It was a carefully constructed worldview that strongly nudges moral reasoning toward alignment with current sociopolitical trends—while still presenting itself as...
Post a Comment
Read more

From Socks to Social Justice: Questioning Occupational Therapy’s Shift Toward Universalism

Image
Every profession needs a vision. Vision statements chart the future, express values, and signal where a field aspires to go. Occupational therapy has long embraced this idea. Yet visionary language, when untethered from the realities of practice, can obscure more than it clarifies. This tension is increasingly visible in the language of AOTA’s Vision 2030. Vision 2030 declares that occupational therapy "maximizes health, well-being, and quality of life for ALL people, populations, and communities." The capitalization of "ALL" signals more than inclusivity. It implies universality—if not absolutism—shifting the vision from aspirational to morally directive. But does this align with occupational therapy as it exists and has historically been practiced? Consider daily occupational therapy work. Hospital-based therapists arrive at 7 a.m. to help patients regain basic life functions: dressing, sitting up, toileting. In schools, therapists assist students with handwriti...
Post a Comment
Read more

Ethics Deserve Deliberation: A Petition for Transparent Governance in Occupational Therapy

Image
In April 2025, the American Occupational Therapy Association Representative Assembly approved substantial revisions to the Occupational Therapy Code of Ethics as part of a bundled consent agenda — without open deliberation. Ethics are not routine administrative matters. They define the values, boundaries, and identity of a profession. This petition was submitted to respectfully challenge the process by which the new Code of Ethics was adopted, to call for greater transparency, and to reinforce the importance of meaningful member participation in shaping the standards that govern our work. Members deserve transparency, deliberation, and stewardship. I encourage all colleagues to remain engaged in the governance of our profession. Note: For purposes of this public posting, I have redacted personal information such as my address and AOTA member number, as well as removed the names of individual forum contributors cited in the original petition. These edits do not alter the substance of th...
Post a Comment
Read more