This article asks the question, what evidence is there demonstrating the Ethics Commission's knowledge of social justice? The result of the research is: hardly anything. This article does not purport to establish what the Ethics Commission members actually know, for they could know much but have just not demonstrated their knowledge in a publicly accessible way (or in some venue or document that my research has not turned up). The goal is to see what the evidence shows and then leave it up to the members of the Ethics Commission to speak to the evidence. We need not assume that the evidence reviewed here is the totality of their knowledge, but neither need we assume that they are much more informed than the available evidence warrants.

          Before beginning a review of the evidence, I would like to orient the reader in the broadest terms to the structure of the 2010 AOTA Code of Ethics. At its core are seven principles that are numbered 1-7. The social justice requirement is formally known as “Principle 4.” In addition to a title and subtitle, each principle is divided into two main parts. The first part explains the principle. The second part contains subsections listed in alphabetical order. These subsections are generally meant to be the practical application of the principle. (Principle 4 has seven subsections. They are titled A-G. See Code of Ethics 2010 here: http://www.aota.org/Consumers/Ethics/39880.aspx ).

          The next several sections will address some of what each of the members of the Ethics Commission has demonstrated regarding their knowledge of social justice. 

    1.      Dr. Kathlyn Reed

          Dr. Kathlyn Reed made only one post on social justice on OTConnections. This post made three arguments for keeping the social justice requirement in the Code of Ethics. As it turned out, the first argument was a LOGICAL  FALLACY – the fallacy of appealing to pity. She commited this by suggesting that those who are for the social justice requirement are for it because they care about providing services to disabled children whereas those who do not care about the disbaled children receiving services could vote against the requirement.

         In a second argument we get SLOPPINESS and CONTRADICTION when she used a quote from a source that contradicts her claim about what she calls "ethical social justice." For the specifics on this point, the reader is directed to Chapter Seven of Beware the Googlers, titled "Cherry Picking a Right to Health Care."

          And in the third arguement we get the statement that removing social justice from the Code of Ethics would also require removing it from the Practice Framework II. As best as I have been able to determine, this appears to be an INACCURATE STATEMENT. I have written to several members of the Ethics Commission about this and did not receive an answer. I only received a response from one of them telling me that Dr. Reed was no longer with the Ethics Commission and that she was sent my letter. That Dr. Reed was no longer with the Ethics Commmission was irrelevant, however, as I was asking the current Ethics Commission about the existence of a rule that substiantiated the statement that removing the social justice requirement from the Code of Ethics also required that it be removed from the Practice Framework II.

          In addition to not getting an answer from the current Ethics Commission, and its chair, Barbara Hemphill, Dr. Reed has not repsonded to my query either. I think it safe to assume that something as easy as pointing an AOTA memeber to such rule, if there is such a rule, would be quite simple. All the Ethics Commission would have to do is say, "Look here for the rule found on page X." That that has not happened suggests that the statement is inaccurate. 

          Furthermore, such a rule for the social justice requirement would be an anamoly for a couple of reasons. One of these reasons is that there is no rule for any such parallelism between the Code of Ethics and The Practice Framework II regarding the other principles in the Code of Ethics. And second, the Practice Framework II was published in 2008, two years before the Code of Ethics was approved. In other words, there was a time when there was no such parallelism, and in fact, it could not have been known beforehand that the RA was going to accept the 2010 revision to the Code that included the social justice requirement.    

          As to other sources that might have revealed Dr. Reed's knowledge regarding social justice, she contributed material to The Reference Guide to The Occupational Therapy Code of Ethics & Ethics Standards (Ed. By Slater) (2010). There Dr. Reed contributed an article titled “Ethics in Governance.” In it she makes specific references to every other principle in the Code of Ethics, but NOTHING regarding a specific reference to Principle 4.

          Additionally, I have performed a word search in Google Books on Dr. Reed’s co-authored book, Concepts in Occupational Therapy, which is found here: http://books.google.com/books?hl=en&lr=&id=1ZE47g_IRTwC&oi=fnd&pg=PR7&dq=kathlyn+reed+social+justice&ots=sKjtdVok-Q&sig=FiMPiA03gHpZMFoLXXFPzY8C0C0#v=snippet&q=justice&f=false. This search found NOTHING on the subject of social justice. These searches, however, are not perfect, and so if anyone knows of the existence of the term “social justice” in that book, please inform us so that we can see if the mention carries any substance that may affect the thesis being advanced here.

2.      Dr. Barbara Hemphill

          From Dr. Hemphill we also got a LACK OF FAMILIARITY regarding how terms are used in political philosophy. We saw this in Dr. Hemphill’s statement that the term "distribution" in the Code of Ethics means that there is a right to health care to maintain normal functioning but, (and this is a major but), that such a right does not require the distribution of wealth. This statement makes no sense. Again, the reader is directed to Chapter Seven of Beware the Googlers for a discussion of why this is so.

3.      Dr. Lea Brandt

          Dr. Brandt’s contribution to the OTConnections forum amounted to CONTRADICTION as she stated that the social justice requirement was such an inclusive concept that even libertarians could adhere to it. The problem is that such a statement goes against Dr. Hemphill’s claim that there is such a thing as a right to health care in the Code of Ethics. Dr. Hemphill claimed, as a co-author of the Code of Ethics, that the term "distribution" in the Code mean that there was a right to health care. The problem for Dr. Brandt is that the textbook listed in the social justice section of the Code of Ethics states that libertarians do not recognize the legitimacy of a thing called a "right to health care." In fact, such a concept is immoral under the libertarian theory of justice (see Beauchamp and Childress Principles of Biomedical Ethics 6^th Ed, pp. 245-46). In other words, the textbook Dr. Brandt cited to in her capacity as co-author of the Code of Ethics contradicts her point about libertarians. And even if you found libertarians who said they were for something they call social justice, it would be nothing like the social justice that is supported in the Code of Ethics. For a discussion of social justice and libertarianism, I refer to the reader to Chapter Five of Beware the Googlers, titled "Cherry Picking Libertarian Social Justice."

          Dr. Brandt also plays LINCOLN’S LANGUAGE GAME with what she calls “an ethical obligation.” She says that the Code of Ethics deals with ethical obligations not political ones. But what she considers to be "an ethical obligation" is the political activity of demanding that the government engage in the redistribution of wealth to fund various programs (see Beware the Googlers, Chapter Seven for an explanation of Lincoln's Language Game). Thus she is playing a language game in order to justify the social justice requirement.

          Furthermore, in 2010, AOTA published The Reference Guide to the Occupational Therapy Code of Ethics & Ethics Standards (Ed. by D. Slater). In this book, Dr. Brandt teamed up with Dr. Donna Homenko, another member of the Ethics Commission, to write an article titled “Balancing Patient Rights and Practitioner Values.” The only reference to the social justice requirement, Principle 4, in this article is to Subsection E. Subsection E of Principle 4 states that a therapist must:

          “Make efforts to advocate for recipients of occupational therapy services to obtain needed services through available means.”

          An interesting fact about Subsection E of Principle 4 in the 2010 Code of Ethics, however, is that it is really a subsection taken from another principle from the 2005 Code of Ethics. In the 2005 Code of Ethics, the statement that is now Subsection E of Principle 4 was in Subsection C of Principle 1, Beneficence. Beneficence refers to the idea that therapists have on obligation to demonstrate concern for the safety and well-being of patients. To that end, the 2005 Code of Ethics stated under the principle of Beneficence the following requirement, listed in Subsection C:

          “Make every effort to advocate for recipients to obtain needed services through available means.”

          As can be seen, it is the same language as Subsection E of Principle 4 from the 2010 Code of Ethics. The reason this is significant is because the social justice requirement was a new and controversial requirement. What the Ethics Commission should be able to demonstrate is the conduct (new and different conduct from what is in the 2005 Code) that is necessary for the ethical practice of occupational therapy. This would help demonstrate that it was worth all the trouble entailed in putting social justice in the Code of Ethics. But, if all the Ethics Commission has done is ransacked other subsections from the old Code of Ethics to put them into the social justice section of the new Code of Ethics, then that is a clear demonstration that the social justice requirement was not required at all, and thus all the controversy was completely unnecessary.

          So far, what this shows is that the Ethics Commission added nothing new to the applications section of Principle 4 that could not have been perfectly covered by the 2005 Code of Ethics under Principle 1 Subsection C. As will be shown, using Subsection E of Principle 4 to make it seem as if there was something of substance contained within the social justice requirement's practical application section is a common pattern among the members of the Ethics Commission. Therefore, in the sections that follow, when one of the Ethics Commission members writes about Principle 4 Subsection E, we will call it by its previous name, THE PRINCIPLE OF BENEFICENCE SUBSECTION C TRANSFERRED FROM THE 2005 CODE OF ETHICS.

4.      Ms. Ann Moodey Ashe

          Ms. Ann Moodey Ashe is the author of the advisory opinion on social justice, which goes by the official title “Advisory Opinion on Social Justice and Meeting the Needs of Clients.” It was published in 2010, the same year as the new Code of Ethics. This advisory opinion is where we could expect to see the Ethics Commission members’ justification for the social justice requirement; we should be able to see some of the problems necessitating the inclusion of the requirement. Unfortunately, Ms. Ashe doesn't give us anything new. In fact, she only tells us two things about the new and controversial social justice requirement. One thing she tells us is in reference to Subsection E, that therapists are to make efforts to advocate for patients to get needed services through available means. In other words, she tells us nothing new by referencing Subsection E because that is THE PRINCIPLE OF BENEFICENCE SUBSECTION C TRANSFERRED FROM THE 2005 CODE OF ETHICS. The second thing she tells us is that in order to comply with Principle 4 Subsection G, therapists are to CONSIDER WORKING FOR FREE. This advice, however, is actually redundant because the Principle of Beneficence states that beneficence is about "charity," "kindness," and "helping others." In other words, it is about therapists considering working for free. Thus Subsection G tells us nothing that isn't already contained in Principle 1.

          Ms. Ashe was also one of the speakers at the 2013 San Diego conference presenting on “Everyday Ethics.” In this presentation, Ms. Ashe spoke of Principle 1 (Beneficence), Principle 2 (Non-malfeasance), and Principle 5 (Procedural Justice).  She may have also mentioned Principle 3 (Autonomy and Confidentiality), but my notes are not clear on this point. What is clear is that she had absolutely NOTHING to say about Principle 4, Social Justice.

5.      Dr. Yvette Hachtel

          Dr. Yvette Hachtel is the new Chair of the Ethics Commission. She too was a speaker at the San Diego Conference on “Every Day Ethics.” In her lecture, Dr. Hatchel mentioned Principles 2, 3, 5, 6 and 7, but she had NOTHING to say about Principle 4, Social Justice.

6.      Ms. Deborah Slater

          Ms. Deborah Slater is the permanent member of the Ethics Commission, working as AOTA’s staff liaison to elected members of the Commission.  She was also one of the speakers for the “Everyday Ethics” presentation at the San Diego Conference. She was the only panelist to mention social justice. But her reference to social justice wasn’t anything new. The only thing she mentioned was THE PRINCIPLE OF BENEFICENCE SUBSECTION C TRANSFERRED FROM THE 2005 CODE OF ETHICS.

          Ms. Slater is also the editor of The Reference Guide to the Occupational Therapy Code of Ethics & Ethics Standards (2010), a book to which she contributed several articles. One of those articles was titled “Legal and Ethical Practice: A Professional Responsibility,” where she refers to Principle 5 Subsection F, Principle 1 Subsection G and Principle 2, but NOTHING about Principle 4.

          A second article was titled “Ethics in Practice: Whose Responsibility,” which mentions Principle 5, Principle 6 Subsection B, Principle 1 Subsection H and Principle 2, but NOTHING about Principle 4.

          A third article was titled “The Ethics of Productivity.” Although this one mentions Principle 4, it is in reference to Subsection E, which is just the old PRINCIPLE OF BENEFICENCE SUBSECTION C TRANSFERRED FROM THE 2005 CODE OF ETHICS.

          There is also a fourth article, which was co-authored with Dr. Brandt, titled “Combating Moral Stress,” which mentions NOTHING about Principle 4.

           A fifth article is titled “Ethical Considerations in Private Practice,” which mentions Principles 1, 2, 5, 6, and 7, but NOTHING about Principle 4.

          A sixth article is titled “Ethical Issues Around Payment for Services.” This one mentions two subsections from Principles 4. One is Subsection G, telling therapists to CONSIDER WORKING FOR FREE, and the other one is just the old PRINCIPLE OF BENEFICENCE SUBSECTION C TRANSFERRED FROM THE 2005 CODE OF ETHICS. In other words, it mentions nothing not already contained in Principle 1, either from the 2010 or 2005 Code of Ethics.

7.      Ms. Loretta Foster

          Ms. Foster is also a member of the Ethics Commission and wrote the advisory opinion titled “OT/OTA Partnerships: Achieving High Ethical Standards in a Challenging Health Care Environment” (2010). In this advisory opinion she mentions Principle 5 Subsections C, F and G, Principle 1 Subsection E, Principle 2 Subsection A, Principle 6 Subsections A and H, but mentions NOTHING about Principle 4.

8.      Ms. Joan Estes

          Ms. Joan Estes, also a member of the Ethics Commission, wrote the advisory opinion titled “Telehealth.” In this opinion she refers to two subsections from Principle 4. But one of them, Subsection E, we know, is the old PRINCIPLE OF BENEFICENCE SUBSECTION C TRANSFERRED FROM THE 2005 CODE OF ETHICS.

          The second subsection mentioned from Principle 4 is Subsection F, which has not been addressed in this paper yet. Some may greet the reference to Subsection F with relief because it would signal that perhaps there is something of value that is unique to the social justice requirement. But it would be in vain, as Principle 4 Subsection F from the 2010 Code of Ethics was taken from yet another subsection of the Principle of Beneficence in the 2005 Code of Ethics. It is the PRINCIPLE OF BENEFICENCE SUBSECTION A FROM THE 2005 CODE OF ETHICS. It is not something new, just more evidence of the ransacking that was done to the old code of ethics in an attempt to make the social justice requirement in the new code of ethics seem useful in practical terms.

          What is interesting is that Subsection A of Principle 1 from the 2005 Code of Ethics was cut up into two parts. The second part is what was transferred to Principle 4 Subsection F in the 2010 Code of Ethics. The first part is actually the subtitle of the social justice requirement. This subtitle reads:

          “Principle 4: Occupational therapy personnel shall provide services in a fair and equitable manner.”

         What this tells us is that what is written under the social justice requirement in the 2010 Code of Ethics is really just a Frankenstein's Monster. The Ethics Commission was merely grabbing parts of this and that from the 2005 Code of Ethics in hopes of making something work.

Conclusion

          So far, the material reviewed does not allow us to conclude that the members of the Ethics Commission are well-versed on the subject of social justice. If there is evidence to contradict this conclusion, it should be presented.