Ethical considerations related to evidence-based practice.

In this article, we have identified some of the ethical considerations related to evidence-based practice and surrounding issues as they bear on occupational therapy and rehabilitation. We acknowledge that practitioners are professionally and morally obligated to ensure that their decisions are informed and reflect best practices. Further, we recognize the value of encouraging practitioners to assume responsibility for searching and appraising available evidence so that informed options can be shared with patients. Table 1 summarizes the ethical considerations in evidence-based practice. Ethical dilemmas are a natural part of the health care enterprise. They existed before evidence-based practice became an everyday term, and they present themselves whether or not evidence-based practice is introduced into a clinical decision. From a moral and professional standpoint, the dangers of not attending to evidence are just as significant as the ethical issues attending to its application. Evidence-based practice has clear limitations in occupational therapy and rehabilitation. Currently, these limitations loom as major obstacles to practice behaviors that are better informed and influenced by research. In the United States, the implementation of a prospective payment system in rehabilitation will provide increased impetus for research and for attention to the results of that research. As we consider and apply this research to practice, we must do so judiciously, mindful that evidence-based practice is a gift that comes to health care in ethical wrappings.