Ethical Misconduct of HPCSA-Registered Occupational Therapists in South Africa (2014– 2023): A Follow-Up Study

Introduction In light of recent changes to South Africa’s healthcare regulatory landscape, including updates to HPCSA disciplinary processes, the introduction of minimum fines, and reforms to streamline case inquiries, this study examines cases of ethical misconduct among occupational therapists reported to the Health Professions Council of South Africa (HPCSA) between 2014 and 2023. Maintaining ethical integrity in occupational therapy is important to earning public trust, strengthening the profession’s identity, and ensuring accountability in patient care. Building on the findings of Nortje and Hoffman in 2015, this study analyses the types of transgressions, and the penalties imposed to better understand evolving trends in professional ethics and regulation. Methodology A qualitative historical document review approach was used to analyze archival material from the HPCSA. Available data were sorted into one of nine general categories and one of 180 subcategories, using the classification framework adapted from HPCSA disciplinary codes and tan earlier study which reviewed the ethical misconduct of HPCSA registered occupational therapists from 2007 to 2013. Results A total of 66 cases were reported; of these, fraudulent conduct was the most common transgression (61 cases), followed by professional registration misconduct, improper professional role conduct, negligence, and performing procedures without patient consent. These 66 cases were committed by a total of nine offenders, five of whom were repeat offenders. Penalties ranged from fines (R10,000 to R210,000) to suspensions of up to 2 years and mandated ethics courses. Some of these fines fell below HPCSA minimums, raising concerns about consistency and enforcement. Conclusion Compared to 2007–2013, the 2014-2023 period had a larger number of violations, which reflects the changing professional demands and regulatory landscapes. The penalties for these violations remain largely punitive, which undermines rehabilitation and broader efforts to deter unethical behaviour. This study highlights the need for continuous ethics training, consistent enforcement of penalties, and regular updates to regulatory frameworks to promote long-term ethical compliance and protect patient trust in occupational therapy practices. Implications for practice: • Highlights the importance of integrating reflective practice and ethics education as part of continuous professional development. • Emphasizes the need for consistent enforcement of HPCSA penalties to ensure accountability and deter repeat offenses. • Supports the inclusion of rehabilitative measures, such as ethics and practice management courses, alongside financial penalties. • Importance of being and acting ethical to maintain patient trust and upholding the integrity of occupational therapists