Introduction Ethical tensions are an unavoidable part of occupational therapy practice. Given the significance of this, and the divergent nature of the literature, a need was identified for a systematic examination of the published literature on this topic. The purpose of this scoping review therefore was to identify, summarize, and describe existing literature on ethical tensions in occupational therapy practice. Method A comprehensive scoping review was conducted. In the initial search, 459 articles, spanning a 13-year time frame, were retrieved from six databases; 32 articles met the criteria for full review. Results Seven themes were identified that highlighted ethical tensions related to: (a) resource and systemic issues; (b) upholding ethical principles and values; (c) client safety; (d) working with vulnerable clients; (e) interpersonal conflicts; (f) upholding professional standards and (g) practice management. Conclusion This scoping review highlights a breadth of ethical tensions that have implications for practice, education, policy and research. It represents an important first step in mapping knowledge about ethical tensions in occupational therapy practice, and lays a foundation for future research directions.
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