The importance of the client versus patient issue for occupational therapy.

The tendency for our official language to refer to an occupational therapy client rather than an occupational therapy patient reached on obvious consensus by 1983, and this shift from a patient-based to a client-based service reflects more than a mere name change. The tone, style, and quality of occupational therapy is being transformed as powerful ethical, legal, and economic forces reshape the practice, administration, education, and research of the discipline. The real significance of change to a client service is that somewhere, at some level, a decision has been made that changes the purpose of occu pational therapy service. In the history of our discipline there is probably no more important policy decision than this one, which changes the focus of service from patient to client. The astounding aspect of the decision is not that it was made, but that it was made outside the awareness of most of the membership. Because this policy forces a radical transformation of the nature of occupational therapy, it threatens the survival of the discipline. A greater danger, however, lies in the disinterest or lack of attention the membership has paid to the Issue. It is my conviction that occupational therapists who fail to examine the meanings behind the shift to a client service and to act on understandings derived from a public probing of the issue