Making Choices from the Choices we have: The Contextual-Embeddedness of Occupational Choice

Abstract

Background.: “Choice” is central to occupational therapy’s theoretical tradition, which maintains that individuals can impact their well-being through wisely choosing their occupations. However, the assumption that opportunities to choose are universally available is negated by research evidence. Purpose.: To review the ideology of “choice” in occupational therapy theory, and to encourage more critical approaches toward determinants of occupational opportunity and choice. Key Issues.: Evidence indicates that within Canada, and throughout the world, opportunities to make occupational choices are inequitably distributed among people of different socioeconomic classes, castes, genders, races, abilities, sexualities, citizenship statuses, and experiences of colonialism. Implications.: Because occupation is a determinant of health and well-being, social injustices that create inequitable occupational choices are unfair violations of occupational rights. The occupational therapy profession’s espoused aim of enhancing well-being through occupation demands theories that explicitly recognize the socially structured and inequitable shaping of choice, and consequent impact on people’s occupational rights.