Sixty-one of 100 occupational therapists were surveyed about whether they felt frustrated or not in treating outpatients with chronic hemiplegia, and, if so, why. Seventy-percent of the respondents reported some frustration. Their major frustration occured when the treatment occupational therapists thought the best was different from the treatment patients wanted to receive. This frustration would result in dilemmas if the different opinions of the therapist and patient were made apparent through the process of informed consent. The problems that rehabilitation teams face with informed consent are discussed in this paper. These problems are related to the process of decision-making as a team which includes many kinds of professionals, different needs from clients and care-givers, low competency of clients, and the patient's lack of acceptance of his/her disabilities. Ethical considerations have rarely been discussed using actual rehabilitation cases in Japan. Knowing that dilemmas actually happen in daily practice is the first step for starting a discussion of ethical issues in occupational therapy.

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