Two ethical dilemmas commonly experienced in occupational therapy are presented: whether a terminally ill patient should be told the truth that he or she is dying and how therapists make choices when faced with limited resources. The article commences with an introduction to ethical theories and the use of these with regard to the two dilemmas being discussed. The theories selected are deontology and utilitarianism. A number of ethical principles are described, the major ones being truth telling (veracity), doing good (beneficence) and doing no harm (non-maleficence). The two practice dilemmas are then given with discussion of how ethical theories and principles might help the therapist who is confronted with these difficult issues. The material being discussed is related to the College of Occupational Therapists' Code of Ethics and Professional Conduct at all relevant points. The conclusion is drawn that while there are no easy solutions to these difficult decisions, there are theories and reasoning strategies that can help.