The following issues in the practice of brain injury rehabilitation ar
e explored: (1) validity of support for efficacy based on experience i
n clinical practice, (2) validity of support for efficacy based on res
earch, (3) consumer protection, (4) qualifications and regulation of i
ndividual providers, (5) regulation of programme development and marke
ting. Ethical responses to these issues from each of three cultural be
lief systems (humanism, science and self-interest) are examined from a
metaphilosophical perspective based on contemporary cognitive psychol
ogy and on philosophies of social constructionism and existentialism.