Law & Ethics Flashcards
What does CTCMPAO stand for?
College of Traditional Chinese Medicine Practitioners and Acupuncturists of Ontario
Who is the Governing Body of TCM in Ontario?
CTCMPAO
Under what 2 Acts is the CTCMPAO regulated under?
- Regulated Health Professions Act 1991
2 Traditional Chinese Medicine Act 2006
CTCMPAO act upon who’s interest?
Public Interest
The colleges primary duty is to serve and protect the publics interest by?
- Regulating the practice and conduct by members
- Maintain a public register of members
- Develop programs to help members improve
- Review and Investigate complaints
- Assessing whether a member is fit to practice
- Disciplining members when necessary
- Promoting inter-professional collaborating
- Offering guidance and support to members and assisting public with information
3 duties Practitioners must provide to their patients?
- Be Honest
- Good Service
- Inform and Consent
2 duties Practitioners must have towards each other?
- Be polite
2. Work with practitioners to serve the welfare of patients
Do practitioners have the responsibility to work with the college to protect the public from dishonest and incompetent practitioners?
Yes
Are Practitioners in Ontario Self-Regulated?
Yes
What does it mean to be self-regulated?
The government can delegate authority to a profession to regulate itself under the Act.
Who makes up the College council that regulates the profession?
- Members elected by the profession
2. Public members appointed by government
The council being the board of directors makes policies that the College oversees, what are the regulatory activities it oversees?
- Professional Misconduct Regulations
2. Approves budget
The college operates through which 2 committees?
- The Registration Committee
2. The Discipline Committee
Most members of the Registration and Discipline committee are practitioners and members of the public?
Yes
The term of office of a Member elected to council is approximately how long?
3 years
A member who has served on council for 9 consecutive years is ineligible for election to council until how many full terms have passed?
3 years
Can the college advertise on behalf of its members?
No
How many members of the committee should be public member?
Almost half
Are discipline hearings open to the public?
Yes all council meetings are open to the public
Does the college consult with members of the profession and the public before making any regulations or by-laws?
Yes. The college must propose any regulations or by-laws for at least 60 days so that people can comment on them.
Can decisions by the committees be reviewed by other regulatory bodies?
Yes
The government has appointed what 2 bodies to ensure the College is acting upon the interest of the public?
- The office of the Fairness Commissioner
2. The minister of Health and Long-Term Care
How often does the college have to report to the Minister?
Each year
Can the Minister appoint a supervisor to takeover the college operation if there are serious concerns?
Yes
Can the Minister make recommendations and give orders to the council?
Yes
Is the college allowed to publish it’s discipline decisions on their website?
Yes the college has to post it’s discipline decisions
A description of the college’s activities must be posted on their website?
Yes
Do council members act like politicians and represent the people who elected them?
No they are like directors of a corporation who have a duty of loyalty to the mandate of the College
Are professional standards written down on the Colleges website?
No, professional standards are learned through practice and are always changing. The college does provide written documents explaining professional standards
Standards of Practice, Policies and Guidelines are for what purpose?
These are to remind the practitioner how to practice safely, ethically and effectively and can be found on the Colleges website and cover a wide variety of topics
Are professional standards considered Law?
No not the same way as a statue or regulation is but failing to comply with a published standard will often lead to a violation of the law or will result in a professional misconduct
What is Professional Misconduct?
Professional Misconduct is behavior that falls below the minimum expectations of a safe and ethical practitioner
Professional Misconduct is written in either the act or regulations.
A practitioner who behaves unprofessionally can be disciplined
In what 3 ways can the discipline committee discipline a practitioner?
Fine a practitioner
Suspend a practitioner’s certificate of registration
Revoke a practitioner’s certificate registration
What is Incompetence?
Incompetence happens where a practitioner shows a serious lack of knowledge, skills or judgment when assessing or treating a patient
Can the College investigate a concern of incompetence by a practitioner?
Yes.
The committee could order that the practitioner use a supervisor or
The Committee could suspend or revoke the practitioners certificate
During an investigation of incompetence the College will usually look at the practitioner……
Records
The College will interview the Patient and the Practitioner.
What is Incapacity?
A practitioner is incapable when he or she has a health condition that prevents them from practicing safely. (EG. Thinking clearly)
Even a severely disable practitioner can practice safely so long as the practitioner understands their limits.
Practitioners who may be Incapabale are referred to who?
The Fitness to Practice Committee for a hearing.
The Fitness to Practice committee can order the practitioner to undergo medical treatment, to have medical monitoring and to restrict their practice.
If a practitioner continues to sees patients while impaired, the Fitness to Practice committee can suspend or revoke the practitioner’s registration in order to protect the public?
True
Statues are also known as Acts?
True
Canadian Charter of Rights and Freedoms take priority over other Statues?
True
What are the 2 Acts practitioners will need to be most aware of?
RHPA - Regulated Health Professions Act
TCMA - Traditional Chinese Medicine Act
Regulations are made by the government when a statue allows them to be made.
Under the Regulated Health Professions Act regulations can be proposed by what 2 authorities?
The College
Minister of Health & Long-Term Care
By-laws, which mostly deal with the internal operations are made up by who?
The College
What does the College publish that are not “law” but help practitioners and College committees understand and interpret the law. These documents are also known as “soft law”
Standards of Practice
Guidelines
Policy Statements
Position Statements
What does RHPA stand for?
Registered Health Professionals Act
The Regulated Health Professions Act applies equally to all 26 health Colleges in Ontario. It describes the duties and responsibilities of ……
The Minister of Health and Long Term Care
The Colleges and each of it’s committees
Duties of the Practitioners
Out of the 13 controlled acts an Acupuncturist is allowed to do…..
- Communicating to the individual or their personal representative a diagnosis identifying a disease or disorder as the cause of symptoms of the individual in circumstances in which it is foreseeable that the individual or their personal representative will rely on diagnosis.
- Performing a procedure on tissue below the dermis, below the surface of a mucus membrane, in or below the surface or the cornea or in or below the surface of the teeth, including scaling of the teeth (We can only do some of this)
What will a substance have if it is considered a drug?
DIN - drug identification number
What are the four ways in which a health care practitioner can receive legal permission to perform a controlled act?
Authorization
Exceptions
Exemptions
Delegation
The Traditional Chinese Medicine Act authorizes practitioners to perform what controlled acts?
- Performing a procedure on the tissue or dermis below the surface of a mucous or membrane for the purpose of performing acupuncture
- Communicating a traditional Chinese medicine diagnosis identifying a body system disorder as the cause of a persons symptoms using traditional Chinese medicine techniques.
What are the Exceptions permitting people to perform under the Regulated Health Professions Act?
- Helping people in an emergency
- While in training, under supervision or direction of a member of the profession
- Performing the controlled act under supervision
- Treatment by prayer or spiritual means pursuant to one’s religion
- When done for a member of one’s household. This applies only to communicating a diagnosis, administering a substance by injection or inhalation or entering a body opening (helping patient with insulin)
- Helping a person with their routine activities where it includes administering a substance by injection or inhalation or entering a body opening
- Counselling a person - as long as it does not communicate a diagnosis
- Providing indigenous healing within the indigenous community
Exemptions that has been provided under the Minister of Health are?
- Anyone can perform cosmetic body piercing’s and tattooing
- Anyone can perform electrolysis
- Anyone can perform male circumcision
What other physician Members of other Colleges can perform acupuncture under their profession-specific act?
- Chirobody
- Chiropractic
- Massage Therapy
- Naturopathy
- Nursing
- Occupational Therapy
- Physiotherapy
- Dentistry
A health care practitioner who is allowed under their legislation to perform a controlled act can delegate the controlled act to others. Delegation can be made to another health care provider or to an unregistered person. Delegation is subject to a number of rules including…
- The person giving the delegation is limited by any regulations or professional standards of his or her College - person receiving delegation has the knowledge, skills and judgement to perform those procedures and the practitioner has documented those steps
- The person accepting the delegation is limited by any regulation or professional standards of his or her College (if the person is a member of a regulated College) - a practitioner would not be complying with the professional standard to perform brain surgery on a patient even if that procedure had been delegated by a physician
- The person delegating the procedure is responsible for the actions of the person receiving the delegation. - practitioner delegates acupuncture to assistant and needle punctures a vital organ the practitioner would be held accountable.
What is meant by “Scope of Practice”?
Description of what the practice does
Under the Traditional Chinese Medicine Act the scope of practice statement reads:
The practice of TCM is the assessment of body system disorders through Traditional Chinese Medicine Techniques and Treatment using traditional Chinese medicine therapies to promote, maintain or restore health.
Are practitioners of TCM allowed to perform procedures outside there scope of practice so long as they are not dangerous?
Yes
Providing mouth guards to patients who play sports would be permissible as long as:
Tell the patient that this doesn’t fall under the scope of practice
To ensure the patient is not misled, book separate appointments, records and billings
Can non members use the titles “TCM practitioner” or “acupuncturist” or any variations of the title?
No
Practitioners need to be careful not to use a professional title that is permitted to members of other Colleges
Would it be professional misconduct for a practitioner to refer to an educational degree that had not bee received?
Yes
Practitioners are allowed to describe their areas of practice so long as it does not imply specialist statue or certification (practice limited to children)
What is the specific designation of r TCM practitioners and acupuncturists?
R. TCMP
R. Ac
What other acts have mandatory reporting provisions
The Child and Family Services Act
The Personal Health Information Protection Act
A practitioner who makes a mandatory report in good faith is protected by the RHPA?
Yes
Retaliation against people making mandatory reports is prohibited and such retaliation would likely constitute profession misconduct
A practitioner must report sexual abuse of a patient by another health care provider when…
The practitioner believes the sexual abuse occured and
The practitioner learned this information in the course of practicing the profession or while operating a health facility (office / clinic)
Does a practitioner need to investigate the events first before reporting sexual abuse from a patient if the patient told the practitioner?
No
Nor does the practitioner have to believe the information is true - practitioner might know the abuser and can’t believe its true
If the information constitutes reasonable grounds then should a report be made for sexual abuse?
Yes
Reasonable grounds means information that would cause a reasonable person who does not know the individual involved to conclude that it is more likely than not that the information is correct
Where must the sexual abuse report be made?
In writing to the Registrar of the College to whom the alleged sexual abuser belongs
It has to have
The reporting practitioners name
The grounds of the report
The report cant have the patients name unless the agree in writing
The report must be made within 30 days of receiving the information
- if patient is is continuing to be harmed a report must be made right away.
A practitioner must report if they end a business relationship with another health care provider on the basis that the other health care providers is incompetent or incapacitated or engaged in professional misconduct.
Yes
The report must be made even if the person quits or resigns first
The report must be made within 30 days of ending or proposed ending the business relationship
Under mandatory reporting obligations the name of the patient can be included without the patients consent
The report must be made even if the business relationship has not ended
Ex. if the health care provider at the facility is found to have a drug addiction and goes into a treatment program while the job is kept for them the report would still have to be made
All practitioners must report themselves when they have been charged with or found guilty of an offense?
Yes
The following information must be given Name of practitioner filing report Nature and description of the offence The date the practitioner was charged The name and the location of the court The status of the appeal initiated respecting the charge
They also require any bail conditions or restrictions
If there’s an appeal that alters the information, an updated report must be made
