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Treatment

Treatment

The HCCA defines a treatment to mean “anything that is done for a therapeutic, preventive, palliative, diagnostic, cosmetic or other health-related purpose, and includes a course of treatment, plan of treatment or community treatment plan”. In this context, treatment does not include:

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(a) the assessment for the purpose of this Act of a person’s capacity with respect to a treatment, admission to or confining in a care facility or a personal assistance service, the assessment for the purpose of the Substitute Decisions Act, 1992 of a person’s capacity to manage property or a person’s capacity for personal care, or the assessment of a person’s capacity for any other purpose,

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(b) the assessment or examination of a person to determine the general nature of the person’s condition,

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(c) the taking of a person’s health history,

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(d) the communication of an assessment or diagnosis,

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(e) a person’s confining in a care facility;

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(f) a personal assistance service,

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(g) a treatment that in the circumstances poses little or no risk of harm to the person,

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(h) anything prescribed by the regulations as not constituting treatment.

[HCCA 199 s. 2(1)]

Plan of Treatment

The HCCA defines the plan of treatment to mean a plan that

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(a) is developed by one or more health practitioners,

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(b) deals with one or more of the health problems that a person has and may, in addition, deal with one or more of the health problems that the person is likely to have in the future given the person’s current health condition, and

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(c) provides for the administration to the person of various treatments or courses of treatment and may, in addition, provide for the withholding or withdrawal of treatment in light of the person’s current health condition.

[HCCA 1996, s. 2(1)]

Therefore, the practitioner proposing a treatment or plan of treatment to a patient/client is responsible for obtaining consent. It is likely that the person proposing the treatment or plan of treatment will be the physician who orders the treatment. However, if an RT is proposing the plan of treatment, it is the RT’s responsibility to obtain consent.

Third-Party Consent

The HCCA also allows for a plan of treatment to be proposed by one health care practitioner on behalf of the health care team involved in the plan. This is referred to as “third-party consent” and is acceptable practice provided the consent is informed and obtained prior to initiating the treatment. It is important to remember that if you are the one performing the procedure, you are accountable for ensuring that third-party consent has been obtained. If you have any doubt whether informed consent has been obtained, it is your professional obligation to obtain it, or to not proceed. The definitions of consent and informed consent are discussed in detail in the section about Consent.

Scenario:

A patient/client comes to your laboratory for pulmonary function tests and says “My doctor sent me here for some tests.”

What do you do?

You must ensure that your patient/client understands the purpose and risks of the tests and verify their consent for the procedure.

Glossary

Attorney for personal care: An attorney under a power of attorney for personal care given under the Substitute Decisions Act.

Consent and Capacity (the board): A board established by and accountable to the government. Its members are appointed by the government. The Board considers applications for review of findings of incapacity, applications relating to the appointment of a representative, and applications for direction regarding the best interests and wishes of an incapable person.

Capable: Means mentally capable; a person is capable if they are able to understand the information that is relevant to making a decision about the treatment and are able to appreciate the reasonable foreseeable consequences of a decision or lack of decision — capacity has a corresponding meaning.

College: College of Respiratory Therapists of Ontario.

CRTO: College of Respiratory Therapists of Ontario.

Emergency: When the person for whom the treatment is proposed is apparently experiencing severe suffering or is at risk, if the treatment is not administered promptly, of sustaining serious bodily harm.

Guardian of the Person: A guardian of the person appointed under the Substitute Decisions Act.

HPPC: Health Professions Procedural Code — Schedule 2 of the Regulated Health Professions Act.

Incapable: Mentally incapable with incapacity having a corresponding meaning.

Partners: Individuals who have lived together for at least one year and have a close personal relationship that is of primary importance in both lives.

Plan of Treatment: A plan that:

      • is developed by one or more health practitioners
      • deals with one or more health problems that an individual has, and may deal with one or more problems an individual is likely to have in the future given their current health
      • allows for administration of various treatments or courses of treatment.

Relatives: Related by blood, marriage or adoption.

Respiratory Care: Equivalent to Respiratory Therapy.

Respiratory Therapist (RT): A Member of the CRTO and includes Registered Respiratory Therapists (RRT), Practical (limited) Respiratory Therapist (PRT) or Graduate Respiratory Therapists (GRT).

Spouses: Individuals who are married to each other, or who are living in a conjugal relationship and have lived together for at least one year, have a cohabitation agreement or are the parents (together) of a child. Individuals living apart and separate are not spouses.

Treatment: Means anything that is done for a therapeutic, preventative, palliative, diagnostic, cosmetic or other health-related purpose, and includes a course of treatment or plan of treatment, but does not include:

      • assessment of a person’s capacity
      • assessment or examination to determine the general nature of an individual’s condition
      • taking a health history
      • communicating an assessment or diagnosis
      • admission to a hospital or other facility
      • a personal assistance service
      • a treatment that, in the circumstances, poses little or no risk of harm
REFERENCES
  1. College of Nurses of Ontario (2017). Practice Guideline: Consent. Retrieved from: https://www.cno.org/globalassets/docs/policy/41020_consent.pdf (cno.org)
  2. Health Care Consent Act (1996).  Retrieved from: Health Care Consent Act, 1996, S.O. 1996, c. 2, Sched. A (ontario.ca)
  3. Health Protection and Procedure Act (1990). Retrieved from: R.R.O. 1990, Reg. 569: REPORTS (ontario.ca)
  4. Regulated Health Professions Act, 1991, S.O. 1991, c. 18. Retrieved from: Regulated Health Professions Act, 1991, S.O. 1991, c. 18 (ontario.ca)