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Legislation

The Health Care Consent Act (HCCA)

The purposes of the HCCA are:

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(a) to provide rules with respect to consent to treatment that apply consistently in all settings;

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(b) to facilitate treatment, admission to or confining in care facilities, and personal assistance services, for persons lacking the capacity to make decisions about such matters;

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(c) to enhance the autonomy of persons for whom treatment is proposed, persons for whom admission to or confining in a care facility is proposed and persons who are to receive personal assistance services by,

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(i) allowing those who have been found to be incapable to apply to a tribunal for a review of the finding,

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(ii) allowing incapable persons to request that a representative of their choice be appointed by the tribunal for the purpose of making decisions on their behalf concerning treatment, admission to or confining in a care facility or personal assistance services, and

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(iii) requiring that wishes with respect to treatment, admission to or confining in a care facility or personal assistance services, expressed by persons while capable and after attaining 16 years of age, be adhered to;

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(d) to promote communication and understanding between health practitioners and their patients or clients;

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(e) to ensure a significant role for supportive family members when a person lacks the capacity to make a decision about a treatment, an admission to or a confining in a care facility or a personal assistance service; and

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(f) to permit intervention by the Public Guardian and Trustee only as a last resort in decisions on behalf of incapable persons concerning treatment, admission to or confining in a care facility or personal assistance services.

(HCCA 1996, c.2, Sched. A, s.1)

The Substitute Decision Act (SDA)

The SDA deals with decision making about personal care (and/or property) on behalf of incapable persons and involves the appointment of substitute decision makers (SDMs). Please see section on SDMs.

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)