Close

When can you treat a patient without consent?

When can you treat a patient without consent?

9

1. A treatment may be administered to an incapable patient/client without obtaining consent only if:

9

i. there is an emergency; AND

9

ii. the delay to obtain consent will prolong the suffering that the patient/client is apparently experiencing or will put the patient/client at risk of serious bodily harm

[HCCA, section 25].

9

2. A treatment may be administered to an apparently capable patient/client without obtaining consent only if:

9

i. there is an emergency; AND

9

ii. the communication required to obtain informed consent is not possible due to a language barrier or communication disability; AND

9

iii. reasonable steps have been taken to enable communication; AND

9

iv. the delay to further means of enabling the communication will prolong the suffering that the patient/client is apparently experiencing or will put the patient/client at risk of serious bodily harm; AND

9

v. there is no reason to believe the person does not want the treatment

[HCCA, section 25].

9

3. An examination or diagnostic procedure may be performed without obtaining consent provided that:

9

i. the examination or diagnostic procedure is necessary to determine whether or not there is an emergency; AND

9

ii. the health care provider believes the patient/client is incapable or that there is a communication barrier that reasonable efforts have not been able to alleviate

[HCCA, section 25].

In any case where treatment is given without obtaining consent, you must:

9

i. document your opinions with respect to capacity and all actions taken (see Documentation PPG); AND

9

ii. continue the treatment only as long as it is reasonably necessary to find a substitute decision maker or to find a practical means to enable communication; AND

9

iii. ensure that reasonable efforts are made to find a substitute decision maker or a means of enabling communication

[HCCA, section 25].

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)