BC Jurisprudence Exam: Understanding Professional Regulations and Ethics, Exams of Law

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CCALA ✔✔Community Care and Assisted Living Act

CFCSA ✔✔Child, Family and community service act

FOIPPA ✔✔Freedom of Information and Protection of Privacy Act

HCCCFAA ✔✔Health care consent and care facility admission act

HPA ✔✔health professions act

PIPA ✔✔Personal Information Protection Act

List profession duties ✔✔duty to be honest with patients

duty to provide good service

duty to tell px what they are going to do

ask for px consent

duty to be polite

work with fellow practitioners

work with regulatory college to protect the public

What does it mean for an activity to be regulated? ✔✔the law imposes restrictions on the activity to ensure the public are not harmed and actually benefit from it

What does self regulation mean? ✔✔government has made a statue (act) giving duty to regulate the profession to a separate body (college), the majority of whose board is elected by the profession

What is the mandate of the college? ✔✔serve the public interest

the college has a duty to serve and protect the public under what act? ✔✔The Health Professions Act

How much notice must the college provide for proposed bylaws or amendments? ✔✔3 months

What fraction of the board and committees of the college must be made of the public ✔✔1/

• Being honest
• respecting confidentiality
• behaving with sensitivity
• maintaining competence
• allowing px to make informed choices

are part of what? ✔✔Code of Ethics

The college is authorized by the HPA to create bylaws that establish standards of professional ethics for its members. Schedule A of the college bylaws contains_________. Schedule B contains __________. ✔✔A: College Code of Ethics

B: General Standards of Practice

Define practice standards ✔✔describe the way in which practitioners practice their profession

Define professional misconduct ✔✔conduct that falls below the minimum expectations of a safe and ethical practitioner

Define incompetence ✔✔where a practitioner demonstrates a lack of knowledge, skill or judgement when assessing or treating a patient

Define incapable ✔✔they have a health condition that prevents them from practicing safely

What does it mean for an activity to be regulated? ✔✔

What act prohibits any practitioner from providing care without consent? ✔✔HCCCFAA (Health care consent and care facility admission act)

What are the requirements for patient consent (5)? ✔✔1. Relate to the proposed health care and treatment

2. be specific (no blanket consent)
3. be informed
4. voluntary

5. no misrepresentation or fraud

to be informed, consent must include the following (7): ✔✔1. nature of the tx or assessment

2. who will be doing procedure
3. reasons for procedure
4. material risks and side effects
5. alternatives to procedure
6. consequences of not having the procedure
7. particular patient concerns

What are the 3 ways of receiving consent? ✔✔1. verbal

2. written
3. implied

what are the requirements of a substitute decision maker (4)? ✔✔1. at least 19

2. must themselves be capable
3. able and willing to act
4. no higher ranked substitute available

Who may make decisions on behalf of a patient? ✔✔- personal guardian

• representative
• substitute decision maker

Rank possible substitute decision makers from highest to lowest: ✔✔1. court appointed guardian

2. person appointed by the patient to be an attorney for personal care (signed document)
3. spouse or partner (marriage-like relationship)
4. child
5. parent
6. brother or sister
7. grandparent
8. grandchild
9. anyone else related to the patient by birth or adoption
10. close friend
11. person immediately related through marriage
12. public guardian & trustee

Who makes the decision if two equally ranked decision makers cannot agree? ✔✔Public guardian & trustee

What are the rules that a substitute decision maker must follow (2)? ✔✔1. act in accordance with last known wishes of px

2. act in the best interest of the px

List the areas where practitioners need to be very cautious to maintain professional boundaries: (8) ✔✔1. Self disclosure

2. Giving or receiving gifts
3. Dual relationships
4. ignoring established customs
5. personal opinions
6. becoming friends
7. touching and disrobing
8. sexual misconduct

Is sexual contact appropriate if the px consents? ✔✔NO

What is the name of the committee in the college that establishes a patient relations program that aims to prevent professional misconduct? ✔✔Patient Relations Committee

What will happen if there is a finding of sexual misconduct? ✔✔- reprimand

• pay costs
• lose the right to practice (for a period of time or indefinitely)

What should a practitioner do if they begin to develop romantic feelings towards a px? ✔✔Put a stop to it and immediately transfer the px to another practitioner

Is dating a former px sexual misconduct? ✔✔No, but it can still be unprofessional and there must be an appropriate "cooling off" period

Who controls the extent of inter-professional collaboration? ✔✔the px

T/F: the college sets fees for practitioners to charge ✔✔F

T/F: px must be told the amount of the practitioner fees before the service is provided ✔✔T

T/F: a practitioner must provide an itemized bill for any px who asks ✔✔T

No fee can be billed when no service was provided. What are the exceptions to this? ✔✔1. px misses an appointment

2. cancels the appointment on very short notice

• provided the px is notified in advance that cancellation fees may apply

T/F: practitioners may offer a reduction in the amount of a bill if it is paid immediately ✔✔F

T/F: A practitioner may not charge interest on overdue accounts even though there is a cost to practitioners in collecting them ✔✔F: a practitioner can charge interest in overdue accounts because there is an actual cost to practitioners in collecting them

T/F: Services provided by a practitioner to himself or family members are covered by MSP ✔✔F

What does MSP stand for? ✔✔medical services plan

List the sources of law and explain the differences between them ✔✔1. Statutes (Acts): Charter of Rights and Freedoms, Human Rights Code, HPA, HCCFAA

2. Regulations: made by the minister of health services; The TCMP and Acupuncturists Regulation
3. Bylaws: proposed by the college board and require the approval of the health minister; deal with the internal operations of the college and obligations of practitioners; professional liability insurance, info practitioners must provide etc.
4. Case Law: important in guiding the procedure of college committees; court decisions are used as a guide by lawyers and judges when similar issues arise in the future.
5. Guiding Documents: college publishes official documents; practice standards; help practitioners interpret the law

What is the HPA? ✔✔Health professions Act

-sets out the duties and responsibilities of the minister of health services and the colleges.

-reporting obligations of practitioners

-lists the bylaws the colleges have the authority to make

-processes for reviewing decisions

T/F: Scope of practice statements do not exclude other regulated professions or unregulated persons from providing services that fall within a particular professions scope of practice ✔✔T

Define scope of practice ✔✔what each professions does and how they do it

define restricted activities ✔✔list of invasive, high risk activities that must not be performed by any person except members of a regulated profession that has been granted specific authority to perform these activities

What are standards, limits and conditions in relation to restricted activities ✔✔identify the terms under which restricted activities can be performed

standards: required level of performance (ex: consent)

limits: specify the limitations on what the practitioner may do (ex: putting wax in the ear canal up to the ear drum)

conditions: circumstances required for a practitioner to perform a restricted activity (ex: certification)

T/F: If a person is not from one of the approved health professions, they cannot use the title (Dr.) in a clinical setting even if the person has earned a doctoral degree ✔✔T

T/F: practitioners can use titles or designations inferring specialist status or certification ✔✔F: Practitioners are free to describe their areas of practice so long as it does not imply specialist status or certification

Both the ______ and ______ provide immunity to practitioners who make a mandatory report in good faith ✔✔1. HPA

2. case law

T/F: mandatory reporting create an exception to the practitioners duty of confidentiality ✔✔T

T/F: a written report of sexual misconduct cannot contain the px name unless the patient agrees IN WRITING that the name can be included. ✔✔T

Who do you report sexual misconduct to? ✔✔Written report to the Registrar of the College to which the practitioner belongs

T/F: A practitioner must report to the College if they terminate the employment of another health care provider, revoke, suspend or impose restrictions on a provider, or dissolve partnership or

association with that person. The practitioner must make a report even if the person quits or resigns first. ✔✔T

The HPA requires that the public have access to certain info about practitioners (6): ✔✔1. name

2. business address and telephone number
3. name, business address and telephone # of each professional corp
4. class of registration
5. any limits or conditions on registration
6. Cancellations or suspensions of registration

___________________ designates TCM and acupuncture as a health profession and establishes the college to govern the profession ✔✔Traditional Chinese Medicine Practitioners and Acupuncturists Regulation

T/F: R.Ac may administer acu as an anesthetic only if a medical practitioner or dentist is physically present and observing ✔✔T

T/F: there is no need to refer a px if there is no improvement in the condition you are treating within 2 months ✔✔f: must advise the px to consult medical practitioner if there is no

improvement in 2 months. If the px does not consult a medical practitioner, the R.Ac must discontinue tx if there is no improvement in 4 months, new symptoms arrive or the condition worsens

Bylaw vs regulation ✔✔bylaw: made directly by the board of the college; relate to administration and internal affairs

regulation: is made by the Cabinet or a minister of the provincial gov't; deal with issues of broader public concern

What is the Labor Motility Act? ✔✔allow for out-of-province registrants from elsewhere in canada to transfer to BC with recognition of their qualifications

How long do registrants have to retain personal info? ✔✔10 years or 10 years from 19th bday

How many days does the practitioner have to comply with a request for access to personal info from a px? ✔✔ 45

Under what conditions can a practitioner refuse access to patient files? ✔✔1. significant likelihood of an adverse effect on px

2. likelihood of harm to 3rd party
3. disclosure could be expected to disclose personal info regarding another individual

Amount registrants must be insured for (liability for negligence) ✔✔$1,000,000 per occurrence

failure to have professional liability insurance would constitute... ✔✔professional misconduct

T/F: reminding existing px of appointments, new developments or changes in the office is solicitation ✔✔F

Failure to make and keep adequate records is a failure to maintain _____________ and is ___________? ✔✔1. minimum professional standards

2. professional misconduct

What info needs to be on every doc within a px file? ✔✔identifying info such as name, DOB, contact info, practitioner

What info should be included in a px file? ✔✔1. identifying info

2. practitioner
3. subjective and objective info
4. findings from assessments
5. results of testing
6. summary of px problems and tx plan
7. actual tx provided
8. progress notes, reassessments and modifications to tx plan
9. if px was referral - who made referral
10. referrals
11. consent

T/F: Practitioners need to keep records for 10 years from last interaction. What constitutes an interaction? ✔✔contact with patient

phone call

email

When a practitioner retires how long should the px record be kept? What is the exception? ✔✔ 10 years unless the file is transferred to a new practitioner

*px must be notified of the transfer

• if the px has been referred but the file not transferred, then the file must be kept 10 years

Except: legal compulsion (in which case the practitioner must keep a legible copy

How do you get rid of px records properly? ✔✔shredding

electronic destruction

How do you properly protect patient records? ✔✔Lock and key

password protected

firewall and virus protection

backed up regularly

What act gives px access to their files and correct any errors? ✔✔Personal Info Protection Act (PIPA)

If it appears that the applicant does not meet the registration requirements the Registrar will refer the application to the ______ ✔✔Registration Committee

If registration is not granted by the Registration Committee, the applicant may seek review by the _______ ✔✔Health Professions Review Board (HPRB) (independent of the college)

What is the Inquiry Committee? ✔✔-is the statutory committee of the college that handles member specific concerns

-involved in allegations regarding professional misconduct, incompetence, or incapacity

-is a screening body

-cannot find wrongdoings or impose disciplinary sanction (only the discipline committee)

How many does does the college have to complete an investigation after a complaint is filed? ✔✔120 days

What actions can the IC do? ✔✔-no action if the complaint is frivolous

-mediation between parties

-seek a consent order from the member

-referral to discipline

-in serious cases it may make an interim order (suspension of registration)

What three things must happen before a Discipline Hearing Begins? ✔✔citation issued

disclosure of info

Chair of discipline selects a panel

In a discipline hearing who presents their witnesses first? ✔✔The college

the discipline committee can impose a fine of up to... ✔✔35,

The _______ has the power to confirm, vary or reverse a decision of the Discipline Committee ✔✔Supreme court

What should a practitioner privacy policy include? ✔✔how px personal info will be protected

how and when personal info will be collected, used and disclosed

T/F: personal info may be disclosed for the purpose of contacting substitute decision maker ✔✔T

How many days does a practitioner have to respond to a written request to correct personal info? ✔✔30 days