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Colleges’ Codes of Ethics

Meeting Purpose

This meeting was part of a two-day conference on February 4th and 5th, 2021. The purpose of this day was to understand the public advisors’ expectations about colleges’ code of ethics.

Key messages from public advisors

  • Cultural safety and humility, and anti-racism should be included in colleges’ codes of ethics.
  • Presenting codes of ethics in plain language at public points of care can help to increase public awareness of colleges’ codes.              
  • One shared code of ethics that encompasses all health practitioners may be helpful for patients to know what to expect from practitioners.
  • Codes of ethics can be a resource that supports advocacy for self and others; colleges should invest in public education about this, through social media and public campaigns.

Responding to BC-PAN input

College partners spoke about how they used BC-PAN’s input from the previous meeting about social media and the complaints process.

Social Media

Kelly Newton, CPSBC Policy and Engagement Lead, gave a brief presentation connecting the colleges mandate to social media, as well as outlining steps taken following BC-PAN’s discussion.

  • Colleges’ overriding interest is the protection and safety of patients.
  • The use of social media raises important questions about a registrant’s professional, legal and ethical obligations.
  • CPSBC recently revised their Social Media professional guideline and used BC-PAN input to clarify that physicians and surgeons are expected to:
    • Maintain clear boundaries with patients.
    • Refrain from establishing online connections with patients on personal social media accounts and noted that in some circumstances it may be appropriate to connect with patients for professional purposes.
Complaints Process

Crystal Chung, CTCMA Director of Compliance, discussed the colleges’ actions regarding the complaints process.  

  • Colleges are responsible for ensuring practitioners provide qualified, safe and ethical care to the public.
  • Public advisors’ input will be shared with CTCMA and COTBC’s Inquiry Committee
    • CTCMA will also be sharing input with their Patient Relations Committee, and reporting to the board.
  • Public advisors’ input was shared with a research team facilitating the Complaints Process Quality Improvement Project.
  • BC-PAN feedback has been helpful in CPTBC’s work on reviewing and improving policies and procedures.
  • CDSBC has included additional research questions in their work on improving their complaints process following BC-PAN’s discussion.
  • CPSBC recently hired a Complaints Navigator who assists people in the complaints process.

Advisor questions and comments

  • How can we ensure that there is physical access for people as well as online?
    • People can call, mail complaint, or fill online. Colleges are working to make sure the public is more aware of the complaints process.
  • An advisor suggested that colleges identify a list of organizations who work with people with health issues to be advocates and work with people who have additional disabilities.

Meeting orientation: Colleges’ codes of ethics

Susanna gave a brief overview of the colleges’ codes of ethics and initiated a poll to introduce the day’s topic. She asked: Have you ever looked at a College’s Code of Ethics before preparing for today’s meeting?

  • Yes, more than a few times – 21%
  • Yes, one to a few times – 43%
  • No – 36%
  • Unsure – 0%

Context presentation: Codes of Ethics

Gillian Vrooman, COPBC Director of Communications and Engagement, gave a brief overview of codes of ethics for BC health regulators.

  • Setting, monitoring and enforcing professional ethics is part of a college’s duty, as written under the Health Professions Act.
  • Colleges use their expertise an understanding of the types of health professionals they regulate to determine how they should best ensure professional ethics.
  • Common aspects found in codes of ethics include acting in the best interest of the public, professional judgement, duty to provide care, conflicts of interest, and ethical business practices.
  • Having standards of professional ethics is essential for holding registrants accountable when they are not upheld.
  • Recommendations to modernize the provincial health profession regulatory framework includes identifying core elements of shared standards and ethics across professions to ensure consistency.

Advisor input: What would you expect to see in a health care profession’s code of ethics?

Public advisors participated in break out groups with college partners to discuss: What would like to see in a health care profession’s code of ethics?

  • Cultural safety and humility, and anti-racism.
    • Address power imbalances between patients and practitioners and improve health outcomes for marginalized patients.
  • Commitment to embedding code of ethics into training.
  • Respecting autonomy to make informed choices.
  • Compassionate care that seeks to understand the unique needs of each patient.
  • The health professional to be an advocate for the patient.
  • Executive summaries help to promote understanding to the public.
  • Addressing language, communication and cultural barriers.
    • Code of Ethics should be presented in ways that reflect different levels of literacy.
  • Signature of acknowledgement.

The public advisors utilized Mentimeter to rank what they believe the important concepts for BC health care codes of ethics are. The top ideas were:

  1. Providing care with respect, dignity, and without discrimination.
  2. Commitment to acting in the best interest for patients.
  3. Protecting patient’s confidentiality and obtaining informed consent.
  4. Recognizing the expertise and limitations of oneself and colleagues for the well-being of the patient.
  5. Compassionate care.
  6. Commitment to the respect for patients.

Other ideas not ranked as often were:

  • Professional honesty and integrity.
  • Maintaining a safe and healthy office environment.
  • Recommending evidence-based treatment.
  • Addressing the institutional, financial, social, political, or other factors influencing health and health care.
  • Transparency regarding fees charged to patients and being considerate about a patient’s ability to pay fees.

Public use of codes of ethics

College partners would like guidance on how to communicate these codes of ethics in a way that is useful to the public, and how codes of ethics can be used in the public’s health care experience.

Advisor input: Public use of codes of ethics

Public advisors participated in break out rooms where they discussed: Thinking about the purpose of a code of ethics, what could help the public benefit from a college’s code of ethics?

  • Information directed at the public about codes of ethics at key points of care. Ex. Clinics, offices, treatment rooms.
  • A standardized and consistent code of ethics to present to the public, regardless of profession, would be beneficial.
  • Ethics and regulatory bodies need to be integrated into the public life.
  • Codes of ethics can be helpful in identifying a complaint.
  • Presenting the code of ethics in plain language for the public to easily understand. 
  • Colleges should promote the idea that code of ethics display confidence in a health care practitioner and is a resource that supports advocacy for self and others.
  • Utilize social media for online public education on codes of ethics.