Ethics

      Code of Ethics for All Canadian Physiotherapists

    Purpose

    A code of ethical conduct sets out the ethical principles governing the conduct of members of the physiotherapy profession in Canada. It is a moral anchor that assures clients, the public, and other health care providers that members of the profession strive for the highest standards of ethical conduct. The code must reflect the societal ethics of the time, as well as the value systems and moral principles of the physiotherapy profession in Canada. The Code of Ethical Conduct applies to members of the physiotherapy profession in all contexts of practice and through all stages of their careers. It must always be used in conjunction with relevant federal and provincial legislation and with regulations, policies, procedures, and standards that regulate professional practice.

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    How to Use the Code of Conduct

    The Code does not tell practitioners exactly how to act in every situation, rather it provides a benchmark against which to measure ethical decisions in every-day practice and in highly complex situations. In every situation, however, it is the duty of members of the profession to act in an ethically responsible manner, using the principles of the Code to guide ethical conduct. As ethical decision-making is often an interdisciplinary issue, practitioners are encouraged to seek additional advice or consultation when ethical decisions are unclear. Members of the physiotherapy profession should be able to articulate their rationale for all ethical decisions and should take responsibility for their decision-making and actions.

    Ethical Principles and Professional Values

    Ethical principles form the foundation of ethical conduct and provide guidance along the pathway to ethical decision-making. While there are several approaches to ethical principles, this document uses the classical ethical principles described below as a basic guide to ethical conduct. Emphasis is on the pursuit of excellence in all professional activities, as well as the ability to act with integrity, accountability and good judgment in the best interests of the client, the public, the individual (self) and the profession. 

    Respect for Autonomy states that people should be allowed to make decisions that apply to their lives and to have control over their lives as much as possible. Autonomy requires a physiotherapist to respect a client’s freedom to decide for themselves and includes obtaining informed consent. 

    Beneficence guides the practitioner to do what is good with respect to the welfare of the client. In physiotherapy practice, the physiotherapist should provide benefit to the client’s health. 

    Least Harm deals with situations in which none of the choices available are judged to be the best. In this case, a practitioner should choose to do the least harm possible and to do harm to the fewest people. For physiotherapists this may mean recommending an intervention that is the best of two alternatives even though both alternatives may have negative side effects.

    Justice requires that the actions chosen are objective and equitable to those involved. An ethical decision that relates to justice has a consistent logical basis that supports the decision. For physiotherapists, justice relates to treating people fairly and to allocating resources fairly between clients.

    In addition to the ethical principles, there are several professional values that help to support ethical conduct in the profession - these are the values that underpin and motivate a member of the physiotherapy profession’s efforts every day and inspire all of their actions. The key values include responsibility, excellence, trustworthiness, honesty, integrity, professionalism, citizenship, respect, dignity, communication, collaboration, advocacy, transparency, and well-being.

    The ethical responsibilities below are described under three headings: those that apply to the client; those that apply to the public; and those that apply to the individual practitioner (self) and the profession. Ethical responsibilities are intended to serve as a guide to ethical conduct. They will not all apply all of the time nor in all situations, but they should serve as a reference to guide to sound ethical conduct and to help to prevent unethical behaviours and choices.

    A. Responsibilities to Clients

    Members of the physiotherapy profession have an ethical responsibility to:

    1. Demonstrate sensitivity toward individual clients, respecting and taking into consideration their unique rights, needs, beliefs, values, culture, goals, and environmental context.

    2. Act in a respectful manner and do not refuse care or treatment to any client on the prohibited grounds of discrimination as specified in the Canadian Human Rights Act as well as on the grounds of social or health status.

    3. Work in partnership with clients to improve, support and/or sustain their health status and well-being.

    4. Maintain professional boundaries that honour and respect the therapeutic relationship with clients.

    5. Communicate openly, honestly and respectfully with clients at all times.

    6. Respect the principles of informed consent including by explaining service options, risks, benefits, potential outcomes, possible consequences of refusing treatment or services, and by avoiding coercion.

    7. Treat clients only when the diagnosis or continuation of the intervention warrants treatment and is not contraindicated.

    8. Respect and support the autonomy of the client to participate in the management and decision-making relating to their own health.

    9. Provide an alternative treatment option through referral to another health care provider/physiotherapist if the therapeutic relationship is compromised.

    10. Respect the confidentiality, privacy, and security of client information in all forms of communication.

    11. Use electronic communication and social media and other forms of digital technology professionally and respectfully, conforming to confidentiality guidelines.

    12. Practice in a safe, competent, accountable and responsible manner during the provision of services.

    13. Take all reasonable steps to prevent harm to clients. Should harm occur disclose it to the client and others as required.

    14. Take responsibility for the client care delegated to students and other members of the health care team.

    15. Practice the profession of physiotherapy according to their own competence and limitations, referring the client to others as necessary.

    16. Practice collaboratively with colleagues, other health professionals and agencies for the benefit of clients.

    17. Enhance their expertise through lifelong acquisition and refinement of knowledge, skills, abilities and professional behaviours.

    18. Comply with all legislation, guidelines, and regulatory requirements that pertain to the profession of physiotherapy.

    B. Responsibilities to the Public

    Members of the physiotherapy profession have an ethical responsibility to:

    1. Conduct and present themselves with integrity and professionalism.

    2. Respect diversity and provide care that is both culturally sensitive and appropriate.

    3. Advocate within their capacity and context to address clients’ needs and the broad determinants of health and to improve the standards of health care.

    4. Work effectively within the health care system and manage resources responsibly.

    5. Act transparently and with integrity in all professional and business practices including fees and billing; advertising of professional services; and real and/or perceived conflicts of interest.

    6. Assess the quality and impact of their services regularly.

    7. Be professionally and morally responsible for addressing incompetent, unsafe, illegal, or unethical practice of any health care provider and legally responsible for reporting conduct that puts the client at risk to the appropriate authority/ies.

    8. Take responsibility for their own physical and mental health and refrain from practicing physiotherapy while their ability to provide appropriate and competent care is compromised.

    C. Responsibilities to Self and the Profession

    Members of the physiotherapy profession have an ethical responsibility to:

    1. Commit to maintaining and enhancing the reputation and standing of the physiotherapy profession, and to inspiring public trust and confidence by treating everyone with dignity and respect in all interactions.

    2. Commit to lifelong learning and excellence in practice.

    3. Act honestly, transparently and with integrity in all professional and business practices to uphold the reputation of the profession.

    4. Recognize the responsibility to share evidence-informed and clinical best practices in physiotherapy with each other and other health care professionals.

    5. Contribute to the development of the profession through support of research, mentoring, and student supervision.

    6. Refrain from harassment, abuse or discrimination of colleagues, employees, or students.

    7. Attend to their own health and well-being.

    Version

    Adopted November 2017
      NSCP Conflict of Interest Board Policy

Introduction

The purpose of this document is to assist individuals who make decisions on behalf of the NSCP. While many of us are familiar with the Code of Ethics that relates to our professional role, this document highlights those issues related to the organizational and decision making operation of the NSCP.

The document aims to assist individuals making decisions on behalf of NSCP to identify where questions of ethical conduct may arise and to provide a process to manage them and this protects both the individual and the NSCP. It is an important safeguard that fair and due process be in place before it is needed.

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Affiliation

While in most situations an individual’s affiliation with other organizations should be of no consequence to the best interests of NSCP, the principles outlined below will be used to record potential and perceived conflict of interest.

Individuals who make decisions on behalf of NSCP will:

1) be in good standing with the College

2) decline or resign membership in any organization whose aim and objectives are in conflict with those of NSCP.

Confidentiality

NSCP values the principles of openness and transparency. At issue is the degree of confidentiality required in its discussions and decisions. The degree of confidentiality must balance the need to be accountable to the public. Discussions within meetings shall remain confidential – meeting notes and minutes shall not be circulated beyond participants until approved by the NSCP for circulation. Confidentiality declaration shall be completed- See Appendix 1.

Conflict of Interest

The decisions made on behalf of NSCP should not be compromised by the real or potential conflicts of a decision maker. Conflict of interest is broadly defined as a situation in which an individual making a decision could be influenced or perceived to be influenced by their personal, financial, business or other concerns, which are not in the best interests of NSCP.

- An individual shall not use his/her position with NSCP or knowledge gained therein in such a manner that a conflict between the interests of NSCP and his/her personal interests arises;

- The interest of NSCP must come foremost;

- NSCP prohibits the conduct of personal business between individuals making decisions on behalf of NSCP except when approved and based on documented policy;

- If an individual making decisions on behalf of NSCP has an interest in a proposed decision or transaction of NSCP in the form of a significant personal financial interest or in any organization involved in the decision, or holds the position in any such organization, he or she must disclose that conflict of interest and withdraw before any or negotiation of such decision.

Avoiding Conflict of Interest

To assess the potential for conflict of interest in any set of circumstances an individual should reflect on the answers to two questions:

1) Am I able to act impartially?

2) Would a reasonably informed person with access to the same information also be confident that the relationship would not impact negatively on my ability to act impartially?

If your answer to either question is ‘no’ then you should decide a conflict of Interest. If you are uncertain seek advise of Chairperson who in order to not involve themselves, may refer to legal counsel.

Individuals who are in conflict of interest shall not participate in a decision or be present for the discussion or vote related to the item on which they are conflicted, where a conflict of interest has been declared.

Responsibility

All Board members will be oriented to this guideline as soon as possible after their appointment and prior to participating in their first formal meeting. They are required to review this guideline and sign the confidentiality agreement.

If one individual perceives that another has breached the policy, he/she is responsible for discussing that perceived breach directly with the affected individual. If a corrective action is planned than the perceived breach should be reported to the Executive Director, unless the individual in breach is the Executive Director, then it should be reported to the Chairperson.

Confidentiality Agreement