Conflict of Interest
A conflict of interest exists when an RT is in a position where their professional judgement, or duty to their patient/client could be compromised, or could be perceived to be compromised, by a personal relationship, commercial interest or financial benefit. A conflict of interest may be actual, potential or perceived.
Actual Conflict of Interest – means that something has happened to influence an RT’s professional judgment during their practice.
Potential Conflict of Interest – occurs when a reasonable person, would conclude that an RT might fail to fulfill their professional obligation to act in the best interest of the client.
Perceived Conflict of Interest – where a reasonable person may conclude that the RT’s professional judgment has been improperly influenced, even if that is not actually the case.
A benefit may be described as a financial or non-financial consideration that might directly or indirectly influence, or appear to influence, an RT’s professional judgment and/or objectivity.
Financial Benefit – considered a tangible conflict because it can be seen and measured (e.g., rebate, credit, gift, profit, business interests).
Example… Being offered a commission for every patient that is added to a company’s roster.
Non-Financial Benefit – may include a personal gain or advantage that may influence treatment decisions or clinical activities (e.g., a patient/client provides an RT with a letter of reference for a research grant application).
A conflict of interest cannot be avoided by moving the benefit to a related person or a related company. In other words, in considering whether or not an actual, potential or perceived conflict of interest exists, an RT must acknowledge that benefits to a related person or a related company are also benefits to them.
Agreement: a revenue, fee or income sharing arrangement.
Fiduciary: a relationship based on trust and confidence
Member: refers to a Respiratory Therapist (RT) who is registered with the CRTO as either a Registered Respiratory Therapists (RRT), Practical (limited) Respiratory Therapist (PRT) or Graduate Respiratory Therapists (GRT).
Professional misconduct: as defined in the Professional Misconduct Regulation (O. Reg. 753/93), which was established under the Respiratory Therapy Act.
Reasonable person: an individual who is neutral and informed
Relationship: in the course of their practice, RTs engage in therapeutic (patient/client) and professional relationships (students, colleagues, coworkers) .
Related person: means any person connected with a member by blood relationship, marriage, common-law or adoption, and
- persons are connected by blood relationship if one is the child or other descendant of the other or one is the brother or sister of the other;
- persons are connected by marriage if one is married to the other or to a person who is connected by blood relationship to the other;
- persons are connected by common-law if the persons have, for a period of not less than three years, cohabited in a relationship of some permanence; and
- persons are connected by adoption if one has been adopted, either legally or in fact, as the child of the other or as the child of a person who is so connected by blood relationship.
Related company: means a company, corporation or business partnership or entity that is owned or controlled, in whole or in part, directly or indirectly, by a person or another person related to the person.
- College of Nurses of Ontario. Professional Conduct (2019). Retrieved from: https://www.cno.org/globalassets/docs/ih/42007_misconduct.pdf
- College of Physicians and Surgeons of Ontario. Physicians’ Relationship with Industry: Practice, Education and Research (2014). Retrieved from: https://www.cpso.on.ca/en/Physicians/Policies-Guidance/Policies/Physicians-Relationships-with-Industry-Practice
- General, O Reg 596/94, retrieved on October 20, 2021. Retrieved from https://canlii.ca/t/527jh
- Institute of Medicine (US) Committee on Conflict of Interest in Medical Research, Education, and Practice; Lo B, Field MJ, editors. Conflict of Interest in Medical Research, Education, and Practice. Washington (DC): National Academies Press (US); 2009. Summary. Retrieved from: https://www.ncbi.nlm.nih.gov/books/NBK22926