Identifying a Conflict of Interest

The magnitude of the benefit is substantial (e.g., a full course meal with drinks at an expensive restaurant vs. muffins & coffee);

The benefit is personal (e.g., a cash donation given to a specific individual vs. the entire RT department);

There is no educational component (e.g., a department being offered lunch during RT week without any educational session vs. a lunch & learn); and

It involves a patient/client (or their family) where there is an ongoing professional relationship (e.g., a current home care patient/client offers their RT a piece of antique china vs. the family of a deceased patient/client offering the same gift in gratitude for the RT’s past services).

1. Why is this benefit being offered to me? (i.e., what advantage does this transaction provide to the person/organization proposing the benefit?)

2. Are there factors in this situation that influence, or might influence, my professional judgement and/or objectivity?

3. Is it possible that others might perceive that my professional judgement and/or objectivity is impaired?

1. Is my relationship with this patient/client purely professional?

Treatment of a Spouse*

The sexual abuse provision in the Regulated Health Professions Act (RHPA) [Schedule 2 s. 1(3)] prohibits healthcare professionals from treating their spouses in a professional capacity. In the RHPA, sexual abuse is defined by an action, not by the intent. In addition, under the RHPA’s definition of sexual abuse, only a patient can be sexually abused. As such, regulated health professionals who provide treatment to their spouse, which then makes them their patient, fall within this definition. In other words, if a health professional is found to be treating their spouse (with whom they inherently have established a sexual relationship) they too would be subject to the mandatory revocation provisions of the RHPA. Therefore, a CRTO Member must not provide respiratory therapy services to their spouse.

* “spouse”, in relation to a Member, has been defined in the RHPA as:

(a) a person who is the member’s spouse as defined in section 1 of the Family Law Act, or

(b) a person who has lived with the member in a conjugal relationship outside of marriage continuously for a period of not less than three years.

Treating a sexual partner who does not meet the definition of a spouse under the RHPA will continue to be considered sexual abuse.

In addition, it is the view of the CRTO that RTs should avoid treating other family members as well. In providing treatment to a family member who is not a spouse, the Member risks not only being in an actual, potential or perceived conflict of interest, but they also risk a lack of objectivity that may affect their professional judgement. However, the CRTO recognizes that there may be circumstances where the RT is the only practitioner available to provide the necessary care, as is the case in sole-charge practice settings. In situations where it is in the patient’s best interest for the RT to treat a family member who is not their spouse, this may be permissible until such time as alternative care arrangements can be made. Emergency care of family members where no one else is available is acceptable because the benefits outweigh the “challenges posed by the personal relationship”. In such circumstances, the RT is encouraged to transfer care to an appropriate provider as soon as possible.

For more information on what constitutes sexual abuse, please see the CRTO’s Abuse Awareness & Prevention PPG.

2. Have I (or do I plan to) offer or receive a benefit (financial or nonfinancial) related to the referral of this patient/client to my practice or to the services that I provide?

3. Have I (or do I plan to) enter into an agreement (including related to my employment) that influences/appears to influence my professional judgement?

4. Have I (or do I plan to) engage in any form of revenue, fee or income sharing agreement that influences/appears to influence my professional judgement (O. reg. 596/94) s. 3(1)(g)?