Illustrations of When a Conflict of Interest is Unlikely

1. An RT offering or availing themself of a hospitality suite or hospitality food and beverage that a broad group of individuals have unrestricted access to.

2. Soliciting, offering, or accepting pens, paper or other reasonable or incidental items or gifts of a promotional nature at a conference.

3. Soliciting, offering, or accepting entertainment or hospitality that is not related to any exercise of professional judgment as a respiratory therapist (e.g. a vendor of respiratory therapy equipment offers you tickets to an entertainment event and you are not in a position, or perceived to be in a position, to influence the purchase of equipment).

4. Accepting reasonable, usual and customary hospitality (e.g. attending a holiday party given by a company).

5. Referring a patient/client to a home care company that has an agreement with the RT’s hospital but that offers no direct benefit to the RT specifically*.

* PLEASE NOTE…

Even in situations where the RT does not receive a benefit, there remains a professional obligation to put the interest of the patient/client above any personal or organizational interests.

Scenario:

A staff RT works for a hospital that has a revenue sharing agreement with a respiratory home care company that maintains an office in the building. While they have not stated it outright, the hospital’s management team has implied that they would like the RTs to encourage patients/clients to use this particular company.

What do you do?

It is the RT’s responsibility to protect the interest of their patients/clients, and not allow themselves to be placed in a conflict of interest situation. Therefore, it is advisable to have a process in place that requires the RTs to disclose the hospital’s relationship with that particular home care company and allow the patients/clients to choose another company if they wish. The patient/client must also be assured that the care they receive will be in no way impacted by their decision to employ the services of a different home care company.

Glossary

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.

REFERENCES

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