News Release

Enhancing End-of-Life Care Guidance and Greater Protection from Sexual Abuse

Sep 14, 2015

The Council of the College of Physicians and Surgeons of Ontario took two major steps today to further support and protect patients.

The updated Planning for and Providing Quality End-of-Life Care policy sets expectations of physicians regarding planning for and providing quality care at the end of life to ensure patients receive care that aligns with their wishes, values and beliefs.

The policy underwent an extensive public consultation. A key feature of the revised policy is expectations regarding the provision of life-saving and life-sustaining treatments that have been significantly updated.

Physicians must obtain consent in order to withdraw life-sustaining treatment, the policy states, which is due in part to the Cuthbertson v. Rasouli Supreme Court decision. The revised policy also requires physicians to engage patients in a discussion before writing a no-CPR order and engage in conflict resolution if there is disagreement. While the conflict resolution process is underway, if an event requiring CPR occurs, physicians must provide CPR.

“Quality end-of-life care aims to reduce suffering, respect the wishes of patients, and lessen conflict and distress,” said College President Dr. Carol Leet. “This policy guides physicians in assisting patients to identify meaningful and realistic goals of care that are compassionate, respectful and seek to incorporate their wishes, values and beliefs.”

Council also made a number of decisions and recommendations to protect patients from physician sexual abuse and ensure their voices are heard during the College’s investigations and discipline processes.

This includes a number of proposed changes to strengthen the Regulated Health Professions Act.

A key proposed amendment is mandatory revocation of a physician’s certificate of registration for all sexual contact between a physician and a patient. Currently under the RHPA, mandatory revocation of a physician’s certificate of registration is only for certain acts of sexual abuse. For sexual abuse that does not involve these acts, the penalty is at the discretion of the Discipline Committee.

Council approved a framework for guiding decisions to accept or order gender-based restrictions on a physician’s certificate. The College will carefully consider the use of this tool based upon the facts of the matter, the history of the matter and of the physician, and the statutory powers available to the College at that stage of proceedings to determine the risks and benefits of using a gender-based restriction.

Proposed amendments to the legislative framework were also approved that will enhance the therapy and counselling program for survivors of sexual abuse; posting a list of community services or agencies that offer support to sexual abuse victims on the College website; and the adoption of sexual abuse prevention principles.

“These changes will further bolster our ability to protect victims of physician sexual abuse and ensure they are heard and have support during the process, as well as, care in the aftermath of proceedings,” said Dr. Leet.

The Planning for and Providing Quality End-of-Life Care policy is now available, including answers to Frequently Asked Questions.

Backgrounder on Sexual Abuse.

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