Guide to Medical Directives and Delegation
This Guide has been developed to address questions regarding the use of orders and delegation to facilitate interprofessional care by health practitioners practicing in any setting. It is designed to complement and assist with fulfilling guidelines, standards, and regulations developed by each health professional college.
The Guide is based on a framework of the fundamental cornerstone of health professional practice: patient interest and public protection achieved by regulated health professionals practicing independently and in teams in accordance with regulatory and legislative expectations for practice.
Interprofessional Collaboration (IPC) eTool
(This eTool is currently being updated and will be reposted soon.)
Consent and Capacity Resources
Resources for health professionals, helping to fully understand legal and professional obligations for obtaining consent in practice settings
Obtaining Informed Consent to Treatment
Every health care practitioner must obtain informed consent to treatment. Consent is not just about having someone say yes, sign a form or check a box. Consent is not always straightforward and can be challenging. Always confirm that you have obtained an informed consent to treatment.
Know Your Professional Obligations
- Follow the Health Care Consent Act, 1996.
- Review your College’s resources about consent.
- Reflect on your practice and stay current.
- Provide the necessary information to patients, including the treatment plan, risks, benefits.
- Answer all questions.
- Respect a patient's right to refuse treatment.
- Provide an emotionally and physically safe environment for all patients: recognize how power imbalances, cultural, social and historical contexts can affect a patient's ability to make an informed decision about their health.
Confirm Capacity to Consent
- It is the responsibility of the healthcare professional who is proposing the treatment to determine if a person has the capacity to consent or refuse treatment. See Myths and Facts for Capacity to Consent to Treatment.
- Presume a person is capable of consent unless there are reasonable grounds to believe they are incapable. A patient is capable if they are able to understand the information relevant to making a treatment decision and the consequences of a decision or lack of decision. See Definitions for Consent to Treatment.
- If a person is deemed to be incapable, obtain an informed consent from their substitute decision-maker. See Capacity Tree.
- Presume a person is capable for any new decision regarding their care. A person may be incapable of consenting to some treatments and capable of consenting to others or may be incapable of consenting at one time and capable at another.
- If a person is incapable of making an informed consent for treatment, make sure you know their rights. See A Person’s Rights When Found Lacking in Capacity for Consent to Treatment.
- Plan ahead. Build consent discussions into your appointment schedule.
- Choose an appropriate time and place for consent discussions.
- Don't rush the consent discussion. Consent may require several conversations.
- Ask what support patients/substitute decision-makers may need to help them make an informed decision, e.g., an interpreter, family member.
- Use plain language and simple terms.
- Provide information in more than one format, e.g., oral, written or visual supports.
- Help patients communicate their decision.
Collaborate & Lead the Change
- Know the team processes and expectations for obtaining informed consent in your practice setting.
- Know when one health practitioner may obtain consent on behalf of all practitioners involved in the plan of treatment.
- Where gaps exist, advocate for clear processes that ensure informed consent is obtained.
- Work with colleagues to change workplace culture and make consent part of team practices.
- Communicate with your colleagues.