Health Care Consent Act (HCCA) & Substitute Decision Makers Act (SDA) – OT/PT Lecture

Vocabulary flashcards covering core legal terms, consent principles, capacity rules, and professional standards discussed in the OT/PT lecture on the Health Care Consent Act and Substitute Decision Makers Act.

Health Care Consent Act (HCCA)

1992 Ontario law that protects patient rights and autonomy by setting rules for consent to (1) health-care treatment, (2) admission to long-term-care, and (3) personal assistance services.

Substitute Decision Makers Act (SDA)

1996 Ontario statute that sets out how substitute decision-makers for personal care or property are appointed through powers of attorney, the Public Guardian and Trustee, or court order.

Informed Consent

A process in which a patient (or SDM) receives and understands information about scope, purpose, risks, alternatives, consequences of not proceeding, payment, and right to withdraw before agreeing to treatment.

Implied Consent

Consent inferred from a patient’s actions or cooperation in low-risk situations; still requires the patient to be informed.

Express (Explicit) Consent

Direct verbal or written agreement to treatment, typically used for higher-risk or invasive procedures.

Capacity (Decision-Specific)

The patient’s ability to understand information relevant to a particular treatment decision and appreciate the reasonably foreseeable consequences of giving or refusing consent.

Substitute Decision-Maker (SDM)

Person authorized under the HCCA/SDA hierarchy to make health-care or personal-care decisions when the patient is incapable.

SDM Hierarchy – Top Rank

1) Court-appointed Guardian of the Person has first priority to decide for an incapable patient.

Attorney for Personal Care

Individual named in a power of attorney document to make personal-care decisions if the grantor becomes incapable; second in the SDM hierarchy.

Consent and Capacity Board (CCB) Representative

A person appointed by the CCB to act as SDM when needed; third in the SDM hierarchy.

Public Guardian and Trustee (PGT)

Government office that acts as SDM of last resort when no higher-ranked SDM is available or when equally ranked SDMs disagree.

Emergency Treatment (HCCA)

Immediate care allowed without full consent if delay risks serious bodily harm or severe suffering and consent cannot be obtained in time.

Withdrawal of Consent

Patient’s right to stop treatment at any time; the provider must cease services unless stopping immediately would cause serious risk.

CPO Standard for Consent (2024)

College of Physiotherapists of Ontario guideline outlining ten elements that must be discussed to obtain informed consent.

COTO Standard for Consent (2023)

College of Occupational Therapists of Ontario guideline listing required consent elements and documentation for OT services.

OTA/PTA Role in Consent

Assistants may explain service details but the supervising OT/PT must confirm the patient’s understanding and agreement.

Risk–Alternative–Benefit–Questions (RABQ) Tip

Documentation mnemonic: record Risks, Alternatives, Benefits, patient Questions & risks of no service when noting consent discussions.

Capacity Assessor (SDA)

Trained professional authorized to evaluate ongoing capacity for personal-care or property decisions under the SDA.

Guardian of the Person

Court-appointed individual with authority to make personal-care decisions, ranking first in SDM hierarchy.

Power of Attorney for Personal Care

Legal document naming someone to act on personal-care matters once the grantor becomes incapable, unless stated otherwise.

Joint Custody (Children)

Family-law arrangement where both parents share decision authority; healthcare providers should obtain consent from both if disagreement is suspected.

Access Parent

Parent with right to health information but not to give or refuse consent when sole custody belongs to the other parent.

Decision-Specific Capacity Assessment

OT/PT’s duty to evaluate capability for each separate treatment; a patient may be capable for one service but not another.

Good-Faith Acceptance

HCCA principle allowing clinicians to rely on a person’s claim to be SDM unless there is reason to doubt it.

Emergency Diagnostic Examination

Assessment that may proceed without consent if reasonably necessary to determine whether an emergency exists.