Professionalism Part 2-legislation W4:L2

Legislation and the MLT:

• Laboratory and Specimen Collection
Centre Licensing Act R.R.O. 1990,
Regulation 682
• Regulated Health Professions Act
1991
• Medical Laboratory Technology Act
1991

Laboratory and Specimen Collection Centre Licensing Act:

1. Responsible for LICENSING of laboratories

2. Defines “Health Professional” as a member of a
health profession COLLEGE

3. Lab Requires a Laboratory Director (medical practitioner
certified by Royal College of Physicians and Surgeons) in order to obtain a license

4. States that only approved (licensed) tests can be performed by a licensed facility

5. States causes for revocation or suspension of license

6. Defines and describes qualifications for

7. Ensures that staff

8. Designates the Ontario Medical Association (OMA) to carry out a quality management program

Laboratory Director:

person who is responsible for the administration
of the scientific and technical operation of a laboratory including the supervision of the test and the reporting of the results of the tests

Supervisor/technical specialist:

person who under the supervision of a laboratory director supervises laboratory personnel and who may perform tests requiring special scientific skills

Laboratory technologist:

person who under general supervision performs tests which require the exercise of independent judgment

Laboratory technician:

person who under direct supervision performs laboratory tests which require limited technical skill and responsibilities

The Regulated Health Professions Act 1991 (RHPA):

“It is the duty of the Minister to ensure that the health
professions are regulated and co-ordinated in the public
interest, that appropriate standards of practice are
developed and maintained and that individuals have access
to services provided by the health professions of their choice
and that they are treated with sensitivity and respect in
their dealings with health professionals, the Colleges and
the Board”

RHPA 1991 objectives:

• Protect the public from harm and from unqualified,
incompetent or unfit providers
• To promote safe, high quality health care
• To make regulated health professions accountable to the
public
• To provide patients/clients access to health care professions of
their choice
• To achieve equality and consistency by requiring all RHP to
adhere to the same purposes, procedures, and public interest
principles
• To treat individual patients/clients and health professionals in
an equitable manner

RHPA 1991: (2 elements)

1. Scope of practice statement
• describes the procedures, actions, and processes that a
healthcare practitioner is permitted to undertake in keeping
with the terms of their professional license

2. Identifies “controlled acts”: acts that only qualified
persons of RHP are authorized to perform as these activities
could cause harm to the public (13)

RHPA Controlled Acts:

Controlled act procedures can only be performed if the authority is given (authorized) under a specific health profession Act or if the authority is delegated

1. Authorized Act: a controlled act procedure, or a portion of a controlled act procedure, that is authorized to a specific profession to perform under the appropriate health profession Act (MLT Act).

2. Delegated Act:a controlled act procedure that is performed under the authority of delegation from someone who is authorized to perform the act

Medical Laboratory Technology Act 1991:

1. States which Controlled Act is authorized to MLTs
• RHPA Controlled Act #2: Performing a procedure on tissue below the dermis, below the surface of a mucous membrane, in or below the surface of the cornea, or in or below the surfaces of the teeth, including the scaling of teeth

2. Defines the Scope of Practice for MLTs:
• The practice of medical laboratory technology is the performance of laboratory investigations on the human body or on specimens taken from the human body and the evaluation of the technical sufficiency of the investigation and their results

MLT Act 1991:

3. States Authorized Acts in more detail
• In the course of engaging in the practice of medical
laboratory technology, a member is authorized, subject to
the terms, conditions, and limitations imposed on his or
certificate of registration, to take blood samples from
veins or by skin pricking

4. States EXEMPTIONS (being free from an obligation) to authorized acts

MLT Act 1991:

5. Established the College for MLTs!
7. States Restricted Title
8. States Representations of Qualification

Negligence:

(1) not doing something which a reasonable person would do, or
(2) doing something which a reasonable person would not do.
• Thus negligence can involve acts of commission and acts of omission

CIVIL Negligence:

lawsuit involves private individuals suing someone for a
negligent act that violates their private rights.
• Generally involves careless or ignorant behavior but not intent,
carelessly ramming a car stopped at an intersection

CRIMINAL Negligence:

more serious and involves committing a crime
against society and intending to commit it.
• involves wanton disregard for the safety or lives of others

Vicarious Liability:

The responsibility of the superior for the acts of their
subordinate!
• The employer is responsible and accountable for the actions of an employee (carrying out the wishes of the employer) while at
work.
• For an act to be considered within the course of employment it
must be authorised

Consent to Treatment:

Health Care Consent Act, 1996 (HCCA): applies to most health
professionals, including MLTs, and sets the requirements for
obtaining a patient’s consent for treatment

Principles of Consent in the HCCA:

• Patients have a right to decide what is done to them
• No treatment should be given to a patient without first obtaining
consent except in an emergency
• Consent must be informed, may be expressed or implied
• Consent may be withdrawn by the patient at any time
• Patients must be capable to consent to their own treatment
• If incapable, treatment decisions may be made by a substitute decision-maker

Treatment:

anything done for therapeutic, preventative, diagnostic,
cosmetic or other health related purpose

Capable:

able to understand the information that is relevant to making
a decision about treatment and able to appreciate the reasonable
foreseeable consequences of accepting or refusing treatment

“Incapable” patients may include minors, hearing impaired, legally not competent, physically unable to write, doesn’t speak language

Substitute decision-maker:

designated person who may make
treatment decisions for a patient deemed incapable.
• May be designated through power of attorney or chosen via hierarchy stated in HCCA
• Guardian, attorney appointed by patient while capable, spouse/partner, parent,
brother/sister, other relative, Public Guardian and Trustee

Informed Consent:

requires that capable patient is
given adequate info re the method, risks, and
consequences of a procedure before giving consent
• Must be non-technical and in language of patient

Expressed Consent:

required for high-risk procedures such as surgery, experimental drugs, research studies
• Written consent is best but verbal is acceptable if noted on patient’s chart
• Assumes capable patient w/informed consent

• What lab related procedures require expressed consent?
• Bone marrow aspirations, lumbar puncture for Sf, FNA, non-urgent blood transfusions

Implied Consent:

patient’s actions imply consent to treatment
extends arm during phlebotomy

Consent for Minors:

The HCCA does NOT state an age of consent!
• If minor is capable of making own treatment decisions then minor can give consent

Refusal or Withdrawn Consent:

patient has right to refuse or withdraw consent for a
medical procedure such as venipuncture

Health care personnel who violate consent to treatment regulations are liable for

Assault and Battery
• Assault: threat of violence
• Battery: physical violence

Confidentiality:

efers to the commitment to protect and safeguard personal information that is disclosed to you