Physician obligations and rights

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Updated: October 24, 2022

Understanding your professional obligations and rights in the context of COVID-19 helps to focus on providing quality care and reduces your medico-legal risk.

FAQ


I have heard Bill C-3 will enhance protections for healthcare workers and patients accessing healthcare services. How can this legislation help protect me, my patients and my colleagues in the context of the COVID-19 pandemic?

Bill C-3 amends the Criminal Code to create a new intimidation offence to prohibit conduct intended to provoke fear, to interfere with the duties of a health care worker, or to impede a person from receiving health care services. The Bill also makes it an offence to intentionally obstruct or interfere with another person’s access to a place at which health services are provided. Bill C-3 does not, however, prohibit individuals from peacefully protesting, even if this activity has a minor impact on the ability of others to access the facility.

Given the novelty of Bill C-3, it is uncertain how it will ultimately be applied and enforced. In the context of the pandemic, the provisions of Bill C-3 could apply to persons demonstrating outside a health facility and purposefully obstructing a healthcare worker or patient from accessing the facility, such as protests outside hospitals held by people opposed to vaccination and other public health measures related to the pandemic. It could also apply to patients trying to intimidate healthcare providers with respect to the implementation of public health measures. Additionally, it could apply where patients are trying to access other health services (e.g. abortion).

Members concerned about their safety for any reason (including intimidating or threatening conduct) in any setting are encouraged to contact police. Members working in a hospital or other facility who are concerned about intimidating or threatening conduct may also wish to consult with their hospital or health facility to inquire whether a policy or procedure has been implemented with respect to the enforcement of Bill C-3. Where it is necessary to make a report to police about a patient, members should minimize the disclosure of personal health information to only the information that is required to make the report.

Members who feel their safety is threatened are also encouraged to contact the CMPA for case-specific advice. Where appropriate, the CMPA will assist members to ensure steps are taken to minimize the risk of harm caused by intimidating and threatening behaviour that creates significant concern for personal safety.


Can I be exempted from the hospital/health authority/clinic requiring me to undergo COVID-19 testing, be vaccinated or adjust/remove religious symbols to ensure proper fitting of protective gear (e.g. shaving facial hair, removing head or face coverings, etc.)?

The CMPA does not typically comment on, or become involved in, public health or policy decisions of hospitals, health authorities or clinics. However, institutions generally have a right to restrict physicians from exercising their privileges if they believe the physician’s actions are posing a reasonable risk to patient safety or workplace safety.

Physicians are encouraged to reasonably consider any hospital/health authority/clinic policy that applies to them, bearing in mind their ethical, professional and legal obligations, including their fiduciary duty to their patients to act in good faith, with loyalty, and not to place his or her own personal interests ahead of patient safety.

Physicians may wish to contact their provincial/territorial medical association for additional guidance and information on these issues.



Can I be exempted from the requirement to self-isolate if I recently returned from out-of-country travel?

Physicians are encouraged to monitor and comply with federal government travel requirements, public health directives in their particular province or territory, as well as guidance from their College and hospital.



What are my obligations if I become aware that I have been exposed to a COVID-19 positive individual?

Physicians should take appropriate steps if they suspect they may have been exposed to or are infected with COVID-19. This includes following all applicable public health recommendations and notifying appropriate third-parties such as public health and their institution. Before returning to practice, physicians are encouraged to monitor and comply with all relevant public health directives, as well as guidance from their College and hospital.

A physician may be found to have breached his/her duty of care to patients for continuing to provide medical services and prevent transmission of the virus where the physician suspects he or she has COVID-19 or has been diagnosed with COVID-19 and patients are subsequently infected. These circumstances may lead to a legal claim, hospital complaint, or College proceedings.

If a physician is required to self-isolate due to unprotected exposure or a positive screening test, the Colleges generally expect physicians to take reasonable steps to ensure patients still receive appropriate care. These steps might include relying on virtual care where possible, coordinating with colleagues to help provide coverage (virtually or in-person), re-directing patients appropriately, and supporting patients as much as possible to access care the physician is not able to provide.



I have been asked to complete requisitions for COVID-19 testing for staff of the long-term care home, clinic or healthcare facility in which I work. What are my obligations towards these staff members if I complete these requisitions?

Whenever a physician orders a test for an individual, the physician will be generally considered to have entered into a doctor-patient relationship. Once a doctor-patient relationship is established, a duty of care arises. Accordingly, a physician agreeing to order COVID-19 testing for staff will need to be in a position to fulfill the obligations flowing from this duty. Physicians should not be agreeable to having their names included on requisitions if they cannot fulfil these obligations.

Specifically, physicians who complete requisitions would be responsible for reviewing the test results and following up with the patient/staff member. Physicians will also need to create a medical record and document the fact that the test was ordered, the results of the test and the recommended follow-up.

Physicians who have been asked to order COVID-19 tests for staff will want to work with the administration at their facility to determine the best way to communicate test results, ensure appropriate follow-up and properly document these encounters.