Resumption of non-essential care

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Updated: October 1, 2021

A return to pre-COVID-19 medical services will require careful planning and prioritization to ensure the best possible care for all patients.

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FAQ


Non-essential medical services have resumed. Should I ask patients to execute consent forms and/or sign waivers for providing care in-person?

In resuming non-essential medical services, physicians will want to follow direction from their ministries of health, chief medical officers of health, and medical regulatory authorities (Colleges).

Physicians should document thoroughly the informed consent discussion with the patient regarding the material risks and benefits of the proposed in-person treatment, including the risks of contracting COVID-19. While consent forms are helpful as written confirmation that explanations were given and the patient agreed to what was proposed, a written consent form does not, in and of itself, fulfil the requirement for obtaining informed consent. The key for obtaining informed consent is a good discussion between the physician and patient. The physician must also answer any specific questions posed by the patient regarding the purpose and risks of the treatment. The patient must always be given the opportunity to ask these questions.

A physician’s obligations with respect to treatment and informed consent remain the same whether or not a waiver is signed by a patient. A court or College is unlikely to rely upon a waiver in determining a physician’s liability for an adverse patient outcome related to exposure to COVID-19 while providing care in-person. Some Colleges might also be critical of any attempt to obtain such a waiver.


How do I manage my medico-legal risks with the resumption of non-essential care?

It is expected that there will be only gradual movement to return to pre-COVID-19 medical services and the backlog of postponed care will be difficult to manage. Physicians will need to determine which medical services should be reintroduced and how care should be prioritized in their practices.

In resuming non-essential medical services, physicians will want to follow direction from ministries of health, chief medical officers of health, and the Colleges.

While virtual care may be appropriate in some cases, physicians will want to be mindful of its limitations and ensure patients are provided the opportunity for in-person care where appropriate. Physicians should document in the patient record their rationale for providing care in person or virtually.

Physicians will also want to continue working with other healthcare providers and administrators to appropriately manage scarce resources and wait lists during this period to ensure patient safety and reduce medico-legal risk. Regular communication with colleagues regarding ways to deal with prioritization of care, appropriately advocating for your patients, and consideration of best practices for handling scarce resources can assist in demonstrating physicians acted reasonably in the circumstances.