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Medical Assistance in Dying

Professional Standard Regarding Medical Assistance in Dying December 14, 2018 [1] Introduction On June 17, 2016 new provisions of the Canadian Criminal Code came into force. These amendments to the Criminal Code followed the Supreme Court of Canada decision in Carter v Canada (Attorney General)[2], which struck down the previous prohibitions against medical assistance in dying. The effect of the Carter decision, combined with the subsequent changes to the Criminal Code is that it is now legal for a physician or nurse practitioner to assist an adult patient to die if specified criteria have been met. The College of Physicians and Surgeons of Nova Scotia ([...]

Disruptive Behaviour by Physicians

Professional Standard Regarding Disruptive Behaviour by Physicians Preamble This professional standard specifies the College's expectations of physician behaviour in a professional environment. Disruptive behaviour is conduct characterized by the use of inappropriate words, actions or inactions by physicians which shows disrespect for others or any interpersonal interaction that interferes with or is likelyl to interfere with quality health care delivery. Good faith advocacy is not considered disruptive behaviour. Physicians may be accused of disruptive behaviour by their colleagues, patients or administration and/or leaders at the institution where they practice. In such instances, physicians should contact the Canadian Medical Protective Association as these matters may come before [...]

Physician Use of Social Media

Professional Standards and Guidelines Regarding Physician Use of Social Media Professional Standards Physicians are responsible to act in a manner that upholds the professional standards and ethics of the medical profession at all times. Expectations of professional and ethical conduct are the same whether physicians are interacting in person or online through social media. When using social media, physicians must: Not communicate with individual patients about anything pertaining to their medical care. Do not doctor on social media; Ensure all communications are professional, ethical and in keeping with the standards of the profession. For example, physicians should refrain from portraying any unprofessional images of themselves [...]

Reducing the Size of a Medical Practice

Professional Standards and Guidelines Regarding Reducing the Size of a Medical Practice Preamble Tension exists between the professional duty not to abandon patients and the physician's freedom to manage the size of their practice. Physicians may not discriminate against patients at any time including when considering discharging them from their practice. As providers of professional services, physicians are bound by the Nova Scotia Human Rights Act, which prohibits discrimination regarding provision of or access to services or facilities on the basis of age, race, colour, religion, creed, sex, sexual orientation, gender identity, gender expression, physical disability or mental disability, an irrational fear [...]

Interest or Ownership in a Facility or Enterprise

Professional Standards Regarding Interest or Ownership in a Facility or Enterprise Preamble This document deals with specific conflicts of interest that may arise when a physician has financial interest or ownership in a facility or business.  This document sets out responsibilities in addition to those set out in the College’s Professional Standards Regarding Conflict of Interest. Professional Standard(s) Where the physician has a financial interest in a facility or enterprise to which the physician is referring a patient, the physician: must fully disclose any interest the physician has in the facility to a patient prior to any referral to that facility; [...]

Physician Participation in Continuing Professional Development

Professional Standards Regarding Physician Participation in Continuing Professional Development Preamble The primary purpose of Continuing Professional Development (CPD) activities is to address the educational needs of physicians in order to improve the health care provided to patients. The interests of industry always include a profit motive, which may influence the delivery of CPD. This standard identifies the responsibilities of physicians involved in organizing, presenting or attending a continuing medical education event. Professional Standard(s) Physicians must ensure the scientific validity, objectivity and completeness of any information they present at a CPD event. Physicians must disclose where any presentation materials they use have been developed by industry. Physicians must [...]

Advertising and Public Communications by Physicians

Professional Standards Regarding Advertising and Public Communications by Physicians Preamble Canadian law recognizes advertising by professionals as protected free speech, with such advertising to be regulated to maintain a high standard of professionalism. Professional Standard(s) Physicians must ensure that any public communication is compatible with the best interests of the public and upholds the reputation of the medical profession. Regardless of the medium, all communication by physicians with the public must not be misleading or deceptive. Advertising Specifically, any communication by physicians with the public must not: claim or imply any superiority of [...]

Billing

Professional Standards Regarding Billing Preamble The College endorses the Canadian Medical Association Code of Ethics, which recognizes that physicians must not exploit patients and must use healthcare resources prudently. Medical care is changing, with more delivery by physicians of publicly uninsured services (hence private medicine) in addition to insured services paid for by the Nova Scotia Medical Services Insurance Program or MSI (hence public medicine). Whether for private or public medicine, inappropriate billing is recognized by the College as a form of professional misconduct. When providing private medical services, physicians bear the responsibility to inform their patients about the commercial aspects of the [...]

Conflict of Interest

Professional Standards Regarding Conflict of Interest Preamble A conflict of interest exists whenever a reasonable person could perceive that a physician’s personal interest is at odds with the physician’s professional responsibilities. Conflict of interest can be actual or perceived, provided the perception is reasonable. At all times the onus is on the physician to demonstrate that the patient’s interests have been maintained as paramount. Recognition and disclosure of a conflict of interest alone may not ensure that the patient’s best interests have been maintained. Professional Standard(s) In all situations of conflict of interest, the physician must: Recognize the conflict; Disclose the conflict to the patient, [...]

Sale of Products and Services to Patients

Professional Standards Regarding the Sale of Products and Services to Patients Preamble The sale of products or services by physicians to patients gives rise to potential ethical problems. The College endorses the Canadian Medical Association Code of Ethics, as it relates to the sale of products or services by physicians to patients. This standard should be read in conjunction with the College’s Professional Standards Regarding Conflict of Interest. Professional Standard(s) Physicians must disclose to patients any financial interest they have with the manufacture or sale of a product or service.