Negligence Causation Test Revisited:
The Difficult Case of Necrotizing Fasciitis
By Kate Hughes
In a recent decision entitled Aristorenas v. Comcare Health Services,
[2006] O.J. No. 4039, the Court of Appeal reviewed the applicable legal
tests for proving medical malpractice. This case is of particular interest
to nurses, midwives, physicians and other health professionals who may
be sued in negligence. The case involved a woman who developed necrotizing
fasciitis (flesh eating disease) following her caesarian section birth.
An obstetrician and a group of nurses, employed by Comcare Health Services,
provided home care to the woman following the birth and were found by
the Trial Judge to be liable for negligence when her surgical wound became
infected. Three days after she was admitted to hospital, the woman was
diagnosed with necrotizing fasciitis. She had to undergo life saving surgery,
spent ten days in intensive care and then faced a long period of rehabilitation,
ultimately missing half a year at work. Given the lack of expert evidence
regarding the cause of the still mysterious necrotizing fasciitis, other
than it requires the presence of an infection, the Trial Judge that the
health care professionals were negligent in their care and that this negligence
caused the necrotizing fasciitis. However, on appeal, the Court of Appeal
ultimately found that the test for causation had not been made out to
satisfactorily establish that the health care practitioners’ actions
caused the necrotizing fasciitis.
At trial, it was found that Mrs. Aristorenas, the Plaintiff, entered
home care with an obviously infected wound, which then deteriorated. The
doctor and the nurses in follow-up care were found negligent in their
post-natal treatment of the Plaintiff, who had delivered a baby by caesarian
section. The Plaintiff was at a high risk for infection after the caesarian
section due to her obesity. She was treated by a physician and several
home care nurses over a two week period following the birth. It was found
by the Trial Judge that the nurses did not assess the wound appropriately,
did not document according to the standards expected (the standards for
homecare nurses were found to be the same for other nurses in the profession)
and did not notice the serious downward trend. The physician was found
to have failed to recognize that the conventional treatment did not assist
in healing, despite the large discharges, foul odour and burning pain
resulting from the wound. The Comcare nurses had tried to seek the assistance
of the Comcare wound expert, however that individual had not been available.
Finally, one of the defendant nurses sought the assistance of a senior
nurse who, after examining the Plaintiff, immediately advised her to go
to the hospital. The Plaintiff was admitted to hospital but it was several
days before the hospital staff made the diagnosis of necrotizing fasciitis.
The Plaintiff then underwent several surgeries in which an abdomen muscle
had to be removed and was replaced with muscle from the Plaintiff’s
right leg. The Trial Judge found the homecare nurses and the obstetrician
were negligent and assessed damages in the amount of $55,000.
On appeal, the physician and the nurses admitted to negligence with respect
to delay in treating the infection. The Appellants did not appeal the
Trial Judge’s finding of negligence or his damage award of $55,000.00.
The single issue for the Court of Appeal was whether the necrotizing fasciitis
suffered by the Plaintiff was caused by the defendants’ negligence.
Cases involving malpractice generally apply a legal test for causation
known as the “but for” test, which is as follows:
Causation is established where the Plaintiff proves to the civil standard
on a balance of probabilities that the defendant caused or contributed
to the injury. The general, but not conclusive, test for causation is
the “but for” test, which requires the Plaintiff to show
the injury would not have occurred but for the negligence of the defendant.
Courts have recognized that there are cases in which the “but for”
test is unworkable; however, they have provided little guidance as to
when the “but for” test becomes unworkable. In some cases,
the test of “material contribution” as applied, such as in
cases dealing with exposure to asbestos. In those cases, where it was
clear the Plaintiffs were definitely injured and given there was no other
apparent cause or explanation for the injury, a negligent act can be determined
to have been caused by the defendants if the Plaintiff “could prove
the defendant materially contributed to the injury of the Plaintiff”.
To make matters even more complicated, the Courts also developed the
“robust and pragmatic approach” which the Courts said was
not a distinct test for causation, but rather an approach to analyse the
evidence to demonstrate a necessary causal connection between the conduct
and the injury. In these cases, the Court said the legal burden remained
with the Plaintiff but that the Court could draw an inference of causation,
even though positive or scientific proof for causation has not been adduced.
It was this inference that the Trial Judge in Aristorenas relied on in
making his decision.
The Trial Judge applied the “robust and pragmatic approach”
to the evidence and relied on a chain of inferences. He found that:
- An infected wound left untreated will develop serious complications;
- One possible complication, albeit rare, of an infected wound is necrotizing
fasciitis;
- Necrotizing fasciitis developed in the Plaintiff’s infected
wound;
- Whether or not necrotizing fasciitis would have otherwise developed
in the Plaintiff is not a matter susceptible of scientific proof;
- It developed in this case it the very area of the infected wound which
was permitted to deteriorate due to the defendant’s lack of care,
and was discovered at the proximate time.
In evaluating the evidence, the majority of the Court of Appeal found
that it was difficult to establish causation, even if one assumed a link
between the delay in the treatment of the infection and contracting necrotizing
fasciitis. The Court of Appeal said they had sympathy for the plight of
the Plaintiff, who had suffered grievous injuries and had proved serious
acts of negligence attributable to the healthcare professionals in providing
what should have been basic routine wound care. However, the Court said
that, given the current state of the law, the Plaintiff did not make out
causation. The Court noted that the necrotizing fasciitis could have entered
the wound at a variety of points of time, including at the outset or possibly
at the hospital after the negligent delay. It was not sufficient to prove
that the adequate diagnosis and treatment would have afforded a chance
of avoiding the unfavourable outcome, unless that chance surpasses the
threshold of “more likely than not”.
This case is useful to health care providers beyond the specific facts
of necrotizing faciitis. This case provides a useful review of the law
generally on the legal tests for causation in medical malpractice cases
and more specifically guidance as to how the courts will approach difficult
cases. The nature of necrotizing fasciitis posed a test case regarding
causation as there are no experts and this rare disease still remains
a mystery. Despite sympathetic facts and clear harm to the Plaintiff,
the court was unwilling to draw the inference to hold the health care
providers negligent for the Plaintiff’s acquiring a disease that
the evidence indicated was both rare and not necessarily preventable.
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Recognizing Internationally Trained Professionals: Does
Ontario’s Fair Access to Regulated Professions Bill Measure Up?
By Jo-Anne Pickel
Public hearings into the Ontario government’s proposed Fair Access
to Regulated Professions Act (Bill 124), which is aimed at ensuring
that the registration practices used by regulated professions are transparent,
objective, impartial and fair, have just ended. The Committee is now studying
the Bill and is expected to report back to the legislature in the early
new year. Although the changes made by Bill 124 will apply to all individuals
seeking to register with a professional body, the changes will be of particular
benefit to foreign trained professionals who often find it difficult to
practice their professions in Canada and must instead take jobs well below
the ones they previously practiced in their home countries.
In order to practice a profession in Ontario – such as teaching,
health professions, engineering, law to name only a few examples –
individuals must be registered by the governing body for their profession.
For many decades, internationally trained professionals have faced significant
barriers to practicing their profession in Canada, in large part due to
difficulties in having their skills and non-Canadian credentials recognized.
These barriers have many sources but the most frequently cited are the
various rules of the provincial bodies which regulate access to professions
in Ontario through licensing and registration requirements. These barriers
have been studied for many years and have been the subject of reports
at both the provincial and federal government levels.
Bill124 has been put forward as one piece of the puzzle to help eradicate
some of these barriers. While the Bill introduces some welcome changes,
advocates for internationally trained professionals hope that the Committee
studying the Bill will address some of its shortcomings.
Bill 124 was introduced following the release of a government-commissioned
report by George Thompson (the “Thomson report”) which reviewed
the registration practices and appeal processes from registration decisions
in Ontario’s regulated professions. Although the government has
incorporated some of the report’s recommendations into the Bill,
a number of recommendations have been left out. As such, a number of issues
will need to be addressed in order for the Bill to more effectively break
down the barriers faced by internationally trained professionals seeking
to practice in Ontario.
What is in Bill 124
Bill 124 imposes a general duty on regulated professions in Ontario to
provide registration practices that are transparent, objective, impartial
and fair by:
- providing information to applicants about how the registration process
works, the amount of time it usually takes, the requirements for registration,
the documents of qualifications that must accompany an application,
the alternatives to this documentation that may be acceptable, and the
fees required;
- providing timely written reasons to applicants;
- ensuring the applicants have a right to seek an internal review or
appeal of a decision;
- ensuring that assessments, whether carried out by the regulatory
body or a third party, are transparent, objective, impartial and fair;
- ensuring that individuals assessing qualifications and making registration
decisions are appropriately trained; and
- ensuring that applicants have access to their application records.
The Bill also provides for the appointment of a Fair Registration Practices
Commissioner whose functions will include
- assessing registration practices,
- overseeing the auditing of regulated professions to ensure compliance
with the Bill,
- monitoring third parties retained by regulated professions to assess
applicants’ qualifications,
- advising regulated professions and ministries, and
- reporting to the Minister on registration practices related to internationally
trained professionals.
Finally, Bill 124 will establish an Access Centre for Internationally
Trained Individuals. While the Centre’s precise mandate remains
to be fully developed, the Bill states that the Centre will provide information
and assistance to internationally trained individuals and other applicants
with respect to registration requirements and procedures. Its mandate
will also involve conducting research and analysis as well as providing
information and assistance to ministries, government and community agencies.
Issues to be Addressed
The measures introduced by the Bill appear aimed primarily at increasing
the information available to applicants and thereby enhancing the transparency
of the registration process followed by regulated professions. However,
a number of issues are either not clearly addressed in the Bill or have
been left out of the Bill altogether. For example:
- Should the government follow the Thomson Report’s recommendation
that it establish an independent appeal body to which professional registration
decisions could be appealed?
- What amendments would be necessary to ensure not only that fair,
impartial and transparent processes are used, but that the substantive
evaluation criteria and standards used are also fair and objective?
- What amendments would be necessary to more precisely define what
constitutes a “fair” or “objective” assessment?
- What is the precise mandate of the Access Centre for Internationally
Trained Individuals? In particular, will the Centre provide legal advice
and representation for applicants who need it?
- Should the list of regulated professions to which the Act will apply
be specifically listed in the Act rather than left to government regulation?
It is clear that the Fair Access to Regulated Professions Act is only
one piece of the puzzle when it comes to eradicating the barriers faced
by internationally trained professionals seeking to practice their professions
in Ontario. Even if advocates for internationally trained professionals
welcome many of the measures introduced by the Bill, a number of amendments
will be required for the Bill to achieve its objective of ensuring transparent,
objective, impartial and fair access to regulated professions in the province.
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Reporting Obligations: When Professionals Need to Make
Reports
By Philip B. Abbink
Under a number of different statutes, professionals are faced with the
difficult duty of having to report certain kinds of misconduct by their
colleagues or misconduct involving persons in their care. This does not
mean that professionals have the responsibility of policing their workplace
nor should it be taken to mean that they have to report every mistake
made by a colleague. However, professionals do have an obligation to report
some of the more serious kinds of misconduct, especially when it relates
to vulnerable persons, such as children or the elderly.
Each of the obligations discussed below requires the reporting of suspicions
or grounds that are reasonable. Vague suspicions, intuitions, rumour or
innuendo should not be reported. A penalty, such as a fine, may result
from a failure to report a reasonable suspicion. Penalties may also result
from making a report that is known to be false. There is generally no
duty on professionals to investigate the situation themselves. In fact,
doing so may interfere with a subsequent investigation by the appropriate
authorities. This article outlines some of the many reporting obligations
that relate to children, sexual abuse by health care professionals and
the elderly.
Child & Family Services Act
Section 72 of the Child & Family Services Act obliges anyone who
has reasonable grounds to suspect one of the listed situations to report
the suspicion and the information supporting that suspicion to a Children’s
Aid Society. Situations which must be reported include:\
- physical harm or a risk of physical harm caused by a caregiver;
- sexual misconduct or a risk of sexual misconduct;
- that a child requires medical treatment which is not being provided;
- certain kinds of emotional harm or the risk of those sorts of emotional
harm;
- developmental conditions that are not being addressed;
- that a child has been abandoned; or
- that a child under 12 is likely to cause serious property damage,
has injured another person on more than one occasion, or has killed
or seriously injured another person.
The Ontario Association of Children’s Aid Societies explains “reasonable
grounds” in this way: "Reasonable grounds" are what an
average person, given his or her training, background and experience,
exercising normal and honest judgment, would suspect.”
The obligation to report a reasonable suspicion of any of the situations
listed above attaches to the individual. The duty to report is not met
by reporting to a superior. The individual who has the reasonable suspicion
must personally report that suspicion to a Children’s Aid Society.
If the person has obtained the information in the course of their professional
or official duties and fails to make the appropriate report, they may
be subject to a fine of up to $1000. Teachers and nurses are explicitly
listed as persons who perform such professional duties.
Regulated Health Professions Act
The Regulated Health Professions Act currently obliges all members of
Colleges governed by that act to file a report with the appropriate College
if they have “reasonable grounds, obtained in the course of practising
their profession, to believe that another member ... has sexually abused
a patient.” The duty applies to abuse committed by a member of any
regulated health profession.
Sexual abuse is defined to include sexual intercourse or other forms
of sexual relations, sexual touching, and sexual behaviour or remarks
made by a member towards a patient. The RHPA contains further provisions
dealing with the timing, form and contents of such a report. Failure to
report may be professional misconduct. There is no duty to investigate
the suspected misconduct. The report must be made within 30 days from
when the duty arises. This means 30 days from the receipt of the information
forming the basis for reasonable grounds to believe that the sexual abuse
has occurred. If there are reasonable grounds to believe that the abuse
will continue, the report must be filed immediately.
Nursing Homes Act
Any person who is not a resident in a nursing home is obliged under the
Nursing Homes Act to report to the Director a reasonable suspicion that
a resident has suffered or may suffer harm arising from unlawful conduct,
improper or inappropriate treatment or care, or neglect. They must report
both the suspicion and the information on which it is based. The Nursing
Homes Act also contains provisions explicitly protecting the person who
makes such a report from reprisals and intimidation or coercion.
Any contravention of the Nursing Homes Act, including the obligation
to report a reasonable suspicion that a resident is or was harmed, may
result in a fine of up to $25,000 and imprisonment for up to twelve months.
It is also an offence to make a false report.
Conclusion
While professionals are not required to report every little mistake of
their colleagues, it is important for professionals to know those few
situations in which a report must be made, and to whom that report must
be made. Common sense is as good a guide here as anywhere else. If a professional
believes that he/she has information supporting a reasonable suspicion
that a vulnerable person is being treated inappropriately, he/she may
have a duty to report that information and his/her suspicion. As always,
professionals have an obligation to know the professional standards to
which they will be held, and the same is true of their duty to report.
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Legislative Update: Bills Before the Ontario Legislature
of Interest to Professionals
By Jo-Anne Pickel
A number of Bills currently before the Ontario Legislature are of interest
to both teachers and health professionals and the Unions that represent
them. The following is a list of the Bills that are of greatest interest
with a brief description as well as an update as to their status.
Long-Term Care Homes Act, 2006 (Bill 120)
The Bill establishes a new system of governance for long-term care homes
in Ontario. It replaces the Nursing Homes Act, the Charitable Institutions
Act and the Homes for the Aged and Rest Homes Act. The Bill includes the
following:
- Whistle blowing protections for staff, residents and volunteers;
- A requirement that a registered nurse be on duty in the home 24 hours
per day, 7 days per week;
- A restriction on the use of restraints to a limited circumstances
where they are deemed necessary and with appropriate safeguards; and
- Residents’ Bill of Rights provisions that entitle residents
that, among other things, seeks to provide protections from abuse and
neglect.
The Bill passed Second Reading in the legislature on December 5, 2006
and has now been referred to the Standing Committee on Social Policy.
Mandatory Blood Testing Act, 2006 (Bill 28)
Bill 28 will make changes to the process by which persons may apply for
mandatory blood testing of another person if the person came into contact
with a bodily substance from that person.
- The Bill would repeal and replace section 22.1 of the Health Protection
and Promotion Act. This section allows a person who came into contact
with a bodily substance of another person to apply to a medical officer
of health to order the mandatory blood testing of the other person.
- Bill 28 would shorten the length of time for the process and transfer
the power to make an order for mandatory blood testing from a medical
officer of health to the Consent and Capacity Board.
- The Bill also includes a slightly expanded list of circumstances
in which an application for a mandatory blood test can be made.
The Bill is currently being considered by a legislative committee, following
which it will undergo third reading in the legislature before it is passed.
Safe Needles Save Lives Act, 2006 (Bill 30)
This Bill would require employers in certain workplaces to provide for
and ensure the use of safety-engineered medical sharps in any circumstance
where a worker is required to use a medical sharp.
- The Bill places a duty on employers, in workplaces identified by
government regulation, to ensure that a safety-engineered medical sharp
is provided and used if one is commercially available and appropriate
for the specific task or procedure.
- Employers will also be required to provide instruction and training
to workers who are required to use a medical sharp, or who may otherwise
come into accidental contact with a medical sharp.
Bill 30 has been referred to the Standing Committee on Regulations and
Private Bills on November 16, 2006. No public hearings have yet been announced.
Traditional Chinese Medicine Act, 2006 (Bill 50)
This Bill establishes a system to regulate the profession of traditional
Chinese medicine.
- Practitioners of Traditional Chinese Medicine and Acupuncturists
will be required to become members of the new College of Traditional
Chinese Medicine Practitioners of Ontario in order to practice lawfully
in Ontario.
- The new self-governing College will enforce standards of practice
and practice requirements for the profession. It will also put in place
a complaints and disciplinary process.
- The new College will have the authority to grant the use of the title
of ‘doctor” to certain members of the College who meet established
standards.
- The Health Professions Procedural Code will apply to the new College.
Bill 50 has passed Third Reading in the legislature but has yet to receive
Royal Assent.
Education Bills
A number of Bills of interest to the education sector are also before
the Ontario legislature. Of particular interest are the following:
- Education Amendment Act (Community Involvement), 2006 (Bill 19 )
– The Bill will amend the Education Act to permit the Minister
of Education and Training to require that students complete at least
60 hours of community involvement activities before receiving their
Ontario Secondary School Diploma. The Bill has been referred to the
Standing Committee on Social Policy.
- Education Amendment Act (Learning to Age 18), 2006 (Bill 52) –
The Bill will amend the Education Act to raise the compulsory school
attendance age from 16 to 18 and to provide for the development of “equivalent
learning” opportunities for pupils, i.e. learning opportunities
that fall outside the instruction traditionally provided by a school
board. The Bill is currently undergoing Third Reading in the legislature.
Top
Changes to the Regulated Health Professions Act:
Expected if not Welcomed
By Mia London and Brian
Hanulik
On December 12, 2006, the Ontario Government introduced Bill 171, the
Health Systems Improvement Act, 2006 (the “Act”).
The Act, comprising 17 different schedules, amends and repeals a number
of statutes administered by the Minister of Health and Long-Term Care.
Of particular importance to health care professionals, the Act amends
in important ways the Regulated Health Professions Act, 1991,
(the “RHPA”) and the Health Professions Procedural Code
(the “Code”). In addition, the Act, when passed, will
amend other statutes to allow for the regulation under the RHPA of four
additional health professions – naturopathy, homeopathy, kinesiology,
and psychotherapy.
The Act follows the release of the Health Professions Regulatory Advisory
Council’s recommendations to the Minister in May, 2006. The changes
to the complaints, quality assurance, and discipline processes are substantive
and will affect the relationships between Members, Colleges, and members
of the public.
A. Amendments to the RHPA and the Code
Highlights of proposed amendments to the RHPA and the Code include the
following:
1. Creation of the Inquiries, Complaints and Reports Committee
(“ICR Committee”)
The new ICR Committee will replace the Complaints Committee and assume
many of the functions currently exercised by the Executive Committee and
Boards of Inquiry.
Members will continue to have the right to make written submissions to
the ICR Committee within 30 days. Currently, members may be asked to make
submissions on less than 30 days notice to the Executive Committee. However,
the ICR Committee will have the ability to specify a period of less than
30 days if it holds the opinion on reasonable and probable grounds, that
the conduct of the member exposes or is likely to expose his or her patients
to harm or injury.
The ICR Committee will no longer provide reasons to the complainant and/or
the Member when it takes no action in response to a complaint or report.
In considering whether to refer a specified allegation of a member’s
professional misconduct or incompetence to the Discipline Committee, the
ICR Committee will be required to consider all available prior decisions
involving the member, unless the decision was to take no further action.
The ICR will be prohibited from referring a matter to the Quality Assurance
Committee (QAC), although the panel may exercise the power of the QAC
with necessary modifications.
The time limit for a panel of the ICR Committee to dispose of a complaint
will increase from 120 to 150 days after the complaint is filed. Following
150 days, decreasing time limits are in place, and the Registrar is required
to notify the complainant and the Member of the new expected date on which
the complaint is expected to be disposed of.
The ICR Committee will have the power to make an interim order directing
the Registrar to suspend or impose terms, conditions or limitations on
a member’s certificate of registration without notice to
the member, although the member will have the right to make submissions
while the suspension or the terms, conditions or limitations are in place.
The ICR can exercise this new power if it holds the opinion on reasonable
and probable grounds that the conduct of the member exposes or is likely
to expose his or her patients to harm or injury, and urgent intervention
is needed.
With capacity matters, the ICR Committee will have the ability to direct
the Registrar to suspend a member’s certificate of registration
without notice to the member until she or he submits to a physical or
mental examination. Again, the ICR Committee may take this step if it
is of the opinion, on reasonable and probable grounds, that the physical
or mental state of the member exposes or is likely to expose his or her
patients to harm or injury, and urgent intervention is needed. The Member
is permitted to make submissions while the suspension is in place.
2. Alternative Dispute Resolution Process
The Code will be amended to formally allow for the use of alternative
dispute resolution processes to resolve complaints. The Registrar will
have the ability to refer a matter, with the consent of both the complainant
and the member, to an alternative dispute resolution process if the matter
has not yet been referred to the Discipline Committee and if the matter
does not involve an allegation of sexual abuse.
If a complaint is resolved through an ADR process, the ICR Committee
shall be advised of the resolution. The ICR Committee may stop its investigation
and adopt the resolution, or it may continue to investigate the complaint.
3. Information Available on the Register
The Act will require that a notation of every unresolved matter that
has been referred by the ICR Committee to the Discipline Committee must
be included on the Public Register. This notation will be removed only
when the matter has been resolved.
A notation of every reprimand issued to a member will be included on
the Register.
The requirement that the result of every disciplinary and incapacity
proceeding be on the register will be amended. The result of the proceeding,
including a synopsis of the decision, will be on the Register. If the
Committee makes no finding, the decision will not be included on the Register.
Finally, there will be a new requirement that if a Member resigns and
agrees never to practise again in Ontario during or as a result of a proceeding,
a notation of the resignation and the agreement will be added to the Register.
4. Public Access to Information
The Act will require that every College have a website. The Minister
may prescribe by regulation specific information that must be included
on that website. All information designated as public in the by-laws will
be available on the website. If a member of the public inquires about
a College Member, the Registrar will be required to make reasonable efforts
to provide the person with a list of the information available to the
public on the Register.
The College will be permitted to publicly confirm whether a member is
under investigation if there is a “compelling public interest”
in disclosing that information. Colleges are not currently permitted to
comment on investigations.
The College will also now be required to provide greater public access
to information regarding their members, including practice information,
practice restrictions and any disciplinary action taken against the member.
5. Quality Assurance
The College’s Quality Assurance Committee will have the following
exhaustive list of powers:
- requiring a member whose knowledge, skill and judgment have been
assessed and found to be unsatisfactory to participate in specified
continuing education or remediation programs;
- directing the Registrar to impose terms, conditions, or limitations
for a specified period on the certificate of registration of a member
whose knowledge, skill and judgment have been assessed or reassessed
and have been found to unsatisfactory;
- directing the Registrar to remove terms, conditions or limitations
before the end of the specified period if the QAC is of the opinion
that the knowledge, skill and judgment are now satisfactory;
- disclosing the name of the member and allegations against the member
to the ICR Committee if the QAC is of the opinion that the member may
have committed an act of professional misconduct or may be incompetent
or incapacitated;
- referring a member to the ICR Committee for a failure to co-operate
with the QAC or any assessor appointed by it or to participate in the
quality assurance program or a specified program or assessment.
6. Mandatory Reporting by Facility Operators
In addition to mandatory reports that are currently required in cases
of suspected sexual abuse of patients, facility operators will now be
obligated to report to the College whenever it has “reasonable grounds
to believe” that a Member who practises at that facility is incompetent
or incapacitated. In cases where there are reasonable grounds to believe
that such incompetence or incapacity is likely to expose a patient to
harm or injury and there is an urgent need for intervention, such mandatory
reports must be filed forthwith.
7. Jurisdiction of the College
The Code will be amended and the jurisdiction of the Colleges broadened
to allow that a person whose certificate of registration has been revoked
or who has resigned will continue to be subject to the jurisdiction of
the College for misconduct or incompetence, pursuant to s. 75 of the Code.
In addition, a person whose certificate of registration is suspended will
be subject to the jurisdiction of the College for incapacity, professional
misconduct or incompetence, such that the member could be investigated
pursuant to s. 75 of the Code.
8. Participation of Non-Parties
The Code will be amended to require that a non-party who wishes to participate
in a hearing must make an application before a panel. The panel continues
to have the ability to allow the non-party to participate in a hearing.
B. Regulation of Four Additional Professions
The Act will add four more regulated health professions under the proposed
changes to the RHPA. Specifically, the professions of naturopathy, homeopathy,
kinesiology and psychotherapy will now be regulated through three new
regulatory colleges.
Kinesiology and psychotherapy will each be regulated by newly created
colleges. Naturopathy and homeopathy will be jointly regulated by a single
new health college. Currently, naturopaths are regulated under the Drugless
Practitioners Act while homeopathy, kinesiology and psychotherapy
are currently unregulated.
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Update for Professionals Archives
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If you have specific questions regarding the regulated professions, you
may contact Elizabeth McIntyre at 416.964.5501 or at emcintyre@cavalluzzo.com.
Providing this information does not constitute individualized legal
advice, and does not establish any form of lawyer-client relationship
with our firm or with any of our lawyers. Readers should not rely on or
take any action based on this information; professional advice should
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may be errors and omissions. We disclaim any liability for such errors
and omissions.
Copyright 2006 © Cavalluzzo
Hayes Shilton McIntyre & Cornish LLP
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