British Columbia Order in Council — Order under Health Professions Amending the bylaws of the College of Massage Therapists of BC (O.C. 65/2001)

O.C. 65/2001

British Columbia — Orders in Council

Mister of Health and Minister Responsible for Seniors Presiding M mbar o ncil PROVINCE OF BRITISH COLUMBIA ORDER OF THE LIEUTENANT GOVERNOR IN COUNCIL Order in Council &o.— 65 , Approved and Ordered JAN 2 5 2001 411 P utamilanownowlm Lieutenant Governor Executive Council Chambers, Victoria On the recommendation of the undersigned, the Lieutenant Governor, by and with the advice and consent of the Executive Council, orders that approval is given to the amendments to the bylaws of the College of Massage Therapists of British Columbia 1 as set out in the attached Resolution of the Board of the College dated October 11, 2000, with the exception of

section 5 (2) of

Schedule D, and 2 as set out in the attached Resolution of the Board of the College dated November 24, 2000. (This

part is for administrative purposes only and is not part of the Or&

r) Authority under which Order is made: Act and section:- Health Professions Act,

section 19 Other (specify):- KAHPA.MAS■01C.99\bylaw oic.doc r7G-11001(

THE COLLEGE OF MASSAGE THERAPISTS OF BRITISH COLUMBIA #103 - 1089 West Broadway, Vancouver, British Columbia, Canada, V6H 1E5 Telephone: (604) 736-3404 - Facsimile: (604) 736-6500 Toll Free: 1-877-321-3404 - Email: office©cmtbc.bc.ca Website: www.cmtbc.bc.ca NOTICE Health Professions Act In accordance with subsection 19(1) of the Health Professions Act, R.S.B.C. 1996, c.183, the attached resolution was passed by the Board of the College of Massage Therapists of British Columbia on Friday, September 29, 2000 at Vancouver, British Columbia: Doug McRae October 11, 2000 Registrar Vancouver, British Columbia EXPLANATORY NOTE: The amendments to the CMTBC's Interim Bylaws set out in this Notice: (

a) introduce a new and improved Code of Ethics that replaces two existing bylaw provisions, as well as the Code of Ethics of the Former Rules, and (

b) introduce a new Standards of Practice that replaces one bylaw provision and provides guidance to the membership on a number of practice issues not previously the subject of the bylaws. The amendments to the Bylaws were reviewed by the membership at large prior to a royal b the Board. 1

BE IT RESOLVED that the Interim Bylaws of the College of Massage Therapists of British Columbia approved by the Board on May 26, 1995, as amended, (the "Bylaws") be further amended as follows: 1)

Section 1 ("Definitions and

Interpretation") of the Bylaws is amended by adding the following new defintions to subsection 1(2), as follows. EXPLANATORY NOTE: The following amendments to the definition

section of the bylaws introduce new

definitions that are used in the new Code of Ethics or the new Standards of Practice . (

a) by adding the following new

definitions between the existing

definitions of "College" and "Elected Board Members": "Conflict of Interest" means when a Registrant's ability to protect and serve the interests of a patient is compromised to any extent by the interests of the Registrant; "Consent" means the agreement of a patient verbally or in writing to proceed with treatment which has been duly explained by a Registrant; (

b) by adding the following new definition between the existing

definitions of "Former Rules" and "Honorary Registrant": "Health Care Record" includes a clinical record, medical file, information relating to the medical, psychiatric, or psychological history of a patient, documents, drawings, photographs, letters, papers, and any other thing on which information is recorded or stored by graphic, electronic, mechanical or other means, but does not include a computer program or any other mechanism that produces Records; (

c) by adding the following new

definitions between the existing

definitions of "Inactive Registrant" and "massage therapy": "Lice%ed Practitioner" means a health care practitioner who is registered or licensed to practice in BC pursuant to the Act another health care profession statute, and includes but is not limited to another Registrant, a medical practitioner, a naturopathic doctor, a chiropractor, a physical therapist or an acupuncturist; "Locum" means a Registrant who temporarily replaces another Registrant;

(

d) by amending the definition of "Professional Misconduct" by (

i) repealing clause (

e) of that definition and replacing it with the following new clause: (

e) been found by a panel of the Discipline Committee to have contravened a provision of the Code of Ethical Conduct or the Standards of Practice, (ii) amending clause (

q) by striking out "or these Bylaws" and replacing it with ", these Bylaws or the Code of Ethical Conduct"; (

e) by adding the following new

definitions between the existing

definitions of "Regulation" and "Vice-President": "Sexual Conduct" means sexual intercourse or other forms of physical sexual activity, as well as speech and gestures of a sexual nature, "Student Intern" means a student enrolled in an Accredited Educational Program for massage therapy; 2) The following amendments are made to the Bylaws: EXPLANATORY NOTE: These amendments introduce the new Code of Ethics, which includes provisions that replace sections 75 and 76 of the current bylaws, as well as the 1 remaining sections of the Code of Ethics from the Former Rules. (

a) Part F ("Professional Standards) of the Bylaws is amended by repealing sections 75 and 76, as well as their titles, and replacing them with the following new

section and title: ('ode of Ethical Conduct and Standards of Practice 75. Every registrant shall comply with (

a) the Code of Ethical Conduct set out in

Schedule "C", and (

b) the Standards of Practice set out in

Schedule "D". (

b) the remaining sections of the Code of Ethics of the Former Rules continued under subsection 90(2) are repealed,. (

c) the following is added, after the existing

Schedule "B", as a new

schedule to the Bylaws, to be known as the "Code of Ethical Conduct":

Schedule "C" CODE OF ETHICAL CONDUCT General Duty to Patients 1(1) A Registrant shall: (

a) act in the best interest of a patient; (

b) only provide a treatment if the Registrant has a reasonable expectation that it will be of benefit to a patient; (

c) only provide massage therapy treatments that fall within the scope of practice of massage therapy, as defined in the Regulation.

(2) A Registrant shall not take advantage of a patient's vulnerabilities for the Registrant's sexual, emotional, social, political, or financial interest or benefit.

(3) A Registrant shall not contravene the Human Rights Act or the Human Rights Code, as amended from time to time.

(4) A Registrant shall not refuse to treat a patient unless (

a) the patient's condition renders the treatment unsafe, unnecessary or not beneficial to the patient, (

b) the patient asks the Registrant to perform an illegal or unethical act, (

c) there is a contlict of interest between the Registrant and the patient which cannot be resolved in accordance with

section 8 of this Code ("Conflict of Interest"), (

d) there is incompatibility of character between the Registrant and the patient, (

e) the patient loses confidence in the Registrant, or (

f) the patient fails to satisfy a statement of account for services rendered within 15 days or after 3 treatments. Sexual Conduct Prohihited 2. A Registrant shall not (

a) engage in sexual conduct with a patient, (

b) engage in sexual conduct with a former patient within one year of termination of massage therapy, or (

c) make any inquiry into a patient's sexual history. unless such an inquiry is directly related to the assessment or treatment of the patient's condition. General Duty to the Public 3. A Registrant shall (

a) comply with all Federal, Provincial and Municipa! idWS and regulations pertaining to the business and practice of massage therapy, and (

b) act in an honest, professional and courteous manner towards all persons.

General Duty to the Professions 4. A Registrant shall uphold and advance the honour, dignity and credibility of the profession and, without limiting the generality of the foregoing, shall: (

a) use his/her knowledge and skill to improve the health and well- being of others; (

b) respect the honour, dignity and credibility of other professionals; (

c) promote harmonious working relationships with other professionals; (

d) refrain from undue criticism of the qualifications or the therapies provided by other Registrants or Licensed Practitioners; (

e) avoid competition for patients or professional services by methods that adversely affect the honour, dignity or credibility of the profession; (0 avoid comparing his/her competence or patient outcomes to those of other Registrants or Licensed Practitioners; (

g) refrain from entering into a contract with any person or organization that diminishes the honour, dignity or credibility of the profession; (

h) abide by the Human Rights Act and Human Rights Code, as amended from time to time, in any dealings with Licensed Practitioners and other Registrants, including selection of a Locum. Practising if Impaired Prohibited 5. A Registrant shall not practice massage therapy when the Registrant's ability to practise is impaired by drugs, alcohol, a physical or mental ailment, emotional disturbance or addiction to any substance. Reporting of Registrants 6. If a Registrant has reasonable grounds to believe that another Registrant has (

a) committed

an act of Professional Misconduct, (

b) engaged in Sexual Conduct with a patient, or with a former patient, within one year of termination of massage therapy. (

c) practiced the profession while the Registrant's ability to do so was impaired by drugs, alcohol, a physical or mental ailment, emotional disturbance or addiction to any substance, (

d) engaged in any unsafe, unethical or illegal activity related to the practice of massage therapy, or (

e) permitted his/her office or clinic to be used for an unlawful purpose, that Registrant shall promptly file a written report with the Chair of the Inquiry Committee that contains the following information (

I) the name of the Registrant filing the report, (

g) the name of the Registrant who is the subject of the report,

(

h) details of the alleged professional misconduct, prohibited sexual conduct, incompetence, or incapacity, including the sources of information relied upon, (

i) the identity of any patient involved, after the Registrant has obtained the patient's consent to disclosure of the patient's identity to the Chair of the Inquiry Committee. Guarantees of a Cure Prohibited 7. A Registrant shall not claim that a treatment, or use of certain equipment, will provide a cure, nor shall a Registrant guarantee therapeutic value to a patient. Conflict of Interest 8(1) A Registrant shall make every effort to avoid a conflict of interest while providing massage therapy or carrying out any other professional duty.

(2) Notwithstanding subsection (1), where a Registrant is in a conflict of interest with a patient, that Registrant shall (

a) immediately disclose the nature of that conflict to the patient, (

b) document this disclosure, and (

c) resolve the conflict of interest in consultation with the patient, whether by terminating the therapeutic relationship with the patient or otherwise. 3) The following further amendments are made to the Bylaws: [EXPLANATORY NOTE: These amendments introduce a new Standards of Practice, which includes provisions that replace

section 89 of the current bylaws and introduce a I series of new practice standards for the profession. (

a) Part H ("Miscellaneous") of the Bylaws is amended by repealing

section 89, as well as it's title; (

b) the following is added, after the new

Schedule "C", as a new

schedule to the Bylaws, to be known as the "Standards of Practice"

Schedule "D" STANDARDS OF PRACTICE Training 1. A Registrant shall practice only those therapeutic methods which the Registrant has sufficient training to perform safely. Referral from and Recommendation to Another Licensed Practitioner

2(1) If a Registrant determines (

a) that his/her own expertise or massage therapy is not appropriate to treat that patient for the referred condition, or (

b) that the patient's condition warrants further assessment, diagnosis or treatment by a Licensed Practitioner, the Registrant shall, with the patient's consent, direct that patient back to the referring Licensed Practitioner.

(2) A Registrant shall, with the patient's consent, consult with the referring Licensed Practitioner before recommending any alternate and/or complimentary course of treatment . Treatment Environment 3. A Registrant shall render massage therapy (

a) in a safe environment, by doing the following: (

i) maintaining clean and tidy treatment and reception areas; (ii) maintaining safe and clean hydrotherapy, exercise, and other equipment; (iii) maintaining strict infection control procedures in any hydrotherapy facility; (iv) providing clean linens or other similar materials; (

v) maintaining adequate hand-washing procedures; (vi) providing unobstructed fire exits and readily available fire extinguishers, and by knowing and instructing all staff in fire safety for the facility; (

b) in a comfortable environment, by doing the following: (

i) providing adequate space for the safe movement of both patient and the Registrant, so as to minimize inadvertent physical contact between patient and the Registrant, (ii) maintaining appropriate room temperature. Notices 4. A Registrant shall: (

a) display in a visible location, a notice setting out the Registrant's policies and procedures concerning a patient's payment for services, and fees for missed appointments; (

b) provide to a patient on request, a copy of the Code of Ethical Conduct and Standards of Practice; (

c) display the Registrant's Certificate of Registration, in his/her primary practice location. Patient Consent to Treatment 5(1) Before commencing a treatment, a Registrant shall: (

a) obtain and record all necessary information for a safe and effective treatment, including a case history, a physical assessment and/or a diagnosis, and the reason for any Licensed Practitioner's referral;

(

b) describe to the patient the proposed treatment, and any risks of the treatment which the Registrant knows or ought to know may be of concern to the patient, given his or her history and presenting conditions; (

c) answer to the best of the Registrant's ability any of the patient's questions concerning the proposed treatment; (

d) obtain the patient's consent to provide the proposed treatment.

(2) A Registrant is entitled to assume that the patient's consent once obtained remains in effect for all future treatments of a similar nature, s■ ibject to the right of the patient at any time to rescind that consent, whether verbally, in writing or by other means of communication. Removal of Clothing 6(1) A Registrant shall recognize differing cultural and personal attitudes towards disrobing.

(2) Before commencing a treatment, a Registrant shall inform a patient if the removal of certain clothing is preferred for effective treatment.

(3) A Registrant shall respect the right of the patient to decline the removal of certain or any clothing.

(4) If a patient is unable to remove or replace an item of clothing personally, the Registrant may assist the patient so long as the patient has consented to that assistance.

(5) A Registrant must inform a patient in advance of the option of bringing and wearing a bathing suit during any hydrotherapy treatment.

(6) In any public setting, where massage therapy is to be provided, a Registrant shall respect the patient's need for privacy, as the situation permits. Ensuring Patient Privacy in a Closed Setting 7(1) Before commencing a treatment, and in particular before a patient removes any clothing, a Registrant shall: (

a) ensure patient privacy and dignity by providing suitable apparel for assessment; (

b) provide a non-transparent sheet or gown of sufficient length to cover the patient's body from neck to feet during treatment; (

c) instruct the patient on how to cover hinviherself at the commencement of treatment; (

d) provide facilities to ensure physical privacy while a patient disrobes or changes, before and after assessment and treatment; (

e) consider patient privacy with respect to window coverings and mirror location in a treatment room.

(2) During treatment, a Registrant shall arrange the draping so that only the part of a patient's body that is being treated is exposed and all other parts are appropriately draped. Potentially Painful Treatments

8(1) A Registrant shall not inflict pain as an objective of treatment.

(2) A Registrant shall make every effort to minimize pain during treatment.

(3) In relation to potentially painful treatment and notwithstanding subsections (1) and (2), a Registrant shall (

a) inform a patient of the possibility of pain, (

b) obtain consent to treatment by written or oral means, and (

c) inform a patient that the treatment can cease or be modified at any time at the patient's request.

(4) A Registrant shall promptly cease or modify treatment in response to a patient's request. Patient Confidentiality 9(1) A Registrant shall maintain confidentiality of patient information.

(2) Notwithstanding subsection (1), a Registrant may disclose relevant patient information verbally or by a copy of the Health Care Record when (

a) the patient has directed the Registrant, verbally or in writing, to make that disclosure, or (

b) required by law.

(3) A Registrant shall ensure that all office and support personnel who have access to a patient's Health Care Record permanently undertake to maintain the confidentiality of patient information. Delegation and Supervision 10(1) A Registrant may delegate massage therapy treatment to a Student Intern, provided the Registrant (

a) provides adequate supervision in accordance with the Clinical Practicum Standards as set out in the Curriculum Standard, as approved by the Board, (

b) assumes full responsibility for the massage therapy treatment, and (

c) complies with the Clinical Practicum Standards.

(2) A Registrant is responsible for adequate supervision and direction to all office and support personnel for all interactions with patients. Health Care Record Keeping 1 1(1) A Registrant shall generate an indelible clinical record for each patient containing: (

a) the patient's name, address and birthdate; (

b) the name of any referring practitioner; (

c) the date of each professional visit, and the name of the person who rendered the treatment; (

d) health history obtained and updated, findings obtained, clinical impressions and relevant information of the patient's condition; (

e) a treatment plan, including objectives, treatments provided, instructions given, periodic reassessment findings and treatment revisions;

(

f) all written reports received from or sent to other sources with respect to the patient.

(2) A Registrant shall ensure that the information in a Health Care Record is current, legible, accurate and complete.

(3) A Registrant shall not (

a) falsify any part of a patient's Health Care Record, or (

b) sign or issue a certificate, report or any document that contains false or misleading statements concerning a patient's Health Care Record.

(4) A Registrant shall maintain possession and control over a patient's Health Care Record, until that Record can be destroyed or transferred in accordance with

section 13. Patient Access to Health Care Record 12(1) For the purposes of this section. "access to" means a patient's opportunity to examine his/her Health Care Record and obtain photocopies.

(2) A Registrant who is in possession of a Health Care Record must allow a patient access to that patient's Health Care Record, unless the patient's physician is concerned that disclosure of the Health Care Record may result in significant harm to the safety, or mental or physical health of the patient, in which event, the Registrant shall provide written reason to the patient for refusal of access.

(4) Subject to subsection (2), a Registrant shall respond to a patient's request for access to his/her Health Care Record as soon as possible in a medical emergency, otherwise within 30 days of the request by producing the original Health Care Record for inspection.

(5) Where a Registrant provides access and a patient requests a copy of the Health Care Record, a copy shall be provided to the patient and the Registrant may charge the cost of photocopying that Health Care Record.

(6) A Registrant shall provide access to the Health Care Record of a child under 19 years of age to the persons having guardianship or custody of that child, except where (

a) the child has requested that his/her guardian or the person who has legal custody of the child not be granted such access, and (

b) the Registrant is satisfied the child is of the age and maturity to understand the nature, consequences and anticipated benefits and risks of the massage therapy that is the subject matter of the Health Care Record. Preservation of Health Care Records 13(

l) A Registrant shall ensure that Health Care Records remain in the Registrant's treatment facility or place of business until it is necessary to destroy or transfer the records.

(2) A Registrant shall retain Health Care Records in a safe and secure place 10

for at least seven years after the date of the last treatment entered in a patient's record, except where (

a) the Record is of a child under 19 years of age, in which case the seven year period begins the day after that child's 19th birthday, or (

b) the Record is of a person over the age of 19 who is mentally incompetent, in which case that Record should be retained for the life of that patient, or, at the end of seven years after the mentally incompetent patient is restored to mental competency .

(3) A Registrant may retain all Health Care Records for an indefinite period after the applicable minimum retention period in subsection (2) has elapsed .

(4) After the applicable retention period in subsection (2) has elapsed, and a Registrant elects to dispose of a Health Care Record, he/she may do so by (

a) effectively destroying the physical Record by utilizing a shredder or by complete burning, or (

b) erasing information recorded or stored by electronic methods, such as on tapes, disks or cassettes .

(5) A Registrant may, with the patient's consent, transfer a Health Care Record to another Registrant, the patient or a Licensed Practitioner .

(6) A Registrant shall make appropriate arrangements by the appointment of another Registrant as custodian to secure the Health Care Records, in the event that the Registrant dies or becomes unable to practise tbr any reason and is unable to dispose of the Health Care Records in accordance with subsection (5). Locum 14. When a Registrant enlists the services of a Locum, the Health Care Records, both existing and newly-created during the Locum's tenure, remain the property of the Registrant.

Practising with Non-Registrants 15(1) Where a Registrant shares a treatment facility or place of busness with a non-Registrant, the Registrant shall ensure that all patients are informed that the Registrant's practice and services are separate and distinct from that of the non-Registrant.

(2) A Registrant shall grant access to a Health Care Record only to another Licensed Practitioner or to a Student Intern, with patient consent.

(3) A Registrant shall not grant access to a Health Care Record to any other non-Registrant, except as required by Court Order. Ownership and Control of Health Care Records in a Shared Facility 16(1) For the purposes of this section, a "Shared Facility" means a business premises occupied by a Registrant, and one or more other Registrants or Licensed Practitioners. 11

(2) A Registrant shall provide, by written agreement with each other Registrant or Licensed Practitioner within the Shared Facility, clarification regarding the ownership of all Health Care Records created by the Registrant.

(3) It is the responsibility of a Registrant in a shared facility to advise ead- patient on initial treatment of the identity of the owner of the Health Care Record as determined by the written agreement completed as required by subsection (2).

(4) A Registrant shall maintain possession and control over the Health Care Records of the Registrant's patients, for so long as the Registrant occupies the Shared Facility. Continuing Education 17. A Registrant shall comply with the provisions of the Continuing Education Guidelines, as approved by the Board. 12

THE COLLEGE OF MASSAGE THERAPISTS OF BRITISH COLUMBIA #103 - 1089 West Broadway, Vancouver, British Columbia, Canada, V8H 1E5 Telephone: (604) 736-3404 - Facsimile: (604) 736-6500 Toll Free: 1-877-321-3404 - Email: office@cmtbc.bc.ca Website: www.cmtbc.bc.ca NOTICE Health Professions Act In accordance with subsection 19(1) of the Health Professions Act R.S.B.C. 1996, c.183, the attached resolution was passed by the Board of the College of Massage Therapists of British Columbia on Friday, November 24, 2000, by written resolution in accordance with

section 15(4) of the Interim Bylaws: Doug McRae November 24, 2000 Registrar Vancouver, British Columbia

BE IT RESOLVED that the version of the CMTBC Bylaw amendments, as submitted to the Ministry of Health on October 11, 2000 be amended by dropping subsection 5(2) of

Schedule D and replacing that subsection with the following new wording:

(2) A registrant shall discontinue the rendering of a treatment if, at any time, the patient withdraws his or her consent to that treatment, whether verbally, in writing or by other means of communication.

Document details

Collection	British Columbia — Orders in Council
Citation	O.C. 65/2001
Type	order_in_council
Volume / chapter	arc oic 0065 2001
Language	en
Format	pdf
Source	PROVINCIAL
Identifier	87cda622c73b43a975237143de365012565d9208

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