{"id":391,"date":"2024-11-20T14:19:36","date_gmt":"2024-11-20T19:19:36","guid":{"rendered":"https:\/\/live-coto.pantheonsite.io\/?post_type=resource&#038;p=391"},"modified":"2025-02-18T12:00:17","modified_gmt":"2025-02-18T17:00:17","slug":"standard-for-consent-2023","status":"publish","type":"resource","link":"https:\/\/www.coto.org\/resources\/standard-for-consent-2023\/","title":{"rendered":"Standard for Consent, 2023"},"content":{"rendered":"\n\n<div class=\"content-section-block has-fade-in-up  align wp-block-acf-content-section\" id=\"section-overview\">\n    <div class=\"section-header \">\n        <h2>Overview<\/h2>\n            <\/div>\n\n    <div class=\"content-section\" aria-hidden=\"false\">\n        <div class=\"acf-innerblocks-container\">\n\n<p>Under the law, occupational therapists are required to obtain two types of consent:<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Informed consent before starting and throughout the delivery of occupational therapy services (assessment, intervention, and consultation) (Health Care Consent Act, 1996)<\/li>\n\n\n\n<li>Knowledgeable consent for the collection, use, and disclosure of clients\u2019 personal information and personal health information (Personal Health Information Protection Act, 2004)<\/li>\n<\/ul>\n\n\n\n<p>Importantly, the process of obtaining consent is ongoing. When occupational therapists ask clients for consent, it is expected that they consider the power imbalance in client-therapist relationships. Occupational therapists must ask for consent in a way that is culturally sensitive and that allows clients time to ask questions, decline all or part of the services, or withdraw from services at any time.\u2028<\/p>\n\n\n\n<p>If another health professional is obtaining consent on behalf of the occupational therapist, they must be a member of another regulated profession that uses the informed consent process outlined in the Health Care Consent Act, 1996.\u2028Occupational therapists are expected to:<\/p>\n\n<\/div>\n    <\/div>\n<\/div>\n\n\n\n<div class=\"content-section-block has-fade-in-up  align wp-block-acf-content-section\" id=\"section-1-determine-client-capacity-to-provide-consent\">\n    <div class=\"section-header \">\n        <h2>1. Determine client capacity to provide consent<\/h2>\n            <\/div>\n\n    <div class=\"content-section\" aria-hidden=\"false\">\n        <div class=\"acf-innerblocks-container\">\n\n<p>Collaborate with clients using relevant communication and information-gathering methods to determine capacity. Use interpreters or augmentative communication tools if needed. Allow time for clients to understand the information and ask questions before finalizing capacity decisions.<\/p>\n\n\n\n<div class=\"labeled-list\">\n        <div class=\"labeled-list-inner\">\n\n<div class=\"labeled-list-item\">\n    <div class=\"labeled-list-item-label\">\n        <h3>1.1<\/h3>\n    <\/div>\n    <div class=\"labeled-list-item-inner\">\n\n<p>Collaborate with clients using relevant communication and information-gathering methods to determine capacity. Use interpreters or augmentative communication tools if needed. Allow time for clients to understand the information and ask questions before finalizing capacity decisions.<\/p>\n\n\n\n<p>Assume that clients are capable of providing consent unless there is information that indicates otherwise. Do not presume incapacity based on:<\/p>\n\n\n\n<ol style=\"list-style-type:lower-alpha\" class=\"wp-block-list\">\n<li>Age<\/li>\n\n\n\n<li>Communication challenges<\/li>\n\n\n\n<li>Diagnosis of a psychiatric or neurological condition<\/li>\n\n\n\n<li>Disability<\/li>\n\n\n\n<li>The fact that a guardian, power of attorney, or substitute decision-maker is in place<\/li>\n\n\n\n<li>Language differences<\/li>\n\n\n\n<li>Personal bias about social or cultural structures of marginalized groups or communities<\/li>\n\n\n\n<li>Refusal of intervention<\/li>\n<\/ol>\n\n<\/div>\n<\/div>\n\n\n\n\n<div class=\"labeled-list-item\">\n    <div class=\"labeled-list-item-label\">\n        <h3>1.2<\/h3>\n    <\/div>\n    <div class=\"labeled-list-item-inner\">\n\n<p>Assume that clients are capable of providing consent unless there is information that indicates otherwise. Do not presume incapacity based on:<\/p>\n\n\n\n<ol style=\"list-style-type:lower-alpha\" class=\"wp-block-list\">\n<li>Age<\/li>\n\n\n\n<li>Communication challenges<\/li>\n\n\n\n<li>Diagnosis of a psychiatric or neurological condition<\/li>\n\n\n\n<li>Disability<\/li>\n\n\n\n<li>The fact that a guardian, power of attorney, or substitute decision-maker is in place<\/li>\n\n\n\n<li>Language differences<\/li>\n\n\n\n<li>Personal bias about social or cultural structures of marginalized groups or communities<\/li>\n\n\n\n<li>Refusal of intervention<\/li>\n<\/ol>\n\n<\/div>\n<\/div>\n\n\n\n\n<div class=\"labeled-list-item\">\n    <div class=\"labeled-list-item-label\">\n        <h3>1.3<\/h3>\n    <\/div>\n    <div class=\"labeled-list-item-inner\">\n\n<p>Gather relevant information and apply clinical reasoning and judgement to determine the client\u2019s capacity to decide on the proposed services.<\/p>\n\n<\/div>\n<\/div>\n\n\n\n\n<div class=\"labeled-list-item\">\n    <div class=\"labeled-list-item-label\">\n        <h3>1.4<\/h3>\n    <\/div>\n    <div class=\"labeled-list-item-inner\">\n\n<p>If the occupational therapist finds that the client does not have the capacity to provide consent:<\/p>\n\n\n\n<ol style=\"list-style-type:lower-alpha\" class=\"wp-block-list\">\n<li>Explain to or assist the client in exercising their right to have a review of the finding.<\/li>\n\n\n\n<li>Use the&nbsp;Health Care Consent Act, 1996&nbsp;hierarchy of substitute decision-makers (see Appendix) to determine who is to provide consent.<\/li>\n\n\n\n<li>Inform the client that the substitute decision-maker will make decisions regarding occupational therapy services. Involve the client in discussions about services whenever possible.<\/li>\n<\/ol>\n\n<\/div>\n<\/div>\n\n\n<\/div>\n<\/div>\n<\/div>\n    <\/div>\n<\/div>\n\n\n\n<div class=\"content-section-block has-fade-in-up  align wp-block-acf-content-section\" id=\"section-2-obtain-informed-consent\">\n    <div class=\"section-header \">\n        <h2>2. Obtain informed consent<\/h2>\n            <\/div>\n\n    <div class=\"content-section\" aria-hidden=\"false\">\n        <div class=\"acf-innerblocks-container\">\n\n<div class=\"labeled-list\">\n        <div class=\"labeled-list-inner\">\n\n<div class=\"labeled-list-item\">\n    <div class=\"labeled-list-item-label\">\n        <h3>2.1<\/h3>\n    <\/div>\n    <div class=\"labeled-list-item-inner\">\n\n<p>Follow the&nbsp;<em>Health Care Consent Act,1996<\/em>&nbsp;to ensure that clients have all the information a reasonable person would need to decide about the occupational therapy services. This information includes:<\/p>\n\n\n\n<ol style=\"list-style-type:lower-alpha\" class=\"wp-block-list\">\n<li>Scope and reason for the referral or services<\/li>\n\n\n\n<li>Purpose and nature of the services<\/li>\n\n\n\n<li>Expected benefits and risks of proceeding, including any cultural, ecological, or economic considerations<\/li>\n\n\n\n<li>Likely consequences of not proceeding<\/li>\n\n\n\n<li>Expected outcomes<\/li>\n\n\n\n<li>Alternative courses of action<\/li>\n\n\n\n<li>The right of clients to withdraw consent at any time<\/li>\n\n\n\n<li>How services will be paid for<\/li>\n\n\n\n<li>Any legal authority given through a legal process for occupational therapy services<\/li>\n<\/ol>\n\n<\/div>\n<\/div>\n\n\n\n\n<div class=\"labeled-list-item\">\n    <div class=\"labeled-list-item-label\">\n        <h3>2.2<\/h3>\n    <\/div>\n    <div class=\"labeled-list-item-inner\">\n\n<p>Allow time and opportunity for questions and discussion about the proposed services.<\/p>\n\n<\/div>\n<\/div>\n\n\n\n\n<div class=\"labeled-list-item\">\n    <div class=\"labeled-list-item-label\">\n        <h3>2.3<\/h3>\n    <\/div>\n    <div class=\"labeled-list-item-inner\">\n\n<p>Respect clients\u2019 choice if they decide not to proceed.<\/p>\n\n<\/div>\n<\/div>\n\n\n\n\n<div class=\"labeled-list-item\">\n    <div class=\"labeled-list-item-label\">\n        <h3>2.4<\/h3>\n    <\/div>\n    <div class=\"labeled-list-item-inner\">\n\n<p>Explain each component of the plan, and obtain ongoing consent when moving from one component of services to another.<\/p>\n\n<\/div>\n<\/div>\n\n\n\n\n<div class=\"labeled-list-item\">\n    <div class=\"labeled-list-item-label\">\n        <h3>2.5<\/h3>\n    <\/div>\n    <div class=\"labeled-list-item-inner\">\n\n<p>Use interpreters or augmentative communication tools to support the informed consent process.<\/p>\n\n<\/div>\n<\/div>\n\n\n\n\n<div class=\"labeled-list-item\">\n    <div class=\"labeled-list-item-label\">\n        <h3>2.6<\/h3>\n    <\/div>\n    <div class=\"labeled-list-item-inner\">\n\n<p>Obtain consent from clients to involve others in service delivery, such as students and occupational therapy assistants. Clarify their roles and responsibilities.<\/p>\n\n<\/div>\n<\/div>\n\n\n\n\n<div class=\"labeled-list-item\">\n    <div class=\"labeled-list-item-label\">\n        <h3>2.7<\/h3>\n    <\/div>\n    <div class=\"labeled-list-item-inner\">\n\n<p>Be clear about any fees involved and ensure that they are agreed upon before services start.<\/p>\n\n<\/div>\n<\/div>\n\n\n\n\n<div class=\"labeled-list-item\">\n    <div class=\"labeled-list-item-label\">\n        <h3>2.8<\/h3>\n    <\/div>\n    <div class=\"labeled-list-item-inner\">\n\n<p>Apply an informed consent process to third party referrals (for example, independent examinations or expert reports). Explain that the services are at the request of the third party payer. Describe the nature and scope of the occupational therapist\u2019s role and reporting responsibilities.<\/p>\n\n<\/div>\n<\/div>\n\n\n<\/div>\n<\/div>\n<\/div>\n    <\/div>\n<\/div>\n\n\n\n<div class=\"content-section-block has-fade-in-up  align wp-block-acf-content-section\" id=\"section-3-obtain-knowledgeable-consent\">\n    <div class=\"section-header \">\n        <h2>3. Obtain knowledgeable consent<\/h2>\n            <\/div>\n\n    <div class=\"content-section\" aria-hidden=\"false\">\n        <div class=\"acf-innerblocks-container\">\n\n<p><strong>Knowledgeable consent refers to the collection, use, and disclosure of personal information according to the privacy legislation that applies to the occupational therapy practice. In Ontario, one of three privacy laws applies: the&nbsp;<em>Personal Health Information Protection Act, 2004<\/em>, the&nbsp;<em>Personal Information Protection and Electronic Documents Act, 2000<\/em>, or the&nbsp;<em>Privacy Act, 1985<\/em>.<\/strong><br><\/p>\n\n\n\n<div class=\"labeled-list\">\n        <div class=\"labeled-list-inner\">\n\n<div class=\"labeled-list-item\">\n    <div class=\"labeled-list-item-label\">\n        <h3>3.1<\/h3>\n    <\/div>\n    <div class=\"labeled-list-item-inner\">\n\n<div class=\"wp-block-group is-layout-flow wp-block-group-is-layout-flow\">\n<p>Know which privacy law applies to the occupational therapist\u2019s practice, and follow the legal requirements for consent and ongoing consent for the collection, use, and disclosure of information<\/p>\n<\/div>\n\n<\/div>\n<\/div>\n\n\n\n\n<div class=\"labeled-list-item\">\n    <div class=\"labeled-list-item-label\">\n        <h3>3.2<\/h3>\n    <\/div>\n    <div class=\"labeled-list-item-inner\">\n\n<div class=\"wp-block-group is-layout-flow wp-block-group-is-layout-flow\">\n<p>Explain to clients why information is being collected, used, and shared and with whom. Make sure that clients understand that they have a right to withdraw consent, but that the withdrawal cannot be applied retroactively to information already shared.<\/p>\n<\/div>\n\n<\/div>\n<\/div>\n\n\n\n\n<div class=\"labeled-list-item\">\n    <div class=\"labeled-list-item-label\">\n        <h3>3.3<\/h3>\n    <\/div>\n    <div class=\"labeled-list-item-inner\">\n\n<p>Provide professional contact details in case questions arise later about how information was collected, used, and shared during occupational therapy service delivery.<\/p>\n\n<\/div>\n<\/div>\n\n\n\n\n<div class=\"labeled-list-item\">\n    <div class=\"labeled-list-item-label\">\n        <h3>3.4<\/h3>\n    <\/div>\n    <div class=\"labeled-list-item-inner\">\n\n<p>For third party referrals (for example, independent examinations or expert reports):<\/p>\n\n\n\n<ol style=\"list-style-type:lower-alpha\" class=\"wp-block-list\">\n<li>Obtain consent for the disclosure of assessment results, reports, and intervention plans to third party payers, other professionals, partners, and interested parties unless exceptions to this disclosure apply under privacy legislation<\/li>\n\n\n\n<li>Obtain consent before reviewing any additional client health information that was provided by the third party after the original assessment services were completed (for example, other medical reports or surveillance material).<\/li>\n<\/ol>\n\n<\/div>\n<\/div>\n\n\n<\/div>\n<\/div>\n<\/div>\n    <\/div>\n<\/div>\n\n\n\n<div class=\"content-section-block has-fade-in-up  align wp-block-acf-content-section\" id=\"section-4-handle-client-information-respectfully-and-responsibly\">\n    <div class=\"section-header \">\n        <h2>4. Handle client information respectfully and responsibly<\/h2>\n            <\/div>\n\n    <div class=\"content-section\" aria-hidden=\"false\">\n        <div class=\"acf-innerblocks-container\">\n\n<div class=\"labeled-list\">\n        <div class=\"labeled-list-inner\">\n\n<div class=\"labeled-list-item\">\n    <div class=\"labeled-list-item-label\">\n        <h3>4.1<\/h3>\n    <\/div>\n    <div class=\"labeled-list-item-inner\">\n\n<p>Collect only as much client information as is needed to provide the services.<\/p>\n\n<\/div>\n<\/div>\n\n\n\n\n<div class=\"labeled-list-item\">\n    <div class=\"labeled-list-item-label\">\n        <h3>4.2<\/h3>\n    <\/div>\n    <div class=\"labeled-list-item-inner\">\n\n<p>Access only records that apply to the occupational therapist\u2019s role and practice.<\/p>\n\n<\/div>\n<\/div>\n\n\n\n\n<div class=\"labeled-list-item\">\n    <div class=\"labeled-list-item-label\">\n        <h3>4.3<\/h3>\n    <\/div>\n    <div class=\"labeled-list-item-inner\">\n\n<p>Protect the confidentiality of client information, and ensure that all information is secured against unauthorized access, loss, or theft.<\/p>\n\n<\/div>\n<\/div>\n\n\n\n\n<div class=\"labeled-list-item\">\n    <div class=\"labeled-list-item-label\">\n        <h3>4.4<\/h3>\n    <\/div>\n    <div class=\"labeled-list-item-inner\">\n\n<p>Understand privacy legislation and organizational policies and procedures.<\/p>\n\n<\/div>\n<\/div>\n\n\n\n\n<div class=\"labeled-list-item\">\n    <div class=\"labeled-list-item-label\">\n        <h3>4.5<\/h3>\n    <\/div>\n    <div class=\"labeled-list-item-inner\">\n\n<p>In the case of third party referrals, take reasonable measures to ensure that any assessment information shared is accurate and represents the occupational therapist\u2019s professional opinion.<\/p>\n\n<\/div>\n<\/div>\n\n\n<\/div>\n<\/div>\n<\/div>\n    <\/div>\n<\/div>\n\n\n\n<div class=\"content-section-block has-fade-in-up  align wp-block-acf-content-section\" id=\"section-5-document-both-informed-and-knowledgeable-consent\">\n    <div class=\"section-header \">\n        <h2>5. Document both informed and knowledgeable consent<\/h2>\n            <\/div>\n\n    <div class=\"content-section\" aria-hidden=\"false\">\n        <div class=\"acf-innerblocks-container\">\n\n<p><strong>Documentation can take the form of a note in the client record, signed, and dated consent forms, or a consent policy, procedure, or guideline that is referenced in the client record. A signed consent form does not necessarily prove that informed or knowledgeable consent has been obtained. Consent forms should not be a substitute for the communication process that must accompany proper informed consent. Forms, however, can be used to support the process and to standardize methods of obtaining consent.<\/strong><br><\/p>\n\n\n\n<div class=\"labeled-list\">\n        <div class=\"labeled-list-inner\">\n\n<div class=\"labeled-list-item\">\n    <div class=\"labeled-list-item-label\">\n        <h3>5.1<\/h3>\n    <\/div>\n    <div class=\"labeled-list-item-inner\">\n\n<p>Ensure that documentation is timely (determined by practice factors such as workplace policies, client risk, and reporting priorities) and includes notes on these details:<\/p>\n\n\n\n<ol style=\"list-style-type:lower-alpha\" class=\"wp-block-list\">\n<li>Whether or not the client understood and agreed to all, some, or none of the proposed services and plans of care.<\/li>\n\n\n\n<li>Risks, limitations, and benefits of the services discussed.<\/li>\n\n\n\n<li>Any limits imposed on the collection, use, and disclosure of the client\u2019s personal information and personal health information.<\/li>\n\n\n\n<li>Type of alternative communication methods used or details of interpretation services.<\/li>\n\n\n\n<li>Name of the substitute decision-maker. If applicable, include a copy of authorizing documents such as power of attorney for personal care.<\/li>\n<\/ol>\n\n<\/div>\n<\/div>\n\n\n<\/div>\n<\/div>\n<\/div>\n    <\/div>\n<\/div>\n\n\n\n<div class=\"content-section-block has-fade-in-up  align wp-block-acf-content-section\" id=\"section-6-manage-withdrawal-of-consent\">\n    <div class=\"section-header \">\n        <h2>6. Manage withdrawal of consent<\/h2>\n            <\/div>\n\n    <div class=\"content-section\" aria-hidden=\"false\">\n        <div class=\"acf-innerblocks-container\">\n\n<div class=\"labeled-list\">\n        <div class=\"labeled-list-inner\">\n\n<div class=\"labeled-list-item\">\n    <div class=\"labeled-list-item-label\">\n        <h3>6.1<\/h3>\n    <\/div>\n    <div class=\"labeled-list-item-inner\">\n\n<p>Ensure that clients understand their right to withdraw consent and any implications of doing so.<\/p>\n\n<\/div>\n<\/div>\n\n\n\n\n<div class=\"labeled-list-item\">\n    <div class=\"labeled-list-item-label\">\n        <h3>6.2<\/h3>\n    <\/div>\n    <div class=\"labeled-list-item-inner\">\n\n<p>If the client withdraws consent, continue the services only if immediate withdrawal poses a serious risk to the health or safety of the client or others. Explain to the client why the withdrawal cannot be immediate.<\/p>\n\n<\/div>\n<\/div>\n\n\n\n\n<div class=\"labeled-list-item\">\n    <div class=\"labeled-list-item-label\">\n        <h3>6.3<\/h3>\n    <\/div>\n    <div class=\"labeled-list-item-inner\">\n\n<p>Ensure that the record includes all services provided before consent was withdrawn and the reasons the clients withdrew consent (if known).<\/p>\n\n<\/div>\n<\/div>\n\n\n\n\n<div class=\"labeled-list-item\">\n    <div class=\"labeled-list-item-label\">\n        <h3>6.4<\/h3>\n    <\/div>\n    <div class=\"labeled-list-item-inner\">\n\n<p>If the client withdraws consent for disclosure of health information, explain that withdrawal cannot be applied retroactively to information already shared.<\/p>\n\n<\/div>\n<\/div>\n\n\n<\/div>\n<\/div>\n<\/div>\n    <\/div>\n<\/div>\n\n\n\n<div class=\"content-section-block has-fade-in-up  align wp-block-acf-content-section\" id=\"section-related-college-content\">\n    <div class=\"section-header \">\n        <h2>Related College Content<\/h2>\n            <\/div>\n\n    <div class=\"content-section\" aria-hidden=\"false\">\n        <div class=\"acf-innerblocks-container\">\n\n<div class=\"resource-grid has-fade-in-up\" role=\"grid\" aria-label=\"Resource Grid\">\n    \n\n<a \n    href=\"https:\/\/www.coto.org\/wp-content\/uploads\/2024\/11\/consent-checklist.pdf\" \n            target=\"_blank\" \n        rel=\"noopener noreferrer\"\n        class=\"resource-link resource-item has-external\" \n    aria-label=\"Consent Checklist  (opens in a new tab)\"\n>\n    <div class=\"card-header\">\n        <!-- Resource Types -->\n       <div class=\"resource-types\">\n            <div class=\"resource-type-item\">\n                                                            <img loading=\"lazy\" decoding=\"async\" width=\"23\" height=\"25\" src=\"https:\/\/www.coto.org\/wp-content\/uploads\/2024\/12\/Practice-Tools.svg\" class=\"attachment-full size-full\" alt=\"Practice Tools Icon\" aria-hidden=\"true\" \/>                                                                <span>Practice Tools<\/span>\n                                                <\/div>\n        <\/div>\n\n        <!-- Resource Languages -->\n                            <div class=\"resource-languages\">\n                                                        <button \n                        class=\"resource-language-item\"\n                        data-language-url=\"https:\/\/www.coto.org\/resources\/consent-checklist\/consentement-liste-de-verification\/\"\n                        data-external=\"true\"\n                        onclick=\"window.resourceCardHandlers.handleLanguageClick(event, this)\" \n                        aria-label=\"Go to resource in FR - Consentement liste de verification (opens in a new tab)\"\n                        title=\"Consentement liste de verification\"\n                    >\n                        FR                    <\/button>\n                            <\/div>\n                \n\n        <!-- External Resource Indicator -->\n                <!-- File Resource Indicator -->\n                    <span class=\"resource-external\">\n                File <i class=\"far fa-file-pdf\" aria-hidden=\"true\"><\/i>\n            <\/span>\n            <\/div>\n\n    <div class=\"card-title\">\n        <!-- Resource Title -->\n        <h3>Consent Checklist<\/h3>\n    <\/div>\n\n    <!-- Resource Topics -->\n    <!-- <div class=\"card-footer\">\n                    <div class=\"resource-topics\">\n                                    <span class=\"resource-topic-item\">\n                        Consent                    <\/span>\n                                    <span class=\"resource-topic-item\">\n                        Working as an OT                    <\/span>\n                            <\/div>\n            <\/div> -->\n\n<\/a>\n\n\n\n\n<script>\n    \/\/ Initialize the global handler object if it doesn't exist\n    if (typeof window.resourceCardHandlers === 'undefined') {\n        window.resourceCardHandlers = {\n            handleLanguageClick: function(event, element) {\n                event.preventDefault();\n                event.stopPropagation();\n                const url = element.getAttribute('data-language-url');\n                const isExternal = element.getAttribute('data-external') === 'true';\n                \n                if (url) {\n                    if (isExternal) {\n                        window.open(url, '_blank', 'noopener,noreferrer');\n                    } else {\n                        window.location.href = url;\n                    }\n                }\n            }\n        };\n    }\n<\/script>\n\n<a \n    href=\"https:\/\/www.coto.org\/resources\/determining-capacity-decision-tree\/\" \n        class=\"resource-link resource-item \" \n    aria-label=\"Determining Capacity Decision Tree \"\n>\n    <div class=\"card-header\">\n        <!-- Resource Types -->\n       <div class=\"resource-types\">\n            <div class=\"resource-type-item\">\n                                                            <img loading=\"lazy\" decoding=\"async\" width=\"22\" height=\"22\" src=\"https:\/\/www.coto.org\/wp-content\/uploads\/2024\/12\/Practice-Guidance.svg\" class=\"attachment-full size-full\" alt=\"Practice Guidance Icon\" aria-hidden=\"true\" srcset=\"https:\/\/www.coto.org\/wp-content\/uploads\/2024\/12\/Practice-Guidance.svg 160w, https:\/\/www.coto.org\/wp-content\/uploads\/2024\/12\/Practice-Guidance.svg 1536w, https:\/\/www.coto.org\/wp-content\/uploads\/2024\/12\/Practice-Guidance.svg 2048w, https:\/\/www.coto.org\/wp-content\/uploads\/2024\/12\/Practice-Guidance.svg 22w\" sizes=\"auto, (max-width: 22px) 100vw, 22px\" \/>                                                                <span>Practice Guidance<\/span>\n                                                <\/div>\n        <\/div>\n\n        <!-- Resource Languages -->\n                            <div class=\"resource-languages\">\n                                                        <button \n                        class=\"resource-language-item\"\n                        data-language-url=\"https:\/\/www.coto.org\/resources\/determining-capacity-decision-tree\/arbre-decisionnel-pour-determiner-la-capacite\/\"\n                        data-external=\"false\"\n                        onclick=\"window.resourceCardHandlers.handleLanguageClick(event, this)\" \n                        aria-label=\"Go to resource in FR - Arbre d\u00e9cisionnel pour d\u00e9terminer la capacit\u00e9\"\n                        title=\"Arbre d\u00e9cisionnel pour d\u00e9terminer la capacit\u00e9\"\n                    >\n                        FR                    <\/button>\n                            <\/div>\n                \n\n        <!-- External Resource Indicator -->\n                <!-- File Resource Indicator -->\n            <\/div>\n\n    <div class=\"card-title\">\n        <!-- Resource Title -->\n        <h3>Determining Capacity Decision Tree<\/h3>\n    <\/div>\n\n    <!-- Resource Topics -->\n    <!-- <div class=\"card-footer\">\n                    <div class=\"resource-topics\">\n                                    <span class=\"resource-topic-item\">\n                        Consent                    <\/span>\n                                    <span class=\"resource-topic-item\">\n                        Working as an OT                    <\/span>\n                            <\/div>\n            <\/div> -->\n\n<\/a>\n\n\n\n\n<script>\n    \/\/ Initialize the global handler object if it doesn't exist\n    if (typeof window.resourceCardHandlers === 'undefined') {\n        window.resourceCardHandlers = {\n            handleLanguageClick: function(event, element) {\n                event.preventDefault();\n                event.stopPropagation();\n                const url = element.getAttribute('data-language-url');\n                const isExternal = element.getAttribute('data-external') === 'true';\n                \n                if (url) {\n                    if (isExternal) {\n                        window.open(url, '_blank', 'noopener,noreferrer');\n                    } else {\n                        window.location.href = url;\n                    }\n                }\n            }\n        };\n    }\n<\/script>\n\n<a \n    href=\"https:\/\/www.coto.org\/resources\/standard-for-record-keeping-2023\/\" \n        class=\"resource-link resource-item \" \n    aria-label=\"Standard for Record Keeping, 2023 \"\n>\n    <div class=\"card-header\">\n        <!-- Resource Types -->\n       <div class=\"resource-types\">\n            <div class=\"resource-type-item\">\n                                                            <img loading=\"lazy\" decoding=\"async\" width=\"22\" height=\"24\" src=\"https:\/\/www.coto.org\/wp-content\/uploads\/2024\/12\/Standards.svg\" class=\"attachment-full size-full\" alt=\"Standards Icon\" aria-hidden=\"true\" \/>                                                                <span>Standards<\/span>\n                                                <\/div>\n        <\/div>\n\n        <!-- Resource Languages -->\n                            <div class=\"resource-languages\">\n                                                        <button \n                        class=\"resource-language-item\"\n                        data-language-url=\"https:\/\/www.coto.org\/resources\/standard-for-record-keeping-2023\/normes-de-tenue-des-dossiers-2023\/\"\n                        data-external=\"false\"\n                        onclick=\"window.resourceCardHandlers.handleLanguageClick(event, this)\" \n                        aria-label=\"Go to resource in FR - Normes de tenue des dossiers, 2023\"\n                        title=\"Normes de tenue des dossiers, 2023\"\n                    >\n                        FR                    <\/button>\n                            <\/div>\n                \n\n        <!-- External Resource Indicator -->\n                <!-- File Resource Indicator -->\n            <\/div>\n\n    <div class=\"card-title\">\n        <!-- Resource Title -->\n        <h3>Standard for Record Keeping, 2023<\/h3>\n    <\/div>\n\n    <!-- Resource Topics -->\n    <!-- <div class=\"card-footer\">\n                    <div class=\"resource-topics\">\n                                    <span class=\"resource-topic-item\">\n                        Competencies &amp; Standards                    <\/span>\n                                    <span class=\"resource-topic-item\">\n                        Privacy                    <\/span>\n                                    <span class=\"resource-topic-item\">\n                        Record Keeping                    <\/span>\n                            <\/div>\n            <\/div> -->\n\n<\/a>\n\n\n\n\n<script>\n    \/\/ Initialize the global handler object if it doesn't exist\n    if (typeof window.resourceCardHandlers === 'undefined') {\n        window.resourceCardHandlers = {\n            handleLanguageClick: function(event, element) {\n                event.preventDefault();\n                event.stopPropagation();\n                const url = element.getAttribute('data-language-url');\n                const isExternal = element.getAttribute('data-external') === 'true';\n                \n                if (url) {\n                    if (isExternal) {\n                        window.open(url, '_blank', 'noopener,noreferrer');\n                    } else {\n                        window.location.href = url;\n                    }\n                }\n            }\n        };\n    }\n<\/script>\n\n<a \n    href=\"https:\/\/www.coto.org\/resources\/standard-for-the-supervision-of-students-and-occupational-therapy-assistants-2023\/\" \n        class=\"resource-link resource-item \" \n    aria-label=\"Standard for the Supervision of Students and Occupational Therapy Assistants, 2023 \"\n>\n    <div class=\"card-header\">\n        <!-- Resource Types -->\n       <div class=\"resource-types\">\n            <div class=\"resource-type-item\">\n                                                            <img loading=\"lazy\" decoding=\"async\" width=\"22\" height=\"24\" src=\"https:\/\/www.coto.org\/wp-content\/uploads\/2024\/12\/Standards.svg\" class=\"attachment-full size-full\" alt=\"Standards Icon\" aria-hidden=\"true\" \/>                                                                <span>Standards<\/span>\n                                                <\/div>\n        <\/div>\n\n        <!-- Resource Languages -->\n                            <div class=\"resource-languages\">\n                                                        <button \n                        class=\"resource-language-item\"\n                        data-language-url=\"https:\/\/www.coto.org\/resources\/standard-for-the-supervision-of-students-and-occupational-therapy-assistants-2023\/normes-de-supervision-des-etudiants-en-ergotherapie-et-des-aides-ergotherapeutes-2023\/\"\n                        data-external=\"false\"\n                        onclick=\"window.resourceCardHandlers.handleLanguageClick(event, this)\" \n                        aria-label=\"Go to resource in FR - Normes de supervision des \u00e9tudiants en ergoth\u00e9rapie et des aides-ergoth\u00e9rapeutes, 2023\"\n                        title=\"Normes de supervision des \u00e9tudiants en ergoth\u00e9rapie et des aides-ergoth\u00e9rapeutes, 2023\"\n                    >\n                        FR                    <\/button>\n                            <\/div>\n                \n\n        <!-- External Resource Indicator -->\n                <!-- File Resource Indicator -->\n            <\/div>\n\n    <div class=\"card-title\">\n        <!-- Resource Title -->\n        <h3>Standard for the Supervision of Students and Occupational Therapy Assistants, 2023<\/h3>\n    <\/div>\n\n    <!-- Resource Topics -->\n    <!-- <div class=\"card-footer\">\n                    <div class=\"resource-topics\">\n                                    <span class=\"resource-topic-item\">\n                        Competencies &amp; Standards                    <\/span>\n                                    <span class=\"resource-topic-item\">\n                        Supervision                    <\/span>\n                            <\/div>\n            <\/div> -->\n\n<\/a>\n\n\n\n\n<script>\n    \/\/ Initialize the global handler object if it doesn't exist\n    if (typeof window.resourceCardHandlers === 'undefined') {\n        window.resourceCardHandlers = {\n            handleLanguageClick: function(event, element) {\n                event.preventDefault();\n                event.stopPropagation();\n                const url = element.getAttribute('data-language-url');\n                const isExternal = element.getAttribute('data-external') === 'true';\n                \n                if (url) {\n                    if (isExternal) {\n                        window.open(url, '_blank', 'noopener,noreferrer');\n                    } else {\n                        window.location.href = url;\n                    }\n                }\n            }\n        };\n    }\n<\/script><\/div>\n<\/div>\n    <\/div>\n<\/div>\n\n\n\n<div class=\"content-section-block has-fade-in-up  align wp-block-acf-content-section\" id=\"section-appendix-hierarchy-of-substitute-decision-makers\">\n    <div class=\"section-header \">\n        <h2>Appendix: Hierarchy of Substitute Decision-Makers<\/h2>\n            <\/div>\n\n    <div class=\"content-section\" aria-hidden=\"false\">\n        <div class=\"acf-innerblocks-container\">\n\n<p>When a healthcare practitioner believes that a client is not capable of making a decision about assessment, intervention, admission to a care facility, or personal assistance, they must obtain consent from the substitute decision-maker unless the circumstances warrant urgent intervention.<\/p>\n\n\n\n<p>In most situations, the substitute decision-maker does not have to be appointed by the courts. They must be at least 16 years old unless they are the parent of the client, and they must be capable of giving consent.<\/p>\n\n\n\n<p>The&nbsp;Health Care Consent Act, 1996&nbsp;(s. 20 [1]) lists a hierarchy of persons who can provide substitute consent. Generally, the practitioner must obtain consent from the highest-ranking person who is available and willing to be a substitute decision-maker. An exception is if a lower-ranking substitute is present and believes that the higher-ranking substitute would not object.<\/p>\n\n\n\n<ol class=\"wp-block-list\">\n<li>Based on the&nbsp;Health Care Consent Act&nbsp;(s. 20 [1]), the hierarchy is as follows:<\/li>\n\n\n\n<li>The client\u2019s court-appointed guardian of the person if the guardian has the authority to give or refuse consent to treatment<\/li>\n\n\n\n<li>Attorney for personal care conferred by a written form when the client was capable<\/li>\n\n\n\n<li>Representative appointed by the Consent and Capacity Board<\/li>\n\n\n\n<li>Spouse or partner<\/li>\n\n\n\n<li>Child or parent (custodial parent if the child is a minor)<\/li>\n\n\n\n<li>Parent of the incapable person who has only a right of access<\/li>\n\n\n\n<li>Sibling<\/li>\n\n\n\n<li>Any other relative<\/li>\n<\/ol>\n\n\n\n<p>Note: If no person described in the hierarchy meets the requirements, the occupational therapist would go back to the top of the hierarchy, where the Public Guardian and Trustee shall make the decision to give or refuse&nbsp;consent.<\/p>\n\n<\/div>\n    <\/div>\n<\/div>\n\n\n\n<div class=\"content-section-block has-fade-in-up  align wp-block-acf-content-section\" id=\"section-references\">\n    <div class=\"section-header \">\n        <h2>References<\/h2>\n            <\/div>\n\n    <div class=\"content-section\" aria-hidden=\"false\">\n        <div class=\"acf-innerblocks-container\">\n\n<p>Health Care Consent Act, 1996, Statutes of Ontario (1996, c. 2, Sched. A). Retrieved from the Government of Ontario website:&nbsp;<a href=\"https:\/\/www.ontario.ca\/laws\/statute\/96h02\" target=\"_blank\" rel=\"noreferrer noopener\">https:\/\/www.ontario.ca\/laws\/statute\/96h02<\/a><\/p>\n\n\n\n<p>Office of the Privacy Commissioner of Canada. (2018).&nbsp;<em>Summary of privacy laws in Canada<\/em>.&nbsp;<a href=\"https:\/\/www.priv.gc.ca\/en\/privacy-topics\/privacy-laws-in-canada\/02_05_d_15\/\" target=\"_blank\" rel=\"noreferrer noopener\">https:\/\/www.priv.gc.ca\/en\/privacy-topics\/privacy-laws-in-canada\/02_05_d_15\/<\/a><\/p>\n\n\n\n<p>Personal Health Information Protection Act, 2004, Statutes of Ontario (2004, c. 3, Sched. A). Retrieved from the Government of Ontario website:&nbsp;<a href=\"https:\/\/www.ontario.ca\/laws\/statute\/04p03\" target=\"_blank\" rel=\"noreferrer noopener\">https:\/\/www.ontario.ca\/laws\/statute\/04p03<\/a>&nbsp;&nbsp;<\/p>\n\n\n\n<p>Personal Information Protection and Electronic Documents Act, Statutes of Canada (2000, c. 5). Retrieved from the Justice Laws website:&nbsp;<a href=\"https:\/\/laws-lois.justice.gc.ca\/eng\/acts\/p-8.6\/\">https:\/\/laws-lois.justice.gc.ca\/eng\/acts\/p-8.6\/<\/a><\/p>\n\n\n\n<p>Privacy Act, Revised Statutes of Canada (1985, c. P-21). Retrieved from the Justice Laws website:&nbsp;<a href=\"https:\/\/laws-lois.justice.gc.ca\/eng\/acts\/p-21\/fulltext.html\" target=\"_blank\" rel=\"noreferrer noopener\">https:\/\/laws-lois.justice.gc.ca\/eng\/acts\/p-21\/fulltext.html&nbsp;&nbsp;<\/a><\/p>\n\n<\/div>\n    <\/div>\n<\/div>\n\n\n<p><\/p>\n","protected":false},"excerpt":{"rendered":"","protected":false},"author":1,"featured_media":0,"parent":0,"menu_order":0,"template":"","meta":{"_acf_changed":false,"advanced_seo_description":"","jetpack_seo_html_title":"","jetpack_seo_noindex":false,"footnotes":"[]"},"resource-audience":[19,17],"resource-topic":[29,31],"resource-type":[13],"class_list":["post-391","resource","type-resource","status-publish","hentry","resource-audience-employers","resource-audience-registrants","resource-topic-competencies-standards","resource-topic-consent","resource-type-standards"],"acf":[],"jetpack_sharing_enabled":true,"_links":{"self":[{"href":"https:\/\/www.coto.org\/wp-json\/wp\/v2\/resource\/391","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.coto.org\/wp-json\/wp\/v2\/resource"}],"about":[{"href":"https:\/\/www.coto.org\/wp-json\/wp\/v2\/types\/resource"}],"author":[{"embeddable":true,"href":"https:\/\/www.coto.org\/wp-json\/wp\/v2\/users\/1"}],"version-history":[{"count":22,"href":"https:\/\/www.coto.org\/wp-json\/wp\/v2\/resource\/391\/revisions"}],"predecessor-version":[{"id":3224,"href":"https:\/\/www.coto.org\/wp-json\/wp\/v2\/resource\/391\/revisions\/3224"}],"wp:attachment":[{"href":"https:\/\/www.coto.org\/wp-json\/wp\/v2\/media?parent=391"}],"wp:term":[{"taxonomy":"resource-audience","embeddable":true,"href":"https:\/\/www.coto.org\/wp-json\/wp\/v2\/resource-audience?post=391"},{"taxonomy":"resource-topic","embeddable":true,"href":"https:\/\/www.coto.org\/wp-json\/wp\/v2\/resource-topic?post=391"},{"taxonomy":"resource-type","embeddable":true,"href":"https:\/\/www.coto.org\/wp-json\/wp\/v2\/resource-type?post=391"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}