Table of Contents

1. Informed Consent
2. Communications
3. Confidentiality
4. Professional Conduct and Accountability
   • Standard 1
   • Standard 2
5. Sexual Ethics

INFORMED CONSENT

STANDARD:

The member will provide the patient with the necessary information and obtain a valid informed consent prior to the start of any procedure and /or treatment in accordance with the Healthcare Consent Act, 1996.

COMMUNICATIONS

STANDARD:

The member shall take reasonable steps to ensure patient comprehension of assessment findings, diagnoses, treatment plan and prognoses.

CRITERIA:

1. The member will provide complete, accurate information concerning the patient’s assessment/diagnosis, treatment and prognosis, in terms the patient can be reasonably expected to understand.
2. The College recognizes that consent is implied when the patient attends for the purpose of assessment for treatment, and that the nature of any treatment plan must be disclosed to the patient following such assessment prior to the implementation of the treatment plan.
3. It is recommended that in a situation warranting biomechanical assessment, the nature of the procedure should be disclosed to the patient prior to commencement of physical examination beyond the foot.
4. In cases where the member is unable to communicate in a language which the patient can understand, every effort should be made to arrange for an interpreter at the next and subsequent visits.

CONFIDENTIALITY

STANDARD:

The member shall ensure that patient confidentiality is maintained at all times.

CRITERIA:

1. Any personal confidences not relating to the management of the patient should not be discussed with others.
2. Case discussion, consultation, examination and treatment is confidential and should be conducted discreetly.
3. Those individuals, including students, not directly involved in the patient care must seek permission to be present during assessment or treatment.
4. When seeking advice or assistance from a colleague, only relevant information should be communicated.
5. The patient record is regarded as confidential and should be secured appropriately when not in use (see Records).
6. A member will not allow any person, except as authorized by law, to examine a patient health record, or give any information, copy or thing from the patient health record (see Records regulation).
7. The assessment and treatment area should provide a confidential atmosphere. The treatment room should be separated from the waiting and reception area by a closable door, suitable partitioning should be available in the area to provide privacy for removing clothing.
8. Telephone conversations regarding patients should be carried out in privacy.
9. Discussion of patient details should be limited to professional dealings ie. other health care providers.

PROFESSIONAL CONDUCT AND ACCOUNTABILITY

STANDARD 1:

The member shall meet the ethical and legal requirements of professional practice.

CRITERIA:

STANDARD 2:

The member shall not seek special benefit or advantage from relations with a patient.

CRITERIA:

Reference: Professional Misconduct and proposed Advertising regulations under the RHPA.

SEXUAL ETHICS

STANDARD:

The member shall not commit sexual abuse of a patient.

CRITERIA:

1. * The member shall not have sexual intercourse or other forms of physical sexual relations with a patient.
2. * The member shall not carry out touching, of a sexual nature that includes, but is not limited to:
   • genital to genital, genital to anal, oral to genital, or oral to anal contact,
   • masturbation of the member by, or in the presence of, the patient,
   • masturbation of the patient by the member,
   • encouragement of the patient by the member to masturbate in the presence of the member,
   • oral to breast contact
3. * The member shall not exhibit behaviour, or utter remarks of a sexual nature to a patient. Behaviour and remarks include, but are not limited to:
   • disrobing or draping practices that reflect a lack of respect for the patient’s privacy.
   • deliberately watching a patient dress or undress.
   • sexual comments about a patient’s underclothing.
   • criticism of the patient’s sexual orientation.
   • discussion of the patient’s sexual performance.
   • conversations regarding the sexual preferences or fantasies of the member or patient.
   • kissing of a sexual nature
4. * The member has a legal obligation to abide by the mandatory reporting requirements outlined in the Regulated Health Professions Act.

* See Regulated Health Professions Act.

Prescription Custom Foot Orthoses (PCFO) are an integral part of patient care in the management of pedal pathologies and are used to improve gait and to alleviate pain and discomfort from abnormal foot function or structure.

This Standard of Practice reflects what should be performed by Chiropodists and Podiatrists with respect to the manufacturing and dispensing of orthotic devices. [For purposes of this Standard of Practice “dispensing” includes inspecting the PCFO to ensure it meets the prescription, fitting the PCFO on the patient, and educating the patient on the proper use of the PCFO.] However, this treatment therapy is dependent on many variables including each patient’s medical history, footwear, activities, and work environment. As a result of the personalized treatment plan and this multi-factorial and complex process, deviations from this Standard of Practice may be called for in certain circumstances. In these situations, the patient chart should clearly document the revised treatment process and the justification. The College of Chiropodists of Ontario has developed its PCFO Standard to ensure that the public of Ontario has access to safe and effective foot care, including safe and effective PCFO.

The College defines an orthotic prescription (the “prescription”) to be the set of instructions intended for the orthotic laboratory that very specifically outlines the parameters of design, composition and fabrication of the orthotic intended for the treatment of an underlying medical condition or postural imbalance of the patient. Read the Prescription Custom Foot Orthoses Standard.

Prescription footwear is an integral part of patient care for the management of lower extremity pathology and to alleviate pain and dysfunction caused by foot deformities. The College of Chiropodists of Ontario has developed its Prescription Footwear Standard to meet the needs of the profession and to provide the public of Ontario with safe and effective foot care. Read the Prescription Footwear Standard.

The registrant shall ensure that documentation is clear and accurate, satisfying optimum patient care and legal requirements. Read the full Records Standard.

This practice standard provides guidance to registrants on the safety and the manufacturing and modification of orthotic devices. Read the Safety and the Manufacturing and Modification of Orthotic Devices Standard.

It shall be the responsibility of each member to ensure that the practice site be equipped and maintained, and that procedures are in place, to assure health and safety for both patients and staff.

CRITERIA:

1. The premises must be in current compliance with any provincial and municipal requirements including:
   1. The Occupational Health and Safety Act and any regulations applicable to the practice environment
   2. The Healing Arts Radiation Protection Act
2. Potentially hazardous equipment used for examination and treatment is to be serviced and inspected by a qualified technician for safety, efficacy and where applicable, calibrated for accuracy as specified by manufacturer, government guidelines, or every five years.

1. An equipment service record shall be kept that sets out the servicing for every potentially hazardous piece of equipment used to examine, treat or render any service to patients.
2. Deficiencies in equipment are to be brought up to standard. Hazards should be corrected immediately and other deficiencies corrected within 21 days.
3. Policy statements, procedure and equipment manuals, are to be kept on site in office manuals, and must be available at all times.
4. The member will be certified/recertified in C.P.R. at least every three years and support staff should be encouraged to seek certification.
5. Hazardous materials are to be stored in a specific, safe, controlled area.
6. Hazardous materials are to be labelled, and detailed current handling instructions must be reviewed, initialled annually and kept in the office manual. WHMIS guidelines are recommended additions.
7. Written “sharps” policy and procedures are to be kept in the office manual.
8. Pharmaceutical and clinical supplies will be inspected for expiry dates and disposed of appropriately where necessary.

Social media is a powerful tool for communicating and networking and has become pervasive in all aspects of our lives, both personal and professional. This is especially true during global crises, like the COVID-19 pandemic. In recognition of the serious consequences of misusing social media, Council upgraded the Social Media Standard it adopted in January 2023 to a College Standard. Read the Social Media Standard.

This Standard of Practice applies to all registrants who provide supervision or mentorship (the “Supervisor”) to another registrant of the College who practices chiropody in Ontario pursuant to a certificate of registration in the Emergency Class in accordance with O. Reg. 830/93 (the “Supervisee”). Read the Supervision Standard.

The Surgical Competencies Standard of Practice of the College of Chiropodists of Ontario (the “College”) contains practice parameters and standards that should be considered by all Ontario chiropodists and podiatrists in the care of their patients. All members of the College shall only perform surgical procedures within their knowledge, skill, and judgement. The surgical procedures, and complexity of procedures, that chiropodists and podiatrists choose to undertake should reflect the commensurate level of training and courses they have successfully completed and competency and experience they have acquired. Read the full Surgical Competencies Standard.