June 19, 2020
Dear Registrants,
We are pleased to provide this email which includes information on the following:
- Obligations When Obtaining Client Consent to In-person Services
- Obligations When Sharing Information for CoVid-19 Contact Tracing
- Importance of Receiving Mail at Register Address
- Online Materials Now Available: “For Professional Practice in Disaster Response”
- Upcoming Workshop
Registrant’s Obligations When Obtaining Client Consent to In-person Services
The College is aware of a recent document from the BMS insurance company, “Waivers of Liability—Considerations When Resuming Practice.” That document reads, in part, “A best practice would be to consider having your client/patient sign a waiver acknowledging they will not hold you and/or your clinic, employees or agents responsible if they are exposed to and/or contract COVID-19 as a result of attending at your clinic/office/facility.” It goes on to offer a model waiver. (We are also informed that BMS has more recently provided a model form addressing COVID-19 issues that does not include a waiver.) The document also includes this statement: “Asking a client/patient to sign away their legal right to compensation, while possibly offering some degree of protection to the provider, may end up disrupting efforts to establish good patient-practitioner rapport. You should consider your professional and ethical obligations prior to implementing a waiver into your practice, including whether your regulatory body (if applicable) or professional ethics allows you to condition the provision of healthcare services on a signed liability waiver and refuse treatment to a client/patient who chooses not to sign the waiver.”
This suggested practice, requiring clients to sign away their legal right to compensation and refusing service to those who do not sign the waiver, raises significant ethical concerns. This practice does not appear to be in the best interests of clients. Registrants contemplating this insurance company suggestion may wish to review the following Code of Conduct Standards:
3.1 Responsibility
A registrant must assume full responsibility for decisions he or she has made and actions he or she has taken in the performance of psychological services.
5.1 Preserving client welfare
A registrant must take steps to protect or act in accordance with the client’s welfare in all professional relationships.
5.26 Avoiding harm
A registrant must take steps to avoid harming any individual with whom he or she works or has any form of professional relationship. This obligation includes taking steps to avoid foreseeable harm caused by acts of commission and to avoid foreseeable harm caused by a failure to take appropriate action.
As per the information provided to registrants in our CPBC May 15, 2020 document entitled Providing in-person community care during COVID-19: Guidance for Registrants from the College of Psychologists of BC, registrants are responsible for adhering to all pandemic safety best practices, including all relevant guidance from the BC Centre for Disease Control (BCCDC), the BC Provincial Infection Control Network (PICNet), and WorkSafeBC. Registrants were also reminded in this document of their obligation, as part of obtaining informed consent, to ensure that clients/patients who participate in in-person psychological services are advised of, and provide their acknowledgement of, the registrant’s obligation to provide contact information to appropriate health authorities for contact tracing when required. Registrants who are seeing clients in person may wish to consider including such advice to clients as part of their informed consent process, and to seek client acknowledgement of there being no guarantee of freedom from virus exposure in the context of in-person services.
Registrant’s Obligations When Sharing Information for CoVid-19 Contact Tracing
The obligation to provide information to health authorities in order to permit contact tracing is set out in the Public Health Act, which also specifies the persons, such as health officers or other designated persons, able to collect this information. “Novel coronavirus infections” are among the communicable diseases that are prescribed as “infectious agents” under the Schedule to the Reporting Information Affecting Public Health Regulation under the Public Health Act. Moreover, an “infected person” under the Public Health Act is defined to include “a person who … is or is likely infected with, or has been or has likely been exposed to, a prescribed infectious agent … regardless of whether the person … suffers any communicable disease or adverse effect from the infectious agent … or exhibits any symptom of being ill or infected”. This definition of “infected person” includes any person who has likely been exposed to COVID-19 through a contact with someone else who has been diagnosed with COVID-19. The mandatory reporting obligations for health professionals, including registered psychologists, in section 10 of the Public Health Act, should be read and understood in light of that broad definition of “infected person.”
Code of Conduct Standard 7.17 specifies that nothing in the Code is intended to relieve a registrant of any obligation to make any report required by law. Standard 1.6 specifies that if there is a conflict between any provision of the Code and a requirement of law, that the legal requirement prevails but the registrant must take steps outlined in Standard 18.6, to make obligations to comply with the Code known and to take steps to resolve the conflict in a responsible manner. Standard 6.7 specifies that, subject to Standard 6.8, a registrant may disclose confidential information without the informed written consent of the client if any one of a number of conditions are met. These conditions include when disclosure is in accordance with a lawful requirement to do so.
As cited above, the Public Health Act places a reporting requirement on health professionals, including registered psychologists, and COVID-19 is an infectious agent that is reportable under the Reporting Information Affecting Public Health Regulation. Standard 6.8 requires registrants disclosing confidential information without client consent to ensure that disclosure is restricted to persons or agencies, and to content, that is consistent with applicable law and the Code.
In the event you are required to provide client information for tracing purposes, whether you are initiating a report or responding to a request for information from a designated person, you should ensure you are providing only that information deemed necessary, and doing so to the appropriate person designated to collect that information. In the event you have determined you need to make a report, you will need to contact your regional health authority.
Register Address
It is expected that all registrants are able to receive mail at their register address. Registrants needing to change their register address or other contact information can do so through the Registrant Portal.
Professional Practice in Disaster Response Now Available Online!
The College’s May 21, 2020 Continuing Competency Webinar on “Professional Practice in Disaster Response” with a focus on professional practice considerations in “Psychological First Aid” (PFA) has been posted to the Registrant portal for viewing. FAQs in response to questions the College received regarding psychological first aid are also available on the Registrant portal.
Over 359 registrants were in attendance for the Webinar! We are pleased that those who were unable to watch the webinar now have free access to it through the registrant portal.
Upcoming Workshop Announcement
Preparation is now underway for a second free of charge webinar for registrants on the general topic of Strengths for Psychological Recovery (SPR) with midsummer being the target date. Dr. Jeanne LeBlanc and Dr. Susan Turnbull will once again be teaming up to do this webinar. We will announce the date within the next few weeks. Given the huge response to the first workshop on PFA, this is viewed as an important “Part 2” of the College’s effort to ensure registrants have the necessary tools and information to provide psychological services to clients during (and after) the pandemic.
Keeping in Touch:
CPBC email updates and the COVID-19 updates webpage are offered to registrants as a means of keeping registrants informed on a timely basis regarding the practice of psychology during the pandemic.
Comments received via the feedback@collegeofpsychologists.bc.ca email continue to be appreciated, as are the thoughtful comments expressed.
The College continues to be proud and appreciative of the work of registrants in providing professional and competent services under these difficult and novel circumstances.
With kind regards and continued wishes for your good health on behalf of the College Board and staff.
Dr. Andrea Kowaz, Registrar