Table 1 Characteristics of codes of ethics / guidance / standards of Ontario’s 26 health and profession regulatory colleges

General Principles, Values

Pharmacists: Beneficence; Non-Maleficence; Respect for Persons/Justice; and Accountability

Physicians: Compassion; Service; Altruism; and Trustworthiness.

Nurses: Client Well-Being; Client Choice; Privacy & Confidentiality; Respect for Life; Maintaining Commitments; Truthfulness; Fairness.

Protection of Patients / Clients

Pharmacists should “ensure that their primary focus at all times is the well-being and best interests of the patient”; optimize health outcomes for patients; be well-informed about their patients’ needs; and provide all information needed (p.5) [21]. Pharmacists are also expected to avoid harm and conflict of interest; protect the patient’s right to privacy and confidentiality; and ensure that “the healthcare professional/ patient relationship is not exploited by the member for any personal, physical, emotional, financial, social or sexual gain” (p. 7). Pharmacists are expected to respect “the vulnerability of patients”; respect patients’ autonomy and dignity; treat them with “sensitivity, caring, consideration and respect” (p. 8); Pharmacists are expected to respect the patient’s right of informed decision-making. Pharmacists are expected to “recognize the power imbalance inherent in the healthcare professional/patient relationship and assume responsibility for maintaining appropriate professional boundaries at all times” (p. 9) [21].

Respectful treatment of colleagues (including rules against discrimination, harassment)

Physicians and surgeons should collaborate with and support colleagues and other health professionals, which entails “not only getting along and treating others with respect” but also “recognizing and accepting the unique roles and contributions of other health professionals” (p.9) [22]. Examples of potential collaborations are “the exchange of information; developing collaborative guidelines; fostering positive relationships at the institutional level; sharing decision-making, where appropriate and in the patient’s best interest; and developing policies that ensure quality of care” (12) [22].

Competence, skills, quality services

Physiotherapists are expected “to use their knowledge and expertise to promote high quality, competent and ethical care for patients and thereby instill in the public, confidence in the profession“(p.1) [23].

Optometrists are expected to meet the standard of practice of the profession; not practice if impaired by substance or condition; not practice beyond their experience and competence; not practice without authorization and not supervise those without authorization; always use appropriate terms, titles, and designations… [24]

Social Media

Dental surgeons are encouraged to maintain professional boundaries when interacting with clients online and to include all interactions in patients’ files. They are encouraged to very carefully consider friendship requests from a patient; reminded that online privacy is never absolute; asked to avoid unprofessional, inappropriate or unethical behaviour; and avoid making derogatory comments about “individuals, groups, or organizations” [25].

Virtual Practice

Physicians and surgeons “must continue to meet the standard of care and the existing legal and professional obligations that apply to care that is provided in person” (p. 2). There are guidelines to (1) Protect personal health information and ensure privacy, security, and confidentiality; (2) Require informed consent from the patient; (3) Determine whether virtual care is appropriate, and always prioritize in-person care; (4) Ensure high quality of care at all times; and (5) Ensure compliance with licensing requirements when willing to offer care to an Ontario patient when the patient is out of Ontario or when the physician is out of Ontario [26].

Technological competence

Psychologists and behaviour analysts “using technology must a. maintain and address current knowledge of the risks associated with that use; b. Registrants must be competent in the use of technology they adopt; c. Registrants are free to responsibly utilize technological advances … but technology may not be used instead of registrants’ own professional knowledge, skill and judgment. Such professional activities must always be actively reviewed by registrants …. and d. Registrants must ensure, as part of the informed consent process that clients understand how technology is being used to assist them, any risks of technological error, and what risks there are to their privacy when personal information is being used, stored, or transmitted within an external technological application“(p.28) [27].

Artificial Intelligence

“When using artificial intelligence (AI) tools …. [dietitians should] apply professional judgment to review AI output and ensure that the information generated when editing or creating content is consistent with equity, diversity, and inclusion principles”. Additionally, dietitians should “uphold human autonomy when using technology, including Artificial intelligence (AI) tools, ensuring individuals retain decision-making authority, especially regarding person-centred outcomes.” [28]

Employment challenges / Relations with Employers

Psychologists and behaviour analysts: “Registrants working as employees must demonstrate efforts to ensure that their work settings adhere to applicable statutes, regulations, standards, codes of ethics, and guidelines” (p. 6). “Registrants required by an employer to engage in conduct which is contrary to the standards of the profession are expected to advocate for changes within the workplace but are not expected to put livelihood at risk”(p.7) [27].