STANDARD 12.

Professional Boundaries / Therapeutic & Professional Relationships

Respiratory Therapists (RTs) must act with honesty, integrity, and respect appropriate professional boundaries with patients/clients, healthcare team members, students, and others.

Performance Requirements

RTs:

9

Must refrain from abusing a patient/client verbally, emotionally, psychologically, electronically, physically, or sexually, or taking advantage of a patient/ client as a result of the member’s position.

9

Must refrain from abusing a person, with whom the member has a professional relationship or, in relation to whom, the member is in a position of authority or trust.

9

Recognize how a power imbalance can impact therapeutic and professional relationships, and demonstrate integrity in all interactions, including abstaining from entering into personal relationships where professional boundaries could be compromised.

9

Must not make comments, enter into situations, and/or demonstrate behaviour that could be interpreted as abusive, harassing, discriminatory, disrespectful or of a sexual nature (e.g., suggestive/provocative gestures) and must take action to prevent similar behaviour in others by reporting to the appropriate authority.

9

Refrain from maligning the reputation of any colleague.

9

Communicate clearly with patients/clients to explain assessment and therapeutic procedures that could be interpreted as compromising professional boundaries (e.g., touching, positioning) and obtain ongoing voluntary informed consent.

9

Communicate electronically and through social media in a manner that respects therapeutic and professional relationships.

9

Understand the effect and impact of abuse on patients/clients and integrates principles of sensitive practice into their care.

9

Treat all patients and clients equitably without discrimination on any basis, while recognizing their individual needs and levels of physical or cognitive ability.

Patient / Client Expected Outcome

Patients/clients can expect that RTs treat them with integrity while maintaining professional boundaries.

RELATED RESOURCES

College of Respiratory Therapists of Ontario. (2021). A Commitment to Ethical Practice. Available at: https://ethics.crto.on.ca.
College of Respiratory Therapists of Ontario. (2021). CRTO Use of Social Media by Respiratory Therapists Fact Sheet. Available at: https://www.crto.on.ca/pdf/FactSheets/SocialMedia.FS-105.pdf. College of Respiratory Therapists of Ontario. (2024). Zero Tolerance of Sexual and Other Forms of Abuse. Position Statement. Available at: http://www.crto.on.ca/pdf/Positions/sexual-abuse.pdf
College of Respiratory Therapists of Ontario. (2023). Abuse Awareness and Prevention. Professional Practice Guideline. Available at: https://abuse.crto.on.ca.
College of Respiratory Therapists of Ontario. (2021). Respiratory Therapists Providing Education. Professional Practice Guideline. Available at: https://education.crto.on.ca.
National Alliance of Respiratory Therapy Regulatory Bodies. (2016). National Competency Framework for the Profession of Respiratory Therapy. Part 1. National Standards for Entry-to-Practice. Available at: https://nartrb.ca/download/ncf-part-i-entry-to-practice-2016.National Alliance of Respiratory Therapy Regulatory Bodies. (2024). National Competency Framework. Available at: https://nartrb.ca/national-competency-profileframework.

GLOSSARY

Abuse refers to “treating others in a harmful, injurious, or offensive way.”[1]

Communicate refers to “the process of exchanging information, ideas, thoughts, feelings, or messages between individuals or groups using verbal, non-verbal, written, or visual methods.”[2]

Healthcare team refers to “peers, colleagues, and other healthcare professionals (regulated and non-regulated).”[3]

Informed consent means that the information relating to the treatment must be received and understood by the patient/client. Consent may be implied or expressed. Implied consent is determined by the actions of the patient/client. Implied consent may be inferred when performing a procedure with minimal risk that the patient/client has consented to previously and acts in a manner that implies their consent. Expressed consent is more official and may be written or oral.[4]

Patients/clients refer to individuals and their families requiring care or services. This may also include their substitute decision-maker or guardian.[5]

Professional boundaries set the limitations around relationships between patients/clients, health care providers, students, and others to ensure the delivery of safe, ethical, patient/client-centred care. Professional boundaries are characterized by respectful, trusting, and ethical interactions with patients/clients that are free of abuse, sexual abuse, sexual assault, and sexual harassment.[6]

Professional relationships refer to “the connections/interactions of RTs with service providers, students, and others.”[6]

Sensitive practice refers “delivering healthcare that respects the diverse backgrounds, beliefs and values of patients, and providing care with an understanding of how trauma affects health and behaviour”.[7]

Therapeutic relationships refer to “the connections/interactions of RTs with their patients/clients.”[8]

Related Standards

S10. Patient/Client Assessment & Therapeutic Procedures

$

S11. Privacy/Confidentiality

$

S13. Professional Responsibilities

FOOTNOTES

College of Respiratory Therapists of Ontario. (2014). Abuse Awareness and Prevention. Professional Practice Guideline. Available at: http://www.crto.on.ca/pdf/PPG/abuse.pdf
Adapted from Dictionary.Com. (2017). Online Dictionary. Available at: http://www.dictionary.com/browse/communicated
College of Respiratory Therapists of Ontario. (2010). A Commitment to Ethical Practice. Available at: http://www.crto.on.ca/pdf/Ethics.pdf
Adapted from College of Respiratory Therapists of Ontario. (2014). Responsibilities under Consent Legislation. Professional Practice Guideline. Available at: http://www.crto.on.ca/pdf/PPG/UnderConsent.pdf
Adapted from College of Respiratory Therapists of Ontario. (2010). A Commitment to Ethical Practice. Available at: http://www.crto.on.ca/pdf/Ethics.pdf
College of Respiratory Therapists of Ontario. (2014) Abuse Awareness and Prevention. Professional Practice Guideline. Available at: http://www.crto.on.ca/pdf/PPG/abuse.pdf
Adapted from Public Health Agency of Canada. (2009). Handbook on Sensitive Practice for Health Care Practitioners: Lessons from Adult Survivors of Childhood Sexual Abuse. Available at: http://www.integration.samhsa.gov/clinical-practice/handbook-sensitivve-practices4healthcare.pdf
College of Respiratory Therapists of Ontario. (2014). Abuse Awareness and Prevention. Professional Practice Guideline. Available at: http://www.crto.on.ca/pdf/PPG/abuse.pdf