Professionalism and Professional Obligations for Registered Dietitians

Scope of Practice & the Controlled Acts

Each profession under the Regulated Health Professions Act has a scope of practice statement that describes, in broad terms, what that profession does. For dietitians, the statement is set out in the Dietetics Act , Section 3, as follows:

"The practice of dietetics is the assessment of nutrition and nutritional conditions and the treatment and prevention of nutrition related disorders by nutritional means." Presently, there is no exclusivity to this statement. People who are not dietitians can provide these services unless they contravene a provision of the Dietetics Act. Specifically, people who are not dietitians must not use the title "dietitian". They must also not do things or omit to do things which might reasonably result in seriously harming someone.

The primary purpose of the scope of practice statement is to educate dietitians and the public about the focus of the dietetic profession. The College uses the scope of practice statement, for example, to define parameters for developing and supporting compliance of standards.

Controlled Acts
Controlled acts are health care actions that are considered potentially harmful if performed by unqualified persons. The Regulated Health Professions Act sets 14 acts that should only be performed by someone with the legal authority to do so. The system of controlled acts is fundamental to the health regulatory system and the ideals of public protection in Ontario health care. The statutes, limiting the practice of controlled acts to authorized regulated professionals only, apply to everyone, including laypersons. All are forbidden to practice controlled acts without being authorized to do so by law.

Dietitians have not been granted the specific legal authority to perform any of the controlled acts under their profession specific act, the Dietetics Act. Every dietitian must be aware of the complex issues involving the interpretation of controlled acts in relation to dietetics. This understanding is critical, because dietitians would not want to violate the law, and yet would not want to unnecessarily limit their health care activities and efficient delivery of client-centred health care.

When can dietitians perform a controlled act?
Unless a legal exception applies, dietitians can perform a control act only if they obtain the authority to do so from a regulated health professional authorized to perform the act by their profession-specific act, such as a physician. This transfer of authority is known as a delegation of a legal controlled act.

The Interprofessional Guide on the Use of Orders, Directives and Delegation for Regulated Health Professionals in Ontario has been developed as a consensus document by the Federation of Health Regulatory Colleges of Ontario. This interactive web-based guide provides in-depth information for regulated health professionals working together to understand the laws that govern the authority mechanisms that direct health care in Ontario today.