Professionalism and Professional Obligations for Registered Dietitians

• Mandatory Reporting For Dietitians
• Key Elements of a Mandatory Report
• Mandatory Report of Sexual Abuse
• Mandatory Report of Child Abuse
• Duty to Warn
• Mandatory Reports about the Conduct of Another Dietitian
• The Formal Investigation
• Protection from Retaliation

 
Mandatory Reporting for Dietitians
A special duty under the Regulated Health Professions Act, and indeed other statutes, is to make mandatory reports to the proper authority when certain events occur, such as sexual abuse of a client, child abuse, abuse of an elderly person in a nursing home, or unprofessional behavior of another dietitian. If it appears that one of these situations exists, a dietitian should obtain specific advice.

• Generally, failing to make a mandatory report is considered professional misconduct and carries significant consequences. In some cases, dietitians can be prosecuted and fined up to $50,000 in Provincial Offences Court.
• A dietitian could also be sued for any harm that results from a failure to report. Some years ago, a physician was successfully sued for more than half a million dollars for failing to report a client who was a danger to others, and who then harmed someone in a motor vehicle accident.
• A mandatory report is not a breach of confidentiality, even where a client does not want a report to be made. A dietitian's duty of confidentiality is subject to other requirements or authority of law.

• Provide a summary of the concern. Be clear about the concern. Do not make the reader guess, particularly if the matter is technical or clinical.
• Provide details. This will assist the recipient to respond appropriately. It may also reduce your subsequent involvement in answering obvious questions. It is usually acceptable to attach pertinent documents.
• Include a list of witnesses the authority may wish to contact. Remember, for reports of sexual abuse under the Regulated Health Professions Act , the identity of the client cannot be included unless he or she consents in writing.
• Include any response or explanation from the subject of the report. Fairness would suggest that it be mentioned in the report. This demonstrates good faith. In addition, including the response helps everyone understand the complete situation. You are not taking sides by making a report, but providing important information to an authority.
• Outline any action that has been taken to date on the allegation. It is important for the authority to know, for example, that the person has been placed on workplace suspension.

• A report of sexual abuse under the Regulated Health Professions Act must be made if a dietitian has reasonable grounds, obtained in the course of practising dietetics, to believe that a regulated health professional has sexually abused a patient.
• A report of sexual abuse under the Regulated Health Professions Act cannot include the identity of the client unless the client gives written consent to including his or her name.
• A report of sexual abuse under the Regulated Health Professions Act must be made within 30 days unless there are reasonable grounds to believe that additional abuse may occur, in which case the report must be made immediately.

• Reasonable grounds refer to objective information, not personal belief. If the facts are present, a report must be made even though you might not believe the facts to be true. A dietitian does not have to make a detailed evaluation of whether the person providing the information is credible - - so long as there is some objective basis for making the report.
• Reasonable grounds describe the type of information needed to make a report. Mere rumour or gossip does not constitute reasonable grounds; for example, a nurse saying over coffee that everyone knows that a certain doctor in the hospital sleeps with his patients. However, hard evidence or clear proof is not needed either. Information from someone who did not personally observe the event is fine, so long as it contains some specifics.

• terminating an employee;
• terminating an association (e.g., partnership, contract, professional corporation) with another registered health practitioner for professional misconduct, incompetence or incapacity;
• ending a group practice because you could no longer tolerate a practitioner's conduct or incompetence, e.g., drinking or repetitive rudeness to clients;
• intending to terminate an employee or associate but that person resigned or voluntarily relinquished their privileges.

• In every case, try not to disturb the evidence. Make sure that documents are not altered by your inquiries. Ensure that the recollection of witnesses is not affected by asking leading questions, or interviewing them in the presence of other witnesses or people who may, by their mere presence, influence the answers.
• Only make inquiries if there is an important reason for doing so, for example, to ensure that sufficient facts have been collected in order to make the report, establish whether anyone is at immediate risk, or take necessary internal disciplinary action.
• If it is reasonably possible, wait until the authorities have completed their inquiries.