O-7, r. 5 - Code of ethics of optometrists

Updated to 1 September 2012

This document has official status.

chapter O-7, r. 5

Code of ethics of optometrists

Optometry Act

(chapter O-7, s. 3).

Professional Code

(chapter C-26, s. 87).

CHAPTER I DUTIES AND OBLIGATIONS TOWARDS THE PUBLIC

1. An optometrist entered on the roll of the Ordre des optométristes du Québec must promote improvement in the quality and availability of professional services in his field of practice.

O.C. 643-91, s. 1.

2. In the practice of his profession, an optometrist must take into account all the foreseeable consequences that his research and work may have for society.

O.C. 643-91, s. 2.

3. An optometrist must encourage measures for education and information in his field of practice. In particular, he shall help develop his profession by exchanging his knowledge and experience with colleagues and students, and by participating in continuing education courses and training sessions.

O.C. 643-91, s. 3.

4. An optometrist must behave with moderation, dignity and a concern for protecting the health and well-being of the people he serves, individually as well as collectively.

O.C. 643-91, s. 4.

5. (Revoked).

O.C. 643-91, s. 5; O.C. 1072-95, s. 1.

CHAPTER II DUTIES AND OBLIGATIONS TOWARDS THE PATIENT

DIVISION I GENERAL PROVISIONS

6. Before accepting a mandate, an optometrist must take into account the limits of his abilities and knowledge and of the means at his disposal.

O.C. 643-91, s. 6.

7. Where required for the well-being of the patient, an optometrist must consult a colleague, a member of another professional order or any other qualified person and he must refer his patient to a physician where he suspects or ascertains the presence of symptoms or signs of ocular pathology.

O.C. 643-91, s. 7.

The words “suspects or” were declared ultra vires by the Superior Court on 19 March 1992 (No 500-05-008547-919).

8. An optometrist must always recognize his patient’s right to consult a colleague, a member of another professional order or another competent person.

O.C. 643-91, s. 8.

9. An optometrist must refrain from practising when in a condition likely to compromise the quality of his services. In particular, he must not practise his profession when under the influence of alcohol, drugs, hallucinogens, narcotic or anesthetic preparations, or any other substance likely to induce intoxication, weakening or disruption of the faculties, or unconsciousness.

O.C. 643-91, s. 9.

10. An optometrist must seek to establish a relationship of mutual trust between himself and his patient. To that end, the optometrist must in particular:

(1)  refrain from practising his profession in an impersonal manner;

(2)  conduct his interviews in such a way as to respect the values and personal convictions of his patient where the latter informs his thereof.

O.C. 643-91, s. 10.

11. An optometrist must refrain from interfering in the personal affairs of his patient.

O.C. 643-91, s. 11.

12. In the practice of his profession, an optometrist’s behaviour towards each patient must be beyond reproach, whether on the physical, mental or emotional levels.

O.C. 643-91, s. 12.

13. In addition to opinions and advice, an optometrist must give his patient the explanations necessary for him to understand and appreciate the services provided.

O.C. 643-91, s. 13.

14. An optometrist must practise his profession in accordance with the principles generally recognized in his profession.

The optometrist must ensure that the Optometry Act (chapter O-7), the Professional Code (chapter C-26) and the regulations thereunder are respected by employees, students, trainees, shareholders, partners and all other persons he works with in the practice of the profession.

An optometrist who practises his professional activities within a partnership within the meaning of the Civil Code or a joint-stock company contemplated by paragraph VI.3 of the Professional Code must ensure that it respects the Optometry Act, the Professional Code and the regulations thereunder.

The duties and obligations that result from the Optometry Act, the Professional Code and the regulations thereunder are in no way undermined by the fact that an optometrist carries on his professional activities within a partnership or joint-stock company.

O.C. 643-91, s. 14; O.C. 363-2008, s. 1.

DIVISION II INTEGRITY

15. An optometrist must perform his professional obligations with integrity.

O.C. 643-91, s. 15.

16. An optometrist must avoid any misrepresentation of his level of competence or of the effectiveness of his own services or of services provided by the members of his profession.

Similarly, he shall not falsely represent the competence of, or the effectiveness of the services generally ensured by, persons carrying on professional activities within a partnership or joint-stock company.

O.C. 643-91, s. 16; O.C. 363-2008, s. 2.

17. Before giving any opinion or advice, an optometrist must seek full knowledge of the facts.

O.C. 643-91, s. 17.

18. An optometrist must explain to his patient, completely and objectively, the nature and extent of the problem which, in his opinion, emerges from the facts as a whole. He must refrain from giving contradictory or incomplete advice or opinions.

O.C. 643-91, s. 18.

19. An optometrist must inform his patient of any error, complication or incident that occurred while he was providing him with his professional services.

O.C. 643-91, s. 19.

20. An optometrist must take reasonable care of any ophthalmic lens entrusted to him by his patient.

O.C. 643-91, s. 20.

21. An optometrist must avoid performing acts that are not required from an optometrical point of view by repeating such acts more frequently than necessary or performing them where they are not justified.

O.C. 643-91, s. 21.

22. An optometrist must refrain from unduly seeking or making profit from the prescription of lenses or treatments.

O.C. 643-91, s. 22.

23. When dispensing an ophthalmic product, an optometrist must refrain from seeking or making a profit disproportionate to the value of the product.

O.C. 643-91, s. 23.

DIVISION III LIABILITY

24. An optometrist must commit his personal civil liability for acts he has performed, whatever the conditions under which he provides his services. He may not elude or attempt to elude liability, nor request that a client or another person renounce any recourse taken in a case of professional negligence on his part. Furthermore, he may not invoke the liability of the partnership or joint-stock company within which he carries on his professional activities, or that of another person also practising his activities in said partnership or joint-stock company, as a ground for excluding or limiting his personal civil liability.

O.C. 643-91, s. 24; O.C. 363-2008, s. 3.

DIVISION IV AVAILABILITY AND DILIGENCE

25. An optometrist must be available to and diligent towards his patient.

O.C. 643-91, s. 25.

26. Where an optometrist is absent for more than 5 consecutive working days from the office in which he provides services, he shall take the steps necessary to inform people attempting to contact him of the duration of his absence.

O.C. 643-91, s. 26.

27. Except for a just and reasonable cause, no optometrist may refuse or cease to act on behalf of a patient. The following causes, among others, are considered just and reasonable:

(1)  absence or loss of the patient’s trust;

(2)  the fact that the optometrist is in a conflict of interest or in a context such that his professional independence could be called into question;

(3)  incitement by the patient to perform illegal, unjust or fraudulent acts.

O.C. 643-91, s. 27.

28. Before ceasing to treat a patient, the optometrist must ensure that the patient can continue to receive the care he needs and must contribute to such care to the extent necessary.

O.C. 643-91, s. 28.

DIVISION V INDEPENDENCE AND IMPARTIALITY

29. An optometrist must be objective when potential patients ask him for information.

O.C. 643-91, s. 29.

30. An optometrist must place his personal interest as well as that of the partnership or joint-stock company in which he carries on his professional activities or in which he has interests, after that of his patient.

O.C. 643-91, s. 30; O.C. 363-2008, s. 4.

30.1. No optometrist may conclude any agreement that could jeopardize the independence, impartiality, objectivity or integrity required to practise his professional activities.

O.C. 363-2008, s. 5.

31. An optometrist must preserve his professional independence and ignore any intervention by a third person that could influence the performance of his professional duties to the detriment of his patient.

O.C. 643-91, s. 31.

32. An optometrist must not practise optometry where he is in a conflict of interest.

O.C. 643-91, s. 32.

32.1. An optometrist shall take prompt measures to ensure that information and documents relevant to professional secrecy are not disclosed to a partner, shareholder, director, manager, officer or employee of a partnership or joint-stock company within which the optometrist practises his professional activities or in which he has an interest, where he becomes aware that the partner, shareholder, director, manager, officer or employee has a conflict of interest.

The following factors must be considered in assessing the efficacy of such measures:

(1)  size of the partnership or joint-stock company;

(2)  precautions taken to prevent access to the optometrist’s file by the person having a conflict of interest;

(3)  instructions given to protect confidential information or documents related to the conflict of interest;

(4)  isolation, from the optometrist, of the person having a conflict of interest.

O.C. 363-2008, s. 6.

33. An optometrist is in a conflict of interest if, in particular, he:

(1)  shares his professional income, in any form whatsoever, with a person, trust or undertaking, except for:

(a)  a person who is a member of the Ordre des optométristes du Québec;

(b)  a person, trust or undertaking contemplated in subparagraph 1 of section 2 or subparagraph 1 of section 3 of the Regulation respecting the practice of the profession of optometry within a partnership or a joint-stock company (chapter O-7, r. 8);

(c)  a joint-stock company in which he carries on his professional activities;

(2)  grants any commission, rebate, advantage or other consideration of a similar nature relating to the practice of optometry;

(3)  receives, in addition to the remuneration to which he is entitled, any commission, rebate, discount, advantage or other consideration of a similar nature from anyone, including a seller or manufacturer of ophthalmic lenses, frames, medication or other products linked to the practice of optometry, except for customary tokens of appreciation and gifts of small value;

(4)  receives a line of credit from a seller or manufacturer of ophthalmic lenses, frames, medication or other products linked to the practice of optometry, unless he has a written agreement including a declaration that the resulting conditions comply with the provisions of this Code and a clause that authorizes such agreement to be submitted to the Order upon request;

(5)  leases or uses the premises, equipment or other resources of anyone, including a seller or a manufacturer of ophthalmic lenses, frames, medication or other products linked to the practice of optometry, unless he has a written agreement with a declaration that the resulting conditions comply with the provisions of this Code and a clause that authorizes such agreement to be submitted to the Order upon request;

(6)  practices optometry jointly, in a partnership or for a person or within a joint-stock company, unless the partnership, person or joint-stock company is:

(a)  an optometrist;

(b)  a government, governmental or municipal organization, a university or an institution within the meaning of the Act respecting health services and social services (chapter S-4.2) or the Act respecting health services and social services for Cree Native persons (chapter S-5);

(c)  an undertaking retaining his services for the sole purpose of providing optometrical advice or services to its employees;

(d)  a retailer that operates an optical department contemplated by subparagraph a in the sixth paragraph of section 25 of the Optometry Act (chapter O-7) when he is responsible for administration;

(e)  a partnership or joint-stock company contemplated by the Regulation respecting the practice of the profession of optometrist in a partnership or a joint-stock company.

O.C. 643-91, s. 33; O.C. 363-2008, s. 7.

33.1. Notwithstanding section 33, an optometrist is not in a conflict of interest if he accepts a discount from a seller for one of the following reasons:

(1)  for prompt regular payment, when the discount is indicated on the invoice and complies with marketplace rules for discounts;

(2)  due to the volume of products purchased other than medication, where the discount is indicated on the invoice or the account statement and complies with the market rules in similar situations.

O.C. 363-2008, s. 8.

DIVISION VI PROFESSIONAL SECRECY

34. An optometrist is bound by professional secrecy.

O.C. 643-91, s. 34.

35. An optometrist may be released from professional secrecy by written authorization from his patient or where so prescribed by law.

O.C. 643-91, s. 35.

36. An optometrist who asks a patient to reveal confidential information or who allows such information to be entrusted to him must ensure that the patient is fully aware of the aim of the interview and of the various uses that may be made of the information.

O.C. 643-91, s. 36.

37. No optometrist shall reveal that a person has used his services except for the purposes of internal administration of the partnership or joint-stock company in which he carries on his professional activities.

O.C. 643-91, s. 37; O.C. 363-2008, s. 9.

38. No optometrist may use confidential information to the prejudice of a patient or with the intent of receiving, directly or indirectly, an advantage for himself or for others.

O.C. 643-91, s. 38.

38.0.1. An optometrist must ensure that anyone with whom he engages in his professional activities does not disclose to a third party the confidential information of which he may have taken cognizance.

O.C. 363-2008, s. 10.

38.1. The communication by an optometrist of confidential information to ensure the protection of persons, pursuant to the third paragraph of section 60.4 of the Professional Code (chapter C-26), must:

(1)  be made within a reasonable time to achieve the purpose intended by the communication; and

(2)  be noted in the patient’s record, along with the name and contact information of any person to whom the information was communicated, the information in question, the reasons for the decision to communicate the information and the method of communication used.

O.C. 24-2004, s. 1.

DIVISION VII ACCESSIBILITY AND RECTIFICATION OF RECORDS AND ACCESSIBILITY OF PRESCRIPTIONS

O.C. 363-2008, s. 11.

39. An optometrist must respond promptly, at the latest within 20 days of its receipt, to any request made by a patient to consult or obtain a copy of documents that concern the patient in any record made in his respect.

O.C. 643-91, s. 39; O.C. 363-2008, s. 12.

39.1. An optometrist may charge the patient reasonable fees that do not exceed the cost of reproduction or transcription of the documents and the cost of transmitting a copy of them.

An optometrist who intends to charge such fees must inform the patient of the approximate amount to be paid before reproducing, transcribing or transmitting the information.

O.C. 363-2008, s. 13.

39.2. An optometrist must provide a patient or anyone designated by the patient, upon request, with all information that would allow him to obtain a benefit to which he may be entitled.

O.C. 363-2008, s. 13.

39.3. An optometrist must, at the written request of the patient and at the latest within 20 days of the date of such request, provide anyone designated by the patient with the relevant information in the optometric record that he holds or maintains in the patient’s respect.

O.C. 363-2008, s. 13.

39.4. An optometrist must respond promptly, at the latest within 20 days of its receipt, to any request made by a patient to have information that is inaccurate, incomplete, ambiguous, outdated or unjustified corrected or deleted in any document concerning the patient. He must also respect the patient’s right to make written comments in the record.

An optometrist must give the patient, free of charge, a duly dated copy of the document or part of the document filed in the record so that the patient may verify that the information has been corrected or deleted or, where applicable, give the patient an attestation stating that the patient’s written comments have been entered in the record.

O.C. 363-2008, s. 13.

39.5. On written request from the patient, an optometrist must forward a copy, free of charge, of the corrected information or an attestation stating that the information has been deleted or, where applicable, that the written comments have been filed in the record, to every person from whom the optometrist received the information that was the subject of the correction, deletion or comments, and to every person to whom the information was communicated.

O.C. 363-2008, s. 13.

39.6. An optometrist who denies a patient access to information contained in a record established in the patient’s respect or who refuses to grant a request to correct or delete information must provide the patient with written justification explaining his refusal, enter the written justification in the record and inform the patient of his recourses.

O.C. 363-2008, s. 13.

39.7. An optometrist must respond promptly to any written request from a patient to have a document returned to the patient.

O.C. 363-2008, s. 13.

40. An optometrist must respect the patient’s right to have his prescriptions filled at the place and by the person of his choice.

An optometrist shall immediately give a patient his prescription without the patient’s having to ask for it.

The second paragraph was declared ultra vires by the Superior Court on 19 March 1992 (No 500-05-008547-919).

O.C. 643-91, s. 40.

DIVISION VIII FIXING AND PAYMENT OF FEES

41. An optometrist must charge and accept fair and reasonable fees.

O.C. 643-91, s. 41.

42. Fees are fair and reasonable if they are justified by the circumstances and proportionate to the services rendered. In fixing his fees, the optometrist shall give consideration to the following factors, among others:

(1)  the time spent in performing the professional service;

(2)  the difficulty and importance of the service;

(3)  the providing of unusual services or of services requiring exceptional promptness or skill.

O.C. 643-91, s. 42.

43. No optometrist may demand that a patient pay an account for professional services of which a third party assumes the cost unless he is legally entitled to conclude and has concluded an explicit agreement to the contrary with his patient.

O.C. 643-91, s. 43.

44. No optometrist shall charge fees for a professional service provided but not required from an optometrical point of view.

O.C. 643-91, s. 44.

45. No optometrist shall charge fees for professional services not provided or fees which do not correspond to the services actually rendered.

O.C. 643-91, s. 45.

46. An optometrist must provide his patient with all the explanations necessary for him to understand his statement of fees and the terms of payment.

In particular, he must include the following elements in his statement of fees: his name or his firm name, the address and telephone number of his office, the date and, separately, the selling price and a description of the lens, frame or other products, together with the price, description and extent of the services offered in his contract for services.

O.C. 643-91, s. 46.

47. An optometrist must inform his patient of the approximate and foreseeable cost of his professional services.

O.C. 643-91, s. 47.

48. No optometrist may require advance payment of his professional fees. He may, however, require an advance to defray the expenses necessary for the performance of the professional services needed.

O.C. 643-91, s. 48.

49. An optometrist may charge interest on his accounts only after duly advising his patient thereof. The rate of the interest charged must be reasonable.

O.C. 643-91, s. 49.

50. Before taking legal action, an optometrist must exhaust all the other means available to him for obtaining payment of his fees.

O.C. 643-91, s. 50.

51. Where an optometrist entrusts another person with the collection of his fees, he must ensure that the other person proceeds with tact and moderation.

O.C. 643-91, s. 51.

DIVISION IX CONDITIONS, OBLIGATIONS AND PROHIBITIONS RESPECTING ADVERTISING

O.C. 1072-95, s. 2.

51.01. No optometrist may, by any way whatsoever, engage in advertising that is false, misleading, incomplete or likely to mislead the public, or allow such advertising to be engaged in.

No optometrist shall allow a partnership or joint-stock company within which he carries on his professional activities to engage in, by any means whatsoever, advertising that is false, deceitful, incomplete or liable to be misleading.

O.C. 1072-95, s. 2; O.C. 363-2008, s. 14.

51.02. An optometrist may claim special qualities or skills only if he can substantiate them.

O.C. 1072-95, s. 2.

51.03. No optometrist may use an endorsement or testimonial concerning him.

O.C. 1072-95, s. 2.

51.04. An optometrist must see to it that the persons working with him in any capacity whatsoever, in the practice of his profession, comply with the rules respecting advertising.

O.C. 1072-95, s. 2.

51.05. All optometrists who are partners or work together in the practice of their profession are jointly responsible for complying with the rules respecting advertising, unless one of them demonstrates that the advertising was done without his knowledge and consent and in spite of measures taken to ensure compliance with those rules.

O.C. 1072-95, s. 2.

51.06. An optometrist must keep a copy or a reproduction of all documents relating to every advertisement for 3 years after the date of the last broadcast or publication.

O.C. 1072-95, s. 2.

51.07. The Order is represented by a graphic symbol. An optometrist using that symbol in his advertising must make sure that it is identical to the original kept by the secretary.

O.C. 1072-95, s. 2.

51.08. No optometrist may use superlatives or comparisons intended to disparage goods or services provided by another optometrist or by a member of another professional order.

O.C. 1072-95, s. 2.

51.09. An optometrist must indicate in all advertising his name and his title of optometrist.

O.C. 1072-95, s. 2.

51.10. An optometrist advertising a price, a reduction, a discount, free goods or services or a commercial policy must:

(1)  specify the nature and scope of the services and the characteristics of the goods offered, unless all the goods on the premises are involved;

(2)  indicate that additional goods or services are required but not included, if such is the case;

(3)  mention any important fact that may help the public make an informed choice regarding the goods or services offered, particularly the fact that a good has been discontinued;

(4)  give more importance to the goods or services offered than to the price, reduction, discount or commercial policy.

The explanations and indications must be given in such a manner as to inform persons who have no particular knowledge of the goods or services offered by an optometrist.

O.C. 1072-95, s. 2.

51.11. No optometrist may, by any means whatsoever, falsely:

(1)  announce a price reduction;

(2)  indicate the regular price or another reference price for a good or service;

(3)  suggest that the price of a good or service constitutes a good bargain.

O.C. 1072-95, s. 2.

51.12. An optometrist may advertise goods only if he has or can obtain a sufficient quantity thereof to meet the demand, unless he mentions in his advertising that he has a limited quantity of the goods concerned and indicates that quantity.

O.C. 1072-95, s. 2.

51.13. An optometrist must specify the period of validity of any advertised price, reduction, discount, free goods or services or commercial policy.

O.C. 1072-95, s. 2.

CHAPTER III DUTIES AND OBLIGATIONS TOWARDS THE PROFESSION

DIVISION I DEROGATORY ACTS

52. In addition to the acts mentioned in sections 57 and 58 of the Professional Code (chapter C-26) and in section 24 of the Optometry Act (chapter O-7), the following acts are derogatory to the dignity of the profession:

(1)  unduly urging someone to use his professional services;

(2)  failing to report to the Order that he has reason to believe that an optometrist is incompetent or does not act in compliance with professional ethics;

(3)  failing to refer his patient to a physician where he suspects or ascertains the presence of symptoms or signs of ocular pathology;

(4)  falsifying a patient’s record in respect of information gathered at the time of an examination or treatment;

(5)  issuing to anyone, for any reason whatever, a false certificate or attestation or any other document containing false or unchecked information;

(6)  refusing to provide his professional services to a patient for the sole reason that the patient has had or intends to have his prescription filled by a third party;

(7)  practising optometry without identifying himself by his name and profession;

(8)  communicating with a plaintiff without prior written permission of the syndic or his assistant, where the optometrist has been informed of an inquiry into his conduct or professional competence or into the conduct or competence of a person with whom he practises, where he has been served a complaint concerning himself or where he has been informed that a complaint has been served on a person with whom he practises;

(9)  failing to promptly notify the secretary of the Order where, pursuant to the Bankruptcy and Insolvency Act (R.S.C. 1985, c. B-3), an optometrist or the partnership or joint-stock company within which he carries on his professional activities has made an assignment of property for the benefit of his creditors, is the subject of a receiving order, or has made a proposal that has been rejected by his creditors or dismissed or annulled by the court;

(10)  carrying on his professional activities within, or having an interest in, a partnership or joint-stock company whose name compromises the dignity of the optometrist profession or with a person who, to the optometrist’s knowledge, acts in a manner that compromises the dignity of the optometrist profession;

(11)  carrying on his professional activities within, or having an interest in a partnership or joint-stock company, where a partner, shareholder, director, manager, officer or employee of the partnership or joint-stock company, has been suspended for more than 3 months or whose professional permit has been revoked, unless the partner, shareholder, director, manager, officer or employee:

(a)  ceases to occupy the position of director, officer or manager within the partnership or joint-stock company within 15 days of the date on which his suspension or the revocation of his permit takes effect;

(b)  ceases to attend shareholder meetings and to exercise his voting right within 15 days of the date on which his suspension or the revocation of his permit takes effect;

(c)  disposes of his voting shares or transfers them to a trustee within 15 days of the date on which his suspension or the revocation of his permit takes effect.

O.C. 643-91, s. 52; O.C. 363-2008, s. 15.

The words “suspects or” in paragraph 3 were declared ultra vires by the Superior Court on 19 March 1992 (No 500-05-008547-919).

DIVISION II RELATIONS WITH THE ORDER AND THE MEMBERS

53. Where an optometrist is requested by the Order to participate in an arbitration of accounts or a disciplinary council or professional inspection committee, he must accept that office unless he has particular reasons for refusing.

O.C. 643-91, s. 53.

54. An optometrist must reply promptly to any correspondence from the syndic of the Order, or from investigators and members of the professional inspection committee acting in that capacity.

The same applies to any correspondence from the secretary of the Order relating to the setting up and updating of the roll.

O.C. 643-91, s. 54.

55. An optometrist must not betray the good faith of a colleague or be guilty of breach of trust or unfair behaviour towards him. In particular, he must not take credit for work done by a colleague.

O.C. 643-91, s. 55.

56. Where an optometrist is asked for advice by a colleague, he must provide his opinions and recommendations as promptly as possible.

O.C. 643-91, s. 56.

57. An optometrist practising in a group must, subject to the terms of any written agreement, allow a person leaving the group to take with him a copy of the records of the patients who consulted him.

O.C. 643-91, s. 57.

58. (Omitted).

O.C. 643-91, s. 58.

REFERENCES

O.C. 643-91, 1991 G.O. 2, 1691

O.C. 1072-95, 1995 G.O. 2, 2680

O.C. 24-2004, 2004 G.O. 2, 811

O.C. 363-2008, 2008 G.O. 2, 1240

S.Q. 2008, c. 11, s. 212