Code of ethics
PREAMBLE Affiliated to the Université de Montréal, the Institut Philippe-Pinel de Montréal is a supraregional university psychiatric hospital specializing in forensic psychiatry and in the assessment, treatment and management of patients presenting a risk of violent behavior. The Institut renders care and services to a mixed, multi-ethnic and multicultural clientele from the Quebec and Canadian health, correctional and justice systems. Most of the patients are detained as a result of a disposition of the provincial Review Board or serving a sentence. Therefore, the Institut has responsibilities towards its patients and society. The psychiatric patient is a full citizen. He has rights and freedoms. The Code of ethics of the Institut Philippe-Pinel de Montréal has the objective of clarifying the rights of the patients and the practices which follow for the personnel regarding these aspects: the respect of the individual; the respect of ownership; the respect of the freedom of action and opinion; the respect of the environment and of the quality of life; the respect of the accessibility to care and services. Patients rights have accompanying responsibilities. These ones are listed in this code of ethics. The Institut also has responsibilities towards its employees, its partners and the community. Its human resources permit the Institut to provide quality services. Therefore, the Institut must take appropriate means to a sound management of its human resources. The partners of the Institut have an important role in the accomplishment of its mission. The Institut must collaborate with them, in accordance with its mission. The Institut is also responsible for the best possible management of its resources. The Code of ethics identifies the values and establishes the fundamental rules towards the Institut, its patients, its personnel and society. It constitutes a general framework which is consulted by the patients and the personnel. Every service and every unit must appropriate this code, ascertain that it is respected and assimilate it into all its approaches. Sur la route Painting created «the automatist way» by adolescents of IPPM under supervision of Mr. Philippe Chauveau, socio-therapist. The artist are : Danny, Dave, Ian, Jérémie and Yan.
CONTENTS 1.0 Principles 1 2.0 Respect of the individual 2 3.0 Respect of ownership 3 4.0 Respect of the freedom of action and opinion 4 5.0 Respect of the environment and of the quality of life 4 6.0 Respect of the accessibility to care and services 4 7.0 Social responsibilities of the Institut 5 8.0 Responsibilities of the patient 6 9.0 Final clauses 6 Consent forms 7 The mission of the Institut Philippe-Pinel de Montréal 8 1.0 PRINCIPLES 1.1 The Institut Philippe-Pinel de Montréal is a psychiatric hospital with a supraregional vocation, which puts the patient at the centre of its activities. The patient is the main object of the services given. The Institut provides care and services of the best quality possible. 1.2 In their interventions, the personnel respect all applicable laws, regulations, professional and ethical norms. 1.3 The Institut provides all available resources in order to give each patient the optimal care and services. 1.4 The personnel treat the patient or any other person with respect, dignity, fairness and empathy, whatever their beliefs, gender, ethnic group, race, handicap, age or social status. 1.5 The Institut favours patient s blooming and self-esteem, the development of his autonomy and his return in the community. 1.6 In their relations with the patient, the employees give him the same consideration they would like themselves, or their family, to have in an identical situation. 1.7 The Institut acknowledges the professional and technical expertise of its personnel. It promotes the development and the sharing of this expertise. 1.8 The Institut contributes to the improvement of the health of the patients, its personnel and the community. 1.9 The Institut promotes, as soon as possible, the social reintegration of its patients. 1.10 The Institut and every member of its staff are responsible for the application and the respect of the Code of ethics. 1.11 The Institut adopts rules and regulations and promotes a work setting which contributes to the respect of the Code of ethics. 1
2.0 RESPECT OF THE INDIVIDUAL 2.1 The patient receives the best services possible according to available resources. 2.2 The patient, or his representative, receives all the information permitting him to take decisions concerning the treatment, the care and the services available. 2.3 In contact with the patient s needs, the personnel provide the required care and services, consistent with scientific, ethical and social norms, in a personalized manner. 2.4 The Institut assures the patient the respect of his freedom and views. Any limits to this right must be temporary and minimal and can only be justified by the need to protect the physical and psychological integrity of the patient and others. 2.5 The Institut permits the patient to communicate confidentially with the persons and the communication means he wants to. The Institut makes available communication means at the patient s disposal. The patient uses them in a way respecting the rights of others and his own health. Any exception to the rule of accessibility of communication means and of confidentiality is motivated and explained to the patient. 2.6 The Institut protects the patient from any abuse, exploitation and degrading or discriminatory treatment and takes any imperative measure to protect the patient s physical and mental health. 2.7 The patient, or his representative, takes part in the decisions affecting his health condition and his well being, among which the right to be involved in all stages of his treatment. 2.8 The Institut assists the patient when the latter wants to obtain information in order to undertake an administrative or legal claim. 2.9 The Institut answers all the questions a patient may have relative to his care and his rights, including the access to his medical record, making sure that communication of the record or any part thereof would not likely be prejudicial to the user's health or other s rights. 2.10 The personnel provide diligently the best treatments, exams or personal hygiene care while respecting the intimacy of the patient. The personnel inquire about the patient s intentions regarding the care and services offered and the way they are given. When the patient s condition requires an assistance for personal hygiene, the patient receives it from a personnel member of the same gender, except for clinical reasons or for the protection of persons physical and psychological integrity. 2.11 The search of a patient is only done when required. It is done in a reasonable and tactful manner and is the least invasive possible. The motives of the search are explained to the patient. The patient is searched by a personnel member of the same sex, except in the case of an immediate danger. 2.12 Any behavioural restraint measure is minimal, exceptional and motivated by the protection of the integrity of the persons. 2.13 A personnel member witnessing any violation of the Code of ethics towards a patient promptly and adequately intervenes and gives the necessary assistance to the patient. He informs his immediate superior of the situation. 2
2.14 All the professionals and the personnel working at the Institut respect the confidentiality of the information concerning both the clientele and the personnel. When the disclosure of information on a patient is necessary, it is done with great care, in order to protect the confidentiality. 2.15 Before a patient, or his representative, consents to participate in a research project, an experiment or a teaching activity, the Institut must give him complete information and ascertain that the patient understands this information. The Institut respects the patient s right to refuse to participate and to withdraw from these activities without being subjected to any kind of discrimination. 2.16 Before using the name and address of a patient to invite that patient to make a donation to the Fondation Docteur Philippe-Pinel, the Institut must give the patient, or his representative, a valid opportunity to refuse to allow that information to be used for such a purpose. The patient or his representative may at any time request the institution to no longer use that information for such a purpose. If the Institut intends to use the name and address of a patient for such a purpose, the patient, or his representative, will be informed in advance about this intention and his rights. 2.17 The Institut may use the name, address and telephone number contained in a patient's record to carry out surveys to ascertain patient expectations and satisfaction with respect to the quality of the services offered. A patient, or his representative, may at any time request the Institut to no longer use the information concerning the patient for such a purpose. If the Institut intends to use the name, address and telephone number of a patient for such a purpose, the patient, or his representative, will be informed in advance about this intention and his rights. 2.18 The Institut maintains an ethics committee for research, which respects the standards in use. 2.19 The Institut supplies the patient with a balanced diet, adapted to his needs, in an environment promoting healthy nutrition. 2.20 The personnel does not accept any gain resulting from his relationship with a patient, other than the ones provided by his employer. 3.0 RESPECT OF OWNERSHIP 3.1 The patient is entitled to own personal objects, contingent on the space available and considering the protection of the physical and psychological integrity of the patient and others and the respect of the therapeutic milieu. No one is authorized to search through the patient s belongings except for clinical or sanitary reasons or in order to protect people s integrity. If there is a search, it is done in a reasonable and tactful manner and is the least invasive possible and, if possible, it is done in the presence of the patient. 3.2 The Institut protects the patient s personal possessions and belongings. The Institut, through its personnel, helps the patient manage these possessions and belongings. The personnel hands over to the patient, as soon as possible, the possessions and belongings that are sent to him. 3
4.0 RESPECT OF THE FREEDOM OF ACTION AND OPINION 4.1 The Institut respects the patient s spiritual values. The patient receives services according to his beliefs while taking into consideration the resources and the mandate of the hospital. 4.2 The Institut encourages the patient to participate in the organization of the therapeutic milieu by participating, among others, in the users committee. 4.3 The Institut promotes the patient s participation to rehabilitation activities related to his intervention plan and promoting his social reintegration. 4.4 The Institut encourages the possession of cultural material, except if there is a therapeutic or security contraindication. 4.5 The personnel encourage the patient s and visitor s autonomy and expression of his preferences in his clothing, if it is clean, adequate and decent. In cases where this norm cannot be applied, the personnel explain the reasons to the patient and the visitor. 4.6 The Institut respects the patient s political opinions and makes it easier for him to carry out his civic duties. 4.7 The Institut encourages the patient to responsibly take charge of his sexuality while ascertaining the preservation of a therapeutic milieu for all the patients. It also encourages the respectful expression of the patient s feelings. 4.8 The Institut helps patients in exercising their rights, including petitions. 5.0 RESPECT OF THE ENVIRONMENT AND OF THE QUALITY OF LIFE 5.1 The Institut provides the patient with a healthy, clean, welcoming and safe environment, in order to promote the patient s well-being and quality of life. 5.2 The Institut ascertains the patient s security. The personnel know the procedures to follow in case of an emergency or an evacuation and also know the safety measures in case of a general alarm or a fire. The personnel are watchful in order to decrease the risks of accident. 5.3 The Institut advocates a calm and restful environment. The personnel are responsible for the upholding of this climate. 5.4 When the patient is sleeping, the personnel discretely and appropriately observe him in order to detect any anomaly and to ensure the patient s comfort. 5.5 The Institut provides the patient, as often as required, with all the generally known hygienic services. 5.6 The personnel of the Institut dress appropriately for work, taking into account the characteristics of the clientele and the work place. 6.0 RESPECT OF THE ACCESSIBILITY TO CARE AND SERVICES 6.1 The patient receives care and services of quality, corresponding to his physical and mental condition. If the Institut cannot offer these services, it makes sure that another establishment, organism or person provides these services, taking into account, among others, the available resources. 4
6.2 The Institut takes into consideration the will of a patient to be treated by the professional or the staff he chooses. 6.3 The personnel fully and completely involve themselves in order to respond to the patient s needs. 6.4 The Institut responds to the patient s information needs. The personnel receive all the questions, comments and complaints and take action. The Institut provides the patient with a local service quality and complaints commissioner. 6.5 As soon as a patient is admitted, the personnel inform him of the existence of the user s committee. 6.6 The Institut publishes and applies a complaint examination procedure as stated by the law. The personnel inform the patient of the existence of this procedure, make it available to him and assist him in exercising his rights. 7.0 SOCIAL RESPONSIBILITIES OF THE INSTITUT 7.1 The Institut recognizes itself responsible for the best possible use of its human, material and financial resources. 7.2 In order to effectively manage its resources, the Institut establishes the necessary clinical and administrative structures, in agreement with the law. 7.3 When required, the Institut transmits complete information and ensures the respect of confidentiality. 7.4 Aware of their duties towards the community, the personnel work honestly, painstakingly and competently. 7.5 The Institut offers a high standard teaching, of top-quality knowledge, in various professions, according to its mission and the personnel contribute to this teaching in carrying out their work. 7.6 The researches and other connected activities done at the Institut or its Research centre are related to the mission of the Institut. They are made known to interested publics. 7.7 The personnel, the physicians and the researchers promote the development of research and clinic in carrying out their duties. Their activities respect the scientific and ethical standards and are carried out in full respect of the patient. 7.8 Through its communications, the Institut contributes to demystify mental illness and to inform the community. Its spokespersons ascertain the respect of the reputation and integrity of the Institut. 7.9 The Institut initiates contacts and advantageous exchanges with its partners, community centres and governmental bodies. In order for each partner to effectively fulfill its mission, the Institut exchanges services with these partners. 7.10 The Institut recognizes the contribution of various bodies and associations working in mental health, psychiatry and law and of representatives of patient and offers them its collaboration according to its mission. 7.11 In their relationship with suppliers, the personnel promote the interest and the reputation of the Institut and its patients and protect themselves from any conflict of interest. The personnel get no advantages from other persons or corporations. 5
7.12 The Institut and everyone who works in it see that work relations are harmonious. They refrain from being discriminating, harassing, intimidating or from making libellous remarks. 7.13 The Institut considers each of its employees as an important human resource, worthy of respect. It adopts a valorizing attitude in the management of its personnel. 7.14 The Institut promotes the development of feelings of pride and adherence towards the Institut and maintains the motivation, valorization and competence of its personnel. 7.15 The Institut takes care that the contribution of the employee, who have developed programs and other activities, is known. 7.16 The treating teams share their experiences and expertise in order that it profits to as many users as possible and also to the partners of the Institut. 7.17 When hiring personnel, the Institut selects the candidates having the best competence, training, experience and human values. The Institut promotes the further training of its personnel. 7.18 The human and material resources of the Institut are used in the best interest of the patient. 7.19 The Institut makes sure to offer the best possible help to the personnel experiencing difficulties which have an impact on their work. 8.0 RESPONSIBILITIES OF THE PATIENT To the best of his ability, the patient: 8.1 respects the rights and freedom of other patients and of the personnel; 8.2 collaborates to his best to his own treatment; 8.3 collaborates to the good functioning of the hospital and respects its rules; 8.4 collaborates in maintaining a living space aimed at the protection of the physical and psychological integrity; 8.5 manifests autonomy; 8.6 respects the rules of the Institut and of society. 9.0 FINAL CLAUSES 9.1 The Institut Philippe-Pinel de Montréal and its personnel have the foremost responsibility to enforce and respect the Code of ethics in their daily duties. Any breach of the Code of ethics or any departure from it can be interpreted as an inability to adapt its behaviour, attitudes and work habits to the requirements of the relation that has to be maintained with a patient. If the need arises, appropriate measures will be applied. 9.2 The Code of ethics comes into force on the date of its approval by the board of directors of the Institut Philippe-Pinel de Montréal. 6
CONSENT FORM to use the name and address of a patient to invite that patient to make a donation to the Fondation Docteur Philippe-Pinel CONSENT I accept that the Institut use my name, first name and address contained in my file to invite me to make a donation to the Fondation Docteur Philippe-Pinel. I can, at any time, request the Institut to no longer use that information for such a purpose. Date: Signature: Witness: CONSENT FORM to use the name, address and telephone number of a patient to carry out a survey CONSENT I accept that the Institut use my name, first name, address and telephone number contained in my file to invite me to participate to a survey to ascertain patient expectations and satisfaction with respect to the services offered. I can, at any time, request the Institut to no longer use that information for such a purpose. Date: Signature: Witness: 7
THE MISSION OF THE INSTITUT PHILIPPE-PINEL DE MONTRÉAL The Institut Philippe-Pinel de Montréal is a psychiatric, supraregional university hospital, specialized in forensic psychiatry and in the assessment, the treatment and the management of patients presenting risks of violent behavior. The care and services provided are short-term and at tertiary level. The Institut is affiliated with the Université de Montréal and collaborates with other education institutions and other Canadian or international universities. The Institut Philippe-Pinel de Montréal fulfills the following mission: To assess a person s mental state and risks of violence and to provide adapted treatment; To teach to residents in psychiatry and to students in different fields of health sciences and to offer continued education to mental health professionals; To carry out research on biological, sociological and psychological aspects related to violence and dangerousness and on the effectiveness of treatment programs; In collaboration with the Fondation Docteur Philippe-Pinel, to prevent violence by applying specific programs and by sharing its expertise with its partners The patients, the quality and the excellence The Institut renders care and services to a mixed multiethnic and multicultural clientele, from the Quebec and Canada health, correctional and justice systems. Specific services are offered to adolescents. The assessment and treatment processes are readjusted when needed in order to continually improve the quality and to implement best practices. Presented to the board of directors on September 11, 1997 (Resolution CA-97-057) Modified by the board of directors on November 13, 1997 (Resolution CA-97-086) Revised by the board of directors on September 14, 2000 and adopted by the board of directors on October 12, 2000 (Resolution CA-2000-066) Modified by the board of directors on October 14, 2004 (Resolution CA-2004-071) 8 This Code of ethics abrogates the one adopted in 1994. Submitted to the users committee on April 20, 2005 Adopted by the hospital ethics committee on May 13, 2005 (Resolution CEH-2005-011) Adopted by the board of directors on June 09, 2005 (Resolution CA-2005-041) Modified by the board of directors on September 07, 2006 (Resolution CA-2006-060)