Professionalism and Accountability: Who Informs? Who Directs?

The Ontario Government is about to pass a law requiring that all “mental health counselors” be “certified”. This would include anyone who has access to vulnerable populations, who takes money for his or her services, who is recognized as meeting certain performance standards within their regulated professional association, and/or who can issue prescription drugs. Included would be the likes of general practitioners and medical specialists, some nurses, clinical psychologists, and psychiatrists.
Excluded would be social scientists, social workers, religious/spiritual leaders, other non-regulated health care practitioners , and community-based change agents.

A key dimension for upholding public accountability seems to the distinction between merely providing information, and providing direct instruction. Those who tell others what they must/should do to get well, such as taking various forms of medication, are held accountable by this new legislation. Those who merely provide information, as a teacher would, are not.

So if I take money for teaching someone about the features of post-traumatic stress disorder, or obsessive-compulsive disorder, or depression, and where to go to get help, does this intervention constitute being unethical? If I’m a professor teaching my sociology of medicine class about the definition, and the incidence and prevalence of, say, schizophrenia in southern Ontario, and I’m on salary at the university – am I liable for sanction according to this new rule by providing information? Or if, as a clinical or medical sociologist (a member of the Association for Clinical and Medical Sociology in the US, or of the Medical Sociology Association that is a sub-set of the Canadian Sociology Association), I privately teach/consult by one-on-one or group seminars about bi-polar disorder in Canada – without telling participants what to do – am I liable for infringement under the new law? Would a priest or school guidance counselor be similarly vulnerable?

Obviously providing information is not the same as telling people what they should do. But it can be a fine line that separates them. Teaching and guiding are semantically distinct; however, the subtleties of interactive dynamics such as pressure to know, may lead teachers/consultants unwittingly into the land of legislated oz.

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