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The concept of protection of the public

Because its principal function is the protection of the public, the professional system draws on the demands and values of Québec society, expressed in particular by the fundamental rights enshrined in the Québec Charter of Human Rights and Freedoms. These rights may be summarized as follows:

  • the right to physical and psychological integrity
  • the rights to professional secrecy and privacy
  • the right to safeguard personal property

Both by the language used and by their exercise, these rights place individuals at the centre of decisions that concern them. The concept of protection of the public is therefore interpreted in light of these fundamental rights and the role of the person with respect to these rights.

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    The State and the protection of the public

    The State employs diverse means to prevent prejudice or injuries and ensure effective and equitable compensation for prejudice that is sustained. One example would be the opportunity of a wronged person to prosecute for civil or contractual responsibility. Other examples are the adoption of product manufacturing or consumer protection standards.

    Still, in some cases, individuals might find themselves especially powerless in particularly complex situations, or ones involving incompetence or dishonesty. Although they are responsible for their decisions in terms of exercising their fundamental rights, it can sometimes be very difficult to assess the appropriateness and quality of services provided by others without the benefit of training in the field in question. Often people will simply trust in the expertise of another person when it comes to making these decisions.

    Faced with these situations and the seriousness of the potential for prejudice, the State prefers to adopt a preventive approach that consists in verifying the competence and integrity of individuals offering services or controlling product quality. In over 40 fields, the State has therefore instituted a legislative and regulatory framework aimed at protecting the public by preventing prejudice. It is applied according to the principle of self-management by those knowledgeable in these fields, and it is called the professional system.

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    Factors for determining whether activities should be regulated by the Professional Code

    The State considers several factors before deciding whether activities should be regulated by the Professional Code. A non-exclusive list of these factors is presented in section 25 of the Professional Code. They mostly refer to the nature of the activities and the characteristics of the persons who practice them, in particular:

    • the knowledge required in order to engage in the activities;
    • the degree of independence enjoyed by the persons practising the activities and the difficulty which persons not having the same training and qualifications would have in assessing those activities;
    • the personal nature of the relationships between such persons and those having recourse to their services, by reason of the special trust which the latter must place in them;
    • the gravity of the prejudice which might be sustained by those who have recourse to the services of such persons because their competence was not supervised by an order;
    • the confidential nature of the information which such persons are called upon to have in practicing their profession.

    These legislated factors are non-exclusive and subject to interpretation in each case. The institutions of the professional system have therefore integrated additional factors and analytical frameworks to assess the appropriateness of supervising practice by means of professional self-management as set out in the Professional Code.

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    Regulated professions

    Fifty one professions are currently regulated by the Professional Code and supervised by 46 professional orders. The supervision of these professions is similar in some respects but differs in others.

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      Reservation of professional title

      Application of the Professional Code to activities representing a risk of prejudice implies, for all the professions enumerated by the Code, control of the professional title associated with the practice of such activities. This is what is known as a reserved title.

      The Code and the special laws contain a list of professional titles that are reserved for the exclusive use of members of professional orders. This means that persons who are not members of an order may not use any of these titles or allow others to believe they are members of an order by using a similar title or abbreviation. For example, only members of the Ordre des urbanistes du Québec may use the title of urbanist.

      The principal purpose of a professional title is to inform the public about the nature of services offered by a professional. Members of the public are then able to choose the professional who is most apt to meet their needs. The reserved title is also a sign of competence because it allows the public to distinguish between practitioners who are likely to be able to adequately meet said needs from those who simply affirm to have this ability.

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      Exclusive right to practice

      Also, with respect to the acts or activities of specific regulated professions, the Professional Code has established that only members of the order concerned may, in addition to using the title reserved to them, practice such acts or activities. Examples are geologists, advocates and nurses.

      However, even when professional legislation has established exclusivity of practice, orders have the power, through regulation, to authorize certain categories of individuals other than their members, to perform particular acts related to the profession.

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      Two types of professions and orders

      The Professional Code defines two types of professions: professions with reserved titles, numbering 26, and professions with reserved titles and the exclusive right to practise, also numbering 25. The first group is monitored by 21 professional orders (figures in parentheses indicate professions that belong to the same order) :

      • Audiologist (1) 
      • Certified General Accountant
      • Certified Human Resources and Industrial Relations Counsellor
      • Certified Interpreter (2)
      • Certified Management Accountant
      • Certified Terminologist
      • Certified Translator (2)
      • Chartered Administrator
      • Chartered Appraiser
      • Dental Hygienist
      • Dental Technician
      • Dietician
      • Guidance Counsellor
      • Marriage and Family Therapist (4)
      • Medical Technologist
      • Nursing Assistant
      • Occupational Therapist
      • Physical Rehabilitation Therapist (3)
      • Physiotherapist (3)
      • Professional Technologist
      • Psychoeducator
      • Psychologist
      • Registered Respiratory Therapist
      • Social Worker (4)
      • Speech Therapists (1)
      • Urbanist

      Professions with reserved titles and exclusive right to practice are grouped in 25 professional orders.

      • Acupuncturist
      • Advocate
      • Agrologist
      • Architect
      • Bailiff
      • Certified Accountant
      • Chemist
      • Chiropractor
      • Dentist
      • Denturologist
      • Dispensing Optician
      • Engineer
      • Forest Engineer
      • Geologist
      • Hearing-aid Acoustician
      • Land-surveyor
      • Midwive
      • Notarie
      • Nurse
      • Optometrist
      • Podiatrist
      • Pharmacist
      • Physician
      • Radiology Technologist
      • Veterinary Surgeon
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      The specific nature of some health professions

      Under the Ministerial action plan to update the professional system, the National Assembly of Québec modified the Professional Code and specific laws in June 2002, when it passed Bill 90.

      The government’s goal-for the protection of the public—was to modernize the professional organization of health care in the public sector in order to improve the organization of services and speed up access to care. These changes concern the following thirteen health professions:

      • Audiologist
      • Dietician
      • Medical Technologist
      • Nurse
      • Nursing Assistant
      • Occupational Therapist
      • Pharmacist
      • Physical Rehabilitation Therapist
      • Physician
      • Physiotherapist
      • Radiology Technologist
      • Registered Respiratory Therapist
      • Speech Therapist

      Field of practice

      The new law gave these professions a new description of their field of practice, listing the principal activities of the profession as well as its purpose.

      Besides their differences, the professions in question share some elements of their fields of practice. They now share the common mission of health information as well as promotion and preventing illness, accidents and social problems of individuals, families and communities.

      Reserved activities

      The notion of reserved activities transforms the previously established exclusive practice of four professions, those of nurse, physician, pharmacist and radiology technologist.

      The eight other professions, which have reserved titles, were also attributed with exclusive status in the form of reserved activities. Note that some reserved activities are shared by a number of different professions.

      Coming into force

      On January 30, 2003, provisions relating to the professions of nurse, nursing assistant, respiratory therapist, physician, pharmacist, radiology technologist and medical technologist came into force.

      On June 1, 2003, provisions concerning dieticians, occupational therapists, speech therapists and audiologists, physical therapists and physical rehabilitation therapists came into force.

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    Competence: an underlying value of the professional system

    The factors justifying the use of the Professional Code as a tool for the protection of the public reflect the complexity of certain activities and their potential impact on the public. Such complexity and impact necessitate a proactive attitude in order to prevent the infliction of prejudice. This is why competence is the fundamental value of the professional system. It is the essential qualification required of a person intending to practice regulated activities. Later, we will see how competence figures at the centre of mechanisms for the protection of the public and the role of professional orders.

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      The concept of professional competence

      What is meant by competence? It generally refers to the knowledge and skills required to carry out activities. Today it is increasingly being associated with an individual’s capacity to integrate into a workplace, mobility and performance.

      When competence is referred to in the sense of professional competence-in other words, in a context where there is a risk of prejudice-it assumes particular dimensions. Indeed, together with the knowledge and skills associated with a field, professionals must demonstrate the capacity to integrate and apply them in varied and complex situations in the service of a client or employer, and in such a manner as to prevent such persons from sustaining prejudice. Ethical and moral dimensions must therefore be considered in assessing needs and services. Competence so defined serves as the basis for the exercise of professional judgement.

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      The professional orders and competence

      The professional orders are the guardians and promoters of professional competence. They have tools for ensuring the competence of their members. First, they establish standards regarding admission to the practice. Based on their knowledge of the context and content of the practice within the labour market, each of the orders establishes a set of training requirements and other conditions with the aim of satisfying the needs for a sound practice in which the risk of prejudice is minimized. Based on these set requirements, professional orders verify the competence and integrity of candidates to the profession and ensure they are maintained throughout that individual’s professional life.

      Pursuant to their function, professional orders must be aware of the labour market situation, identify training needs with respect to the protection of the public, determine requirements and certify the fulfillment of such requirements. They are aware of the changes in the practice of a profession and consider them in establishing standards and supervising the activities of their members.