Duty to Accommodate Patients with Disabilities

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Patients have the right to expect that they will not be denied a service, including a healthcare service, because of their disability. They also have the right to expect that a reasonable accommodation will be made to ensure that they have fair access to the healthcare services they need.

Fostering an Environment of Respect and Inclusion

The Canadian Human Rights Act, 1985 and the Ontario Human Rights Code, 1990 (the Code) provide a legal framework for the protection of human rights. The College expects all registrants and pharmacy owners to not discriminate, either directly or indirectly, based on a protected ground under the Code.

Protected Grounds Under the Code

The Code prohibits actions that discriminate against people based on a protected ground in a protected social area.

Protected grounds are:

  1. Age
  2. Ancestry, colour, race
  3. Citizenship
  4. Ethnic origin
  5. Place of origin
  6. Creed
  7. Disability
  8. Family status
  9. Marital status (including single status)
  10. Gender identity, gender expression
  11. Receipt of public assistance (in housing only)
  12. Record of offences (in employment only)
  13. Sex (including pregnancy and breastfeeding)
  14. Sexual orientation.

Protected social areas are:

  1. Accommodation (housing)
  2. Contracts
  3. Employment
  4. Goods, services and facilities
  5. Membership in unions, trade or professional associations.

Disability is a protected class, and the Accessibility for Ontarians with Disabilities Act, 2005 (the AODA) requires that standards of accessibility related to goods, services, facilities, employment, accommodation, and buildings be developed, implemented and enforced. Pharmacies provide goods and services to the public and are required to ensure compliance with accessibility standards.

The ethical principles articulated in the College’s Code of Ethics – beneficence, non-maleficence, respect for persons/justice, and accountability – and obligations outlined within human rights law form the basis for the College’s expectation that pharmacy professionals and those that own and operate pharmacies in Ontario will strive to create and foster an environment in which the rights, autonomy, dignity, and diversity of all patients, or those seeking to become patients, are respected.

Registrants and pharmacy owners must comply with the legal duty to accommodate patients living with disabilities. The Standards of Practice indicate that pharmacy professionals are expected to partner with patients to provide safe and appropriate care that meets the patient’s unique needs, goals, and preferences. The Standards of Operation for pharmacies states that when delivering pharmacy services, “all services are based on a review and assessment of patients’ circumstances and provided in order to optimize therapeutic outcomes. Patients are provided the information needed to make decisions about their health and health care” (p. 9).

Ensuring Accessibility of Important Medication Information

Prescription labels contain crucial information that patients need to ensure their medication is taken properly so that they achieve the expected therapeutic effect while avoiding negative side effects from taking medication incorrectly. Typically, this information and any supplemental information is provided in print-only formats that are not accessible to people living with a visual impairment. Patients who are unable to access the information on prescription labels are at heightened risk for receiving sub-optimal treatment and experiencing a medication incident. This presents a significant patient safety concern.

To support safe medication practices for people living with a visual impairment, pharmacies can comply with the legal duty to accommodate by using accessible prescription formats, including audible, braille, and large-print formats based on the patient’s unique needs.

Examples of working with patients to meet their unique needs already exist in pharmacy, such as the use of compliance packaging for patients who take multiple medications to reduce the risk of missed doses.

While large-print prescription labels have been in use to support patients with mild or moderate visual impairment, patients with severe visual impairment or blindness report difficulties in receiving information about their prescription medications in a format that will support safe medication practices at home and meet their unique needs. Patients have reported that access to a pharmacy that can reliably provide an audio prescription label service (where a device in the patient’s home “reads” the label out-loud when it is scanned) is an effective approach that protects their safety and enhances medication compliance.

Registrants and pharmacy owners are advised to review their legal obligations and consult the policies of the Ontario Human Rights Commission, including Policy and Guidelines on Disability and the Duty to Accommodate to better understand how to comply with their legal duty to accommodate patients with disabilities.

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