In July 2019, the College published a Q & A article about occupational therapists completing and signing treatment plans for the medical use of cannabis. We received many comments and wanted to provide further information. We hope the following is helpful to you.

Q: Can an OT complete and sign a treatment plan for the medical use of cannabis for a client?

A: Occupational therapists are expected to practise within the scope of the profession and possess the knowledge, skill, and judgment necessary to meet the standards of practice of the profession. 

Registrants of the College are entitled to full use of the protected title ‘Occupational Therapist’ and the designation ‘OT Reg. (Ont.)’. Title is protected by law and may only be used by registrants of the College. Use of title allows occupational therapists, as regulated health professionals, to apply their signature with title to reports, forms and other practice related documents. Application of signature assigns accountability.

In practice this means an occupational therapist’s signature is recognized as a legal testament to the information contained in the document. When an occupational therapist puts their signature to a document related to their practice, the College expects that occupational therapist is accepting full responsibility for the information and services it represents. 

Let’s take a closer look at the issue of signing treatment plans for medical use of cannabis. Providing advice, recommendations, and determining whether a prescribed medication, such as medical cannabis, is reasonable and necessary for clients, are not within the occupational therapist’s scope of practice. 

In the interest of efficiency, an occupational therapist might consider signing an assessment or treatment plan recommended by someone else for activities that do not fall within the occupational therapist’s scope of practice. This is not appropriate. Occupational therapists must be able to speak to their clinical reasoning and decision-making related to any form bearing their signature and designation and they cannot do that if the services referred to in that document are outside of the scope of practice of the occupational therapist.

The College recognizes that the funding systems to access products and services can be difficult for clients to navigate. In the interest of public safety, we must remember there is an important balance between providing client-centred care and ensuring that one practices appropriately within one’s scope of practice.

If a treatment plan is being submitted with respect to a medical cannabis prescription, that form must be completed and signed by the appropriate health professional who has the legal authority to recommend or prescribe cannabis.

Medical cannabis, like all other prescriptions, has the potential for side effects as well as interactions with other medication and/or affecting pre-existing medical conditions including dependency issues. Signing professionals must have the competency, skills, knowledge and judgment to oversee and manage all aspects of the treatment plan pertaining to the medical use of cannabis. Prescribing any drug, including cannabis, is also a controlled act in Ontario that is not authorized to occupational therapists.

All regulated health professionals must ensure they practice within their scope and comply with their professional practice standards, such as the Standards for Use of Title and Standards for Record Keeping.

If you have any questions about this Q&A, contact the Practice Resource Service: 1.800.890.6570/416.214.1177x240 or [email protected].

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