Seite - 492 - in VULNERABLE - The Law, Policy and Ethics of COVID-19

VULNERABLE492 Because PSWs are unregulated, they have no legally defined scope of practice, no mandatory educational qualifications, no professional misconduct regulations or discipline process.13 While the absence of an overarching regulatory framework outlining standards of practice makes it challenging to delineate precisely the nature of the workers’ rights and obligations, it does not mean they are not required to prac- tise safely and competently, including in the context of a pandemic. For example, when tasks are delegated, regulated health profes- sionals have a duty to make sure that PSWs are competent to perform the procedure and that they understand the extent of their responsi- bilities.14 As well, facilities and agencies who employ PSWs provide some oversight through guidelines and in-house practices.15 Further, enhanced education standards provide PSWs with more skills and bet- ter training.16 Finally, some associations have developed codes of ethics outlining values such as competence, integrity, and respect of dignity.17 There has been considerable debate about whether these piecemeal interventions to oversee PSWs’ practice are sufficient. The COVID-19 crisis has shone a light on existing problems, especially in the LTC con- text. There have been numerous reports of PSWs being denied the use of personal protective equipment (PPE) and having to work very long hours in extraordinarily stressful conditions. Because wages are low, many workers have been forced to work in multiple locations in order to make a decent living, thus increasing the risk of spreading the virus. By contrast, some front line staff have refused to work, leaving LTC residents to their own devices, often with catastrophic consequences.18 13. Ibid at 3. 14. See for example: CNO, Practice  Guideline: Working  with  Unregulated  Healthcare  Providers (2013) at 3. 15. See for example: Saint Elizabeth, A  Practical  Guide  to  Implementing  Person- Centred  Care  Education  for  PSWs  in  the  Home,  Community  and  Long-Term  Care  Sectors (October 2013), online: Saint Elizabeth <https://www.saintelizabeth. com/getmedia/3b053be0-3313-45e5-8aea-872781c0b76d/Practical-Guide-for- Implementing-PCC-Education-for-PSWs-October-2013.pdf.aspx>. 16. See for example: Ontario Ministry of Colleges and Universities, “Personal Support Worker Program Standard” (last visited 14 May 2020), online: Ontario Ministry  of  Colleges  and  Universities <http://www.tcu.gov.on.ca/pepg/audiences/ colleges/progstan/health/supwork.html>. 17. See for example: The Ontario Personal Support Workers Association, OPSWA’s  Code of Ethics (last visited 14 May 2020), online: OPSWA <https://www.ontariop- swassociation.com/code-of-ethics>. 18. Katie Pedersen & Melissa Mancini, “Ontario’s long-term care workers still work- ing at multiple facilities as B.C. clamps down”, CBC News (8 April 2020), online: <https://www.cbc.ca/news/health/nursing-home-workers-1.5526076>