Professional Practice

Ethics Application & Interpretation

This resource is designed to assist members in navigating ethical situations they may encounter in their work. While it provides valuable insights and guidance, it is important to note that this resource is not exhaustive. Ethical dilemmas can be complex and may require thoughtful consideration beyond the information presented here. We encourage members to use this guidance as a tool to support their decision-making and to seek additional resources or consultation when faced with challenging ethical questions.

Standard 1: Practice with competence, integrity, and professionalism to inspire and promote trust and trustworthiness

Each certified member shall:

A) Conduct oneself in the practice of the profession to bring honour and dignity to oneself, the health information management profession, and the Canadian College of Health Information Management (The College).

Exhibit a calm, respectful, and positive attitude, even in stressful situations, to foster a supportive work environment.
Use clear, concise, and respectful language when communicating with everyone, including colleagues, patients, and other partners. This includes active listening and providing thoughtful responses.
Be mindful of the boundaries between personal and professional relationships, ensuring that interactions remain respectful and appropriate.
Always act honestly in all professional dealings, fostering trust and credibility.
Foster an inclusive environment by respecting diverse backgrounds and perspectives in the workplace.
Advocate for the profession and promote the role of health information management in improving patient care and outcomes to others, including healthcare providers and policymakers.
Regularly self-reflect on your actions and decisions to ensure they align with the values of honor and dignity in your professional practice.
Handle conflicts or challenging situations with professionalism and composure, demonstrating respect for all parties involved.

B) Perform duties diligently, adhering to best practices and standards, and offer only those services for which one is qualified.

Follow applicable legislation/regulations, organizational policies, and ethical guidelines strictly, demonstrating a commitment to professionalism and accountability.
Be truthful in all duties, whether it involves personal/patient data/information, organizational practices, or individual conduct. This builds trust and respect within the profession.
Engage in role-specific training programs that enhance skills and knowledge, ensuring you are equipped to provide services relevant to your qualifications.
Disclose your qualifications and areas of expertise to others, fostering transparency and trust.

C) Abide by the policies and by-laws of CHIMA and the College and actively support their strategic directions and reputation.

Follow the established ethical guidelines and standards set by The College, ensuring that your work meets or exceeds professional expectations.
Attend and participate in CHIMA and the College meetings, forums, or workshops to engage with peers and contribute to discussions about strategic directions and policies.
Promote CHIMA and not undermine or otherwise damage CHIMA or the College’s reputation in any manner.

D) Take responsibility for actions and decisions and be accountable to CHIMA and the College, employers, and the broader community.

Own your decisions and actions, acknowledging mistakes and taking steps to rectify them. This demonstrates integrity and commitment to high standards.
Regularly assess your work and decisions, identifying areas for improvement and ensuring adherence to best practices.
Be transparent and answerable about your decision-making processes, particularly when they impact patient care or organizational practices.

E) Conduct oneself in an ethical manner, exemplify the values of CHIMA and the College, and report any unethical practices to the appropriate authority.

Stay informed about the relevant authorities, laws, regulations, and policies that apply to your work.
Always make decisions based on ethical considerations, ensuring that patient welfare is prioritized in all actions.
Follow procedures for reporting privacy/security/confidentiality breaches or concerns related to patient data/information, ensuring accountability and transparency in handling such incidents.
In the absence of appropriate procedures or identified authorities, consult within your organization to identify the suitable action.
Be aware of and utilize whistleblower protections where they exist that allow you to report unethical practices without fear of retaliation.

F) Practice in compliance with applicable laws, regulations, policies, and procedures.

Stay informed about relevant legislation, such as the Personal Information Protection and Electronic Documents Act (PIPEDA) and health information legislation and regulations, ensuring compliance in all aspects of data/information handling.
Within the scope of your role, implement, maintain, and/or abide by robust data/information protection measures in accordance with applicable laws to safeguard patient information and uphold their dignity.
Follow organizational policies related to health data/information management, ensuring that practices align with ethical and legal standards.
Within the scope of your role, participate in regular reviews and updates of policies to ensure they remain compliant with current legislation and best practices.

G) Strive to improve one’s professional knowledge and competence through continuing education and lifelong learning.

Engage in ongoing education and professional development opportunities, such as workshops or certifications, to stay current with industry trends and best practices.
Regularly seek feedback from peers and supervisors on your performance to identify areas for improvement and professional growth.
Engage in reflective practice by analyzing your experiences, decisions, and outcomes to foster personal and professional development.

H) Offer leadership and a proactive, innovative approach to advancements in health information management practices.

Within the scope of your role, engage in discussions or initiatives that influence health data/information policies at local or national levels, ensuring that the profession and its core ethical standards are represented.
Advocate for the implementation of best practices in health data/information management within your organization, leading by example.

I) Support and mentor students, peers, and colleagues to develop and strengthen the workforce and profession.

Offer to mentor new professionals in the field, sharing knowledge and experiences to help them develop their careers.
Build relationships with other professionals in the field, promoting collaboration and knowledge sharing.
Actively participate in team meetings and discussions, valuing the input of others and working collaboratively to achieve common goals.
Within the scope of your role, provide training or share insights with colleagues to enhance overall team performance and professional growth.

J) Practice in a manner that is worthy of the public’s trust – trustworthiness – by adhering to the above principles.

Prioritize the needs and preferences of individuals in all decisions, ensuring their dignity is maintained throughout their care.
Approach interactions with empathy and compassion, recognizing the emotional and psychological aspects of health data/information management.

Standard 2: Respect the inherent dignity and worth of all persons

Each certified member shall:

A) Respect the equal moral worth of all persons, and appreciate the diversity of individuals, communities, and cultures.

When interacting with people, take the time to understand their cultural backgrounds and preferences, adapting communication and care approaches accordingly.
Treat each person as an individual, ensuring that all interactions are respectful and personalized. Consider the whole person, including their physical, emotional, and social needs.
Ensure that all people receive equitable services in accordance with their unique needs.
Be mindful of different communication styles and preferences, adapting your approach to ensure that everyone feels comfortable and respected.
Never treat people as means to an end, but always as ends in themselves.
Treat all individuals—patients, colleagues, and community members—with respect and dignity, recognizing their inherent worth as human beings.

B) Respect the autonomy (i.e., self-determination) of all persons by ensuring they can shape their lives in a manner consistent with their values and independent of the control of others.

Respect individuals’ rights to make choices about their health data/information reinforcing their autonomy in the healthcare process.
Provide people with clear, comprehensive information about their health information collection and use, including risks and benefits, to enable informed decision-making.
Foster an environment where others feel comfortable asking questions and expressing concerns, ensuring they understand their choices.
Encourage people to express their preferences regarding their health information collection and use, empowering them to make choices that align with their values and beliefs.
Honor peoples’ decisions regarding the collection and use of their health information, ensuring they understand the implications while supporting their right to control their information.

C) Treat co-workers, employers, colleagues, fellow members, peers, and the public fairly and with respect.

Always communicate in a professional and respectful tone, avoiding derogatory or dismissive language, regardless of the situation.
Practice active listening by giving your full attention to others when they speak, acknowledging their perspectives, and responding thoughtfully.
Contribute to a positive work environment by showing appreciation for others and encouraging teamwork.
Be aware of and respect personal boundaries, understanding that individuals may have different comfort levels regarding personal space and interaction.
Treat members of the public with respect and professionalism, ensuring that their needs and concerns are addressed promptly and courteously.
Actively seek and listen to feedback from the public regarding services offered, using this information to improve practices and demonstrate respect for their input.

D) Not exploit persons for the advantage (personal, financial, or otherwise) of others (including oneself).

Establish and maintain clear professional boundaries with patients and colleagues, avoiding any relationships that could lead to conflicts of interest or exploitation.
Refrain from practices that could exploit individuals for personal, financial, or organizational gain, such as overbilling or unnecessary services.
Anticipate, disclose, and where possible, avoid conflicts of interest. Where conflicting interests exist and cannot be avoided, disclose them and take actions to minimize or mitigate the conflict.
Be transparent about any potential conflicts of interest in decision-making processes, ensuring that personal or financial interests do not influence professional judgment.
When in doubt, seek input from an unbiased third party to ensure decisions are made in the best interest of all parties involved, rather than for personal gain.
Within the scope of your role, develop clear policies that require employees to disclose any potential conflicts of interest to their supervisors or an ethics committee.
Within the scope of your role, implement (or be aware of) secure and confidential channels for employees to disclose conflicts of interest without fear of retaliation.

E) Respect basic human rights for all.

Implement and enforce policies that prohibit discrimination based on protected grounds in human rights codes such as race, gender, age, sexual orientation, disability, etc., in all aspects of health information roles.
Ensure that all individuals have equal access to health data/information and services, regardless of their socioeconomic status or geographic location.
Within the scope of your role, regularly review organizational policies to ensure they align with human rights principles, making necessary adjustments to uphold these standards.
Within the scope of your role, provide (or partake in) regular training for staff on human rights issues related to healthcare, fostering a culture of respect and awareness.

Standard 3: Prioritize and advocate for the welfare and interests of individuals when collecting, accessing, using, maintaining, disclosing, and disposing of their health information

Each certified member shall:

A) Always strive to provide services consistent with quality, person-centered care.

Practice active listening, allowing people to fully express their concerns and preferences.
Provide information in plain language, ensuring people understand their options and the implications of their choices.
Recognize and respect the unique needs and preferences of each person, tailoring interactions accordingly.

B) Access only that data/information which is necessary to complete one’s work.

Ask oneself whether the data/information is necessary for the current task; if not, refrain from accessing it.
Stay informed about industry best practices regarding data/information access and privacy, fostering a culture of continuous learning.

C) Abide by best practices in all stages of health data/information lifecycle management.

Understand the various circumstances in which implicit, explicit, or deemed consent applies.
Maintain current knowledge of health information lifecycle best practices.
Where appropriate, obtain informed consent from patients before collecting their health information, ensuring they understand how their data/information will be used and their rights regarding that data.
Collect only the data/information necessary for the intended purpose, avoiding unnecessary data/information collection that could infringe on patient privacy.
Implement processes to regularly verify and update health information, maintaining its quality to support effective patient care and decision-making.
Within the scope of your role, conduct or advocate for regular audits of health data/information to identify and rectify inaccuracies, ensuring that patients receive the best possible care based on reliable data.

D) Prevent unauthorized access, use, or disclosure of health information.

Within the scope of your role, implement or advocate for strict access controls so that only authorized personnel can access sensitive health information, thereby protecting patient welfare.
Within the scope of your role, conduct periodic reviews of access permissions to ensure they align with current job responsibilities and that any unnecessary access is revoked.

E) Avoid actions that could cause harm to individuals, such as data/information errors, omissions, or misuse.

Ensure that health data/information is used primarily for the benefit of people, such as improving care quality, enhancing treatment outcomes, supporting health system operations, and improving overall population health.
Within the scope of your role, regularly assess how health data/information is being used in practice to confirm that it aligns with ethical standards and patient welfare.

F) Not use health data/information in a way that will be harmful to individuals or organizations.

Within the scope of your role, conduct periodic reviews of data/information collection and usage practices to ensure they remain aligned with ethical principles and do not expose individuals to unnecessary risks.
Remain aware of the potential for data/information to be weaponized or misinterpreted regarding specific individuals, groups, populations, or organizations, and guard against it.

Standard 4: Safeguard the privacy, confidentiality, security, and quality of health information

Each certified member shall:

A) Only disclose data/information that is necessary and directly relevant to achieve the objective of the disclosure.

Share health data/information only with individuals or entities that have a legitimate and authorized need to know, ensuring that individuals’ privacy and welfare are prioritized.
Within the scope of your role, inform individuals when their data/information is disclosed for purposes other than their direct care, allowing them to understand who has access to their data/information and why.

B) Only disclose data/information with valid authorization and only disclose the minimum necessary for disclosure activities.

Ensure that appropriate consent is obtained from patients/representatives before disclosing their health information, clearly specifying the purpose of the disclosure.
Use standardized authorization forms that comply with legal and regulatory requirements, including necessary details such as the patient’s name, the data/information to be disclosed, and the recipient’s name.
Within the scope of your role, periodically review and update policies regarding disclosure practices to ensure they reflect current laws, regulations, and best practices.

C) Maintain the quality of data/information to support safe, effective, person-centered care and evidence-based decision-making.

Within the scope of your role, conduct regular audits to verify the accuracy and completeness of health information, correcting any identified errors promptly.
Within the scope of your role, implement standardized procedures for data entry to minimize errors and ensure consistency in health records.
Identify any limitations or caveats regarding the quality of the data to ensure appropriate use of the information.

D) Advocate for appropriate uses of data/information resources across the health system(s).

Within the scope of your role, actively participate in the development of organizational policies related to health data/information management, ensuring they reflect ethical and appropriate use standards.
Promote adherence to legal and regulatory requirements related to data/information resource use, ensuring that policies align with industry standards.
Advocate for innovative approaches to health data/information management that enhance the quality and appropriateness of data/information use.
Within the scope of your role, regularly assess and revise practices related to data/information resource use, ensuring they remain aligned with ethical standards and best practices.

E) Inform recipients of the security limitations and risks to privacy and confidentiality associated with the collection of data/information and provision of services.

Within the scope of your role, create easily understandable documents (such as brochures, FAQs, or online resources) that explain the security measures in place, potential risks, and how data/information will be used.
Avoid jargon and technical terms when communicating with people, ensuring that the data/information is accessible to everyone.

F) Demonstrate accountability by maintaining current knowledge of privacy legislation and best practice.

Maintain current knowledge of privacy and security legislation and best practices through relevant educational resources.

Standard 5: Be vigilant not to create or exacerbate inequities and actively work to reduce them

Each certified member shall:

A) Treat individuals and populations with equal moral respect.

Participate in training on cultural competence and sensitivity to help them understand and respect the diverse backgrounds, beliefs, and values of individuals they serve. Training should include case studies that highlight the importance of understanding cultural nuances and treating everyone with respect, regardless of their background.
Promote diversity in leadership positions to ensure that decision-makers reflect the communities they serve and understand their unique challenges. Ensure all individuals receive the same level of care and respect, regardless of their background.

B) Practice in such a way that no segment of the population is disproportionately burdened or harmed.

Identify barriers that different populations face in accessing services, such as transportation, language, or financial constraints, and implement solutions to address these barriers. Advocate for the provision of services and materials in multiple languages to ensure that non-native speakers can access information and support equally.
Within the scope of your role and where possible, involve representatives from diverse communities in the development of policies and programs to ensure that their needs and perspectives are considered.
Within the scope of your role, regularly assess policies for their impact on different populations to ensure that they do not disproportionately disadvantage any group.
Advocate for the rights and needs of marginalized populations, ensuring their voices are heard in decision-making processes.

C) Actively aim to address the needs of the least advantaged.

Advocate for the collection of data to identify and/or address inequities.

D) Advocate for the reduction of unjust health inequalities.

Within the scope of your role, build coalitions with other organizations, community groups, and advocacy networks focused on health equity to amplify voices and create a united front in addressing health disparities.
Within the scope of your role, support or conduct research that identifies the root causes of health inequities and highlights effective interventions, ensuring findings are disseminated to partners and policymakers.
Advocate for the collection and publication of disaggregated health data/information to better understand disparities and monitor progress in addressing health inequalities.

E) Advocate for health data/information practices that are consistent with the general public good.

Advocate for policies that allow public access to health data, enabling individuals to understand health trends and outcomes in their communities.
Support the establishment of clear reporting standards for health organizations to disclose health data/information in a manner that is understandable and accessible to the general public.

F) Work to create safe, inclusive spaces for all.

Within the scope of your role, ensure that physical spaces are accessible to everyone, including individuals with disabilities, by incorporating features like ramps, elevators, and accessible restrooms.
Use inclusive and welcoming environments that reflect diverse cultures and identities to make individuals feel represented and respected. Remove exclusionary graphics/language wherever possible.
Identify and address barriers that may prevent certain groups from participating fully, such as financial constraints, transportation issues, or lack of information.
Within the scope of your role, provide various options for participation (in-person, virtual, hybrid) to accommodate different needs and preferences.
Recognize important cultural events and holidays that reflect the diversity within the community.
Highlight the contributions of diverse individuals and groups within the space, fostering a sense of pride and recognition.

G) Report any inequity-causing activities, behaviours, or practices to the appropriate authority or body.

Within the scope of your role, develop or advocate for explicit guidelines for staff on how to report inequity-causing activities, including what constitutes such behaviors and the steps to take. Implement anonymous reporting mechanisms (e.g., hotlines, online forms) to encourage individuals to report inequities without fear of retaliation.
Conduct or participate in training for all staff members on recognizing inequity-causing practices and the importance of reporting them to the appropriate authorities. Use role-playing exercises to help staff practice how to identify and report inequities in real-world situations.
If systemic inequities are identified within health data/information systems or practices, report these issues to organizational leadership, and/or provincial or federal health authorities, such as Health Canada or the Canadian Institute for Health Information (CIHI).
Compile documented cases of inequities within health data/information practices and advocate for policy changes at the institutional or governmental level based on this evidence.