Death Doula Association of Canada: Scope Of Practice and Code of Ethics

June 14, 2018

Vision:  To raise the standard of End of Life Care.      

Mission: To promote high quality End of Life Care by setting the standard for the doula profession through membership and training based on need and recommendations made by the Ministry of Health, health authorities and outside agencies.

Statement of Values:

  • In alignment with our Code of Ethics and Standards of Practice, we will welcome and embrace our strengths and our differences, encourage involvement and provide equal access to opportunities and information for all members and clients.
  • We recognize the diversity of personalities and skills that comes with a person. We will be respectful and inclusive to all members and clients regardless of their identities.
  • We will promote beneficence in care. We will promote good, prevent and remove harm.

Standard of Practice:

Scope:

  • The End of Life Doula (EOLD) provides emotional, educational and practical support that empowers the client to make informed decisions regarding their end of life care. The Doula communicates in a respectful, non-judgmental, encouraging way so that the client’s wishes can be heard and fully understood.
  • To provide support and resources to primary caregivers and persons supporting the client.

Limits to Practice:

  • EOLD do not and are not qualified to prescribe any treatment, perform medical or clinical tasks, distribute medication, or diagnose a client.
  • If a Doula has qualifications in alternative or complementary modalities (such as nursing, massage therapy, etc.), she/he must make it clear that these are additional services and are not in the scope of practice of an EOLD.
  • Clients and EOLD must recognize that doulas are there to advocate but never to make decisions or project their own beliefs on another person.
  • If an EOLD finds that the client’s needs are greater than the scope of training, referrals are made to the appropriate resources.

Continuity of Care:

  • The Doula should make back-up arrangements with another doula to ensure services to the client if the doula is unable to attend the client due to other life obligations or the need for self-care.  If the doula is discontinuing service to the client prior to the end of the agreed upon time, it is the EOLD responsibility to inform the client in writing, provide a replacement and/or refund of an agreed upon amount of money.
  • This may be accomplished by: Introducing the client to the backup EOLD. Recommending another EOLD or other appropriate resources.

Training and Experience:

  • A EOLD is required to keep up to date with Government and Health agencies policies, the resources available to them and their clients as well as trying to gain as much experience as possible.
  • Completion of recognized EOL education program (to be determined by board).
  • Demonstrate competency, by updating and submitting additional training every 2 years, and by engaging with other doulas
  • Provide references up on request
  • Provide a criminal record check every 2 years.
  • Minimum experience of 40 hours prior to applying to DDAC, not retro-active, with a minimum of 3 clients.

Code of Ethics:

Rules of Conduct

  • Propriety.  The doula will maintain high standards of personal conduct in the capacity or identity as an EOL doula.  The doula should not accept monetary gifts that exceed over and above what is stated in the contract.
  • Competence and Professional Development. The doula will strive to become and remain proficient in the professional practice and the performance of professional functions through continuing education, affiliation with related organizations, and associations with other doulas.
  • The doula will act in accordance with the highest standards of professional integrity.
  • The doula will abide by the law of the jurisdiction they are working in.
  • Health Authority: The doula will abide by the code of conduct of the health authority, if employed as a doula under that health authority. 
  • The doula will avoid actions that may constitute as sexual or personal harassment.

Ethical Responsibility to Clients

  • Primacy of Client’s Interests.  The EOLD primary responsibility is to his or her clients.
  • Rights and Prerogatives of Clients. The EOLD should make every effort to foster maximum self-determination on the part of his or her clients.
  • Confidentiality and Privacy. The EOLD should respect the privacy of the client and hold in confidence all information obtained during professional service.  The only exception is if someone was in danger, going to cause harm or admission of a crime.  If a client shares information that needs to be shared with an outside source, EOLD have a duty to report it in an ethically and respectfully way.
  • Obligation to Serve. The EOLD should assist each client seeking support either by providing services or making the appropriate referrals.
  • When the EOLD agrees to work with a client, his or her obligation is to do so reliably, without fail, for the term of the agreement or to provide an acceptable alternative to care.
  • When setting fees, the EOLD should ensure that they are fair, reasonable and commensurate with services performed.  The EOLD must clearly state the fees to the client, and describe the services provided, terms of payment and refund policies.

Ethical Responsibility to Colleagues

  • Respect, Fairness, and Courtesy.  The EOLD should treat colleagues with respect, courtesy, fairness, and good faith.
  • Dealing with Colleagues’ Clients. The EOLD has the responsibility to relate to the clients of colleagues with full professional consideration.

Ethical Responsibility to the Profession

  • Maintaining the Integrity of the Profession. The EOLD should uphold and advance the values, ethics, knowledge and mission of the profession.
  • Community Service. The EOLD is encouraged to promote the Death Doula Association of Canada vision of “Raise the standard of EOLC” by providing doula services at a reduced cost, if possible, or making appropriate referrals, as available or necessary.
  • The Death Doula Society of Canada reserves the right to update the Standards of Practice and code of Ethics.
  • The Death Doula Society of Canada reserves the right to revoke membership to those members not upholding the Standard of Practice or Code of Ethics.
  • The doula has the right to work in a safe environment. The doula will report all unsafe work environments and/or concerns.

Ethical Responsibility to Society

Promoting general health.  The doula should promote the general health and wellbeing of clients and their families.