Authorized Acts
In the Medical Laboratory Technology Act, 1991, controlled acts authorized to medical laboratory technologists are defined as follows:
Authorized acts
4. In the course of engaging in the practice of medical laboratory technology, a member is authorized, subject to the terms, conditions and limitations imposed on his or her certificate of registration, to take blood samples from veins or by skin pricking. 1991, c. 28, s. 4.
Additional requirements for authorized acts
5. (1) A member shall not perform a procedure under the authority of section 4 unless the procedure is ordered by a member of the College of Physicians and Surgeons of Ontario or the Royal College of Dental Surgeons of Ontario or by a prescribed person. 1991, c. 28, s. 5 (1); 1997, c. 9, s. 5.
Controlled Acts and Scopes of Practice
In their scope of practice, health professionals may be authorized to perform one or more controlled act. Some professions are not authorized to perform any controlled acts.
Controlled acts may only be performed by health professionals in their practice if: the controlled act is authorized to them; or the controlled act is delegated to them by a health professional who is authorized to perform it; or an exemption exists.
The Regulated Health Professions Act , 1991 (RHPA) defines 14 controlled acts
Under the RHPA, no profession has a monopoly over any of the controlled acts. This regulatory structure allows for evolution in professional scopes of practice, and is emulated in other provinces in Canada and other jurisdictions around the world.
MLT Scope of Practice
The practice of medical laboratory technology is the performance of laboratory investigations on the human body or on specimens taken from the human body and the evaluation of the technical sufficiency of the investigations and their results.
MLTs are authorized in the practice of their profession (subject to any restrictions that may have been imposed on his or her certificate of registration) to take blood samples from veins or by skin pricking, which is a part of the controlled act of performing a procedure on tissue below the dermis.
The CMLTO receives numerous inquiries from MLTs regarding scope of practice and it has developed resources about delegation and medical directives and Frequently Asked Questions-MLT scope of practice.
Exemptions
Although performing a procedure below the dermis is a controlled act, there are a number of exemptions in the RHPA and other legislation. Specifically, regulations under the RHPA exempt acupuncture, ear or body piercing for jewellery, electrolysis, cosmetic tattooing and male circumcision for religious tradition. In addition, regulations under the RHPA exempt taking of a blood sample from a vein or by skin pricking if done by an employee of a lab or specimen collection centre licensed under the Laboratory and Specimen Collection Centre Licensing Act, 1990
This exemption allows medical laboratory assistants and medical laboratory technicians (MLA/Ts) to perform phlebotomy in licensed laboratories.
Harm Clause
In addition to the 13 specific controlled acts under the RHPA, a harm clause applies generally to the provision of health care:
“No person, other than a member treating or advising within the scope of practice of his or her profession, shall treat or advise a person with respect to his or her health in circumstances in which it is reasonably foreseeable that serious physical harm may result from the treatment or advice or from an omission from them.”
This clause applies to those aspects of treatment and care that may not be otherwise covered by the controlled acts. For example, performing laboratory tests on human specimens is not one of the controlled acts under the RHPA. However, it is reasonably foreseeable that serious physical harm could result if this were done by someone other than a regulated health professional working within his or her scope of practice.