By Bob Uttl (November 29, 2024)
Psychologists are required to obtain informed consent prior to providing any professional services to any clients. For example, the College of Alberta Psychologists (CAP) Standards of Practice (2005) make it clear that psychologists must obtain “informed consent”, must provide all information that “a reasonable person would want to know to make a decision to consent to the service”, must provide the information “in a timely manner”, etc.. Moreover, in situations where some other party has an interest in the professional services, psychologists must clarify with “all parties prior to rendering the services [emphasis added] the dimensions of confidentiality and professional responsibility.” In any case, psychologists cannot disclose confidential information about clients without the informed written consent of the clients to anyone else, not even to other psychologists. Finally, psychologists cannot delegate their professional responsibilities to non-psychologists, for example, to an employer, technicians, or, to make this point crystal clear, to an express train conductors.
Here are relevant verbatim excerpts from the CAP Standards of Practice (2005):
1 In these standards,
(a) “psychologist” means a person who has been issued a certificate of registration under the Health Professions Act…
…
(e) “professional services” means all actions of psychologists in the context of their professional relationships;
…
(g) “psychologist” means a Psychologist and a registrant;
…
(f) “informed consent” means consent that is given under the following conditions”
(i) adequate disclosure of information by the psychologist,
(ii) the client understanding the information, and
(iii) the client expressing a voluntary choice.
2(1) Psychologists shall obtain the informed consent of all persons who are competent to give such consent for psychological services provided to them except in circumstances of urgent need (e.g., disaster or other crisis)…
2(3) Psychologists shall provide, in obtaining informed consent, such information as a reasonable person would want to know to make a decision to consent to the service. The psychologist must relay this information in language that the persons understand (including providing translation into another language, if necessary) and will take whatever reasonable steps are needed to ensure that the information is understood.
2(4) Psychologists shall provide new information in a timely manner, whenever such information becomes available and is significant enough that it reasonably could be seen as relevant to the original or ongoing informed consent.
18(1) Psychologists shall endeavor in all cases to inform clients of the limits to confidentiality and shall safeguard the confidential information about clients obtained in the course of practice, teaching, research or other professional services.
18(2) Psychologists may disclose, in accordance with section 16 to 1 and 21 to 23, confidential information about a client to an individual other than the client only with the informed written consent of the client.
20 In a situation involving a third party, such as an employee assistance program or an insurance company, in which more than on party has an interest in the professional services rendered by a psychologist to a client or clients, the psychologist shall, to the extent possible, clarify for all parties prior to rendering the services the dimensions of confidentiality and professional responsibility that apply to the rendering of the services.
21(1) When rendering professional services as part of a team or when interacting with other professionals concerning the welfare of a client, psychologists may share confidential information about the client, provided they take reasonable steps to ensure that all persons receiving the information are informed about the confidential nature of the information and have a reasonable appreciation of the rules of confidentiality.
21(2) Psychologists must inform a client that confidential information about the client is to be shared with other professionals or other members of the team pursuant to subsection (1).
(43) Psychologists shall not delegate professional responsibilities to a person who does not have the appropriate credentials or who is not otherwise appropriately qualified to provide the services.
CAP Standards of Practice (2005), see also CAP Standards of Practice (2013) and CAP Standards of Practice (2019)
Canadian Code of Ethics for Psychologists (2000), which all Alberta Registered Psychologists are also required to abide by as per the Health Profession Act, has similar Ethical Standards, see in particular Ethical Standard I.16, I.17, I.23. I.24, I.25, and I.26 (see also Canadian Code of Ethics for Psychologists (2017)).
Dr. Mary Westcott directed her technician to obtain consent from Ms. T
According to Dr. Mary Westcott‘s clinical file, on July 29, 2010, at 8:30 AM, “Consent” was obtained by Ms. DN, Dr. Mary Westcott’s technician. Ms. DN was not a psychologist, and any consent she obtained was invalid because (a) it was not obtained by a psychologist and (b) it could not be and was not informed. Ms. DN had no idea which tests would be administered and for which purpose, and as a result, could not obtain informed consent in any case. Notably, Ms. DN obtained the “consent” in less than five minutes, including Ms. T and Ms. DN signing and dating the consent form.
The figure below is the extract from Dr. Mary Westcott‘s clinical file “documenting” the less than 5-minute long consent.
The actual Consent Form (see below) is similarly non-informative, a mere five lines long (as printed), and entirely pro forma.
CONSENT FORM
I, [Ms. T], of [redacted], B.C., Alberta hereby consent to undergo a Vocational and a Psychological/Disability Assessment by Mary Westcott, as per referral by Cynthia Stewart [Stuart] of Southeast Kootaney School District, and to the transmittal of an assessment report to Ms. Stewart [Stuart]. I also provide my consent for Ms. Westcott to discuss aspects of my assessment with Ms. Stewart [Stuart] as needed. I understand that I may withdraw this consent at any time.
Signed: [Ms. T] Date: July 29, 2010
Witness: [DN — the technician] Date: July 29, 2010
Mandel & Associates Ltd. 620, 1816 Crowchild Trail NW Calgary, Alberta T2M 3Y7
Consent From signed by Ms. T on July 29, 2010
As a preliminary matter, the consent form, prepared by someone in Mandel & Associates Ltd., was written so carelessly that the key information in it was false: (a) the name of Ms. Stuart was misstated as Ms. Stewart, (b) B.C, or British Columbia, is NOT located in Alberta (a fun fact: British Columbia and Alberta are two different provinces of the country called Canada), and (c) the referral was made by Ms. T’s physician rather than by the SD5 (notably, Dr. Westcott herself was so incredibly confused that she did not even know who the referal came from: Dr. Westcott stated in her September 15, 2010 Report that the referral came from the SD5 and Ms. T’s physician at different places of her report.
As is clear, the consent form:
- Did not disclose that Dr. Westcott already obtained confidential information about Ms. T (without any consent) from Dr. Allan Mandel, who in turn obtained the confidential information (without any consent) from the SD5/Ms. Stuart, during a secret ex-parte phone call that Ms. T did not know about, was not invited to join, and that Dr. Westcott did not even mention in her September 15, 2010 Report.
- Did not disclose that Dr. Westcott and Dr. Allan Mandel were already sharing Ms. T’s confidential information (without any consent) and that Dr. Westcott would continue to share Ms. T’s confidential information with Dr. Mandel without any consent.
- Did not disclose that Dr. Westcott was closely supervised by Dr. Mandel and that Dr. Mandel would be involved in Ms. T’s assessment and in Dr. Westcott’s report writing and “quality control”.
- Did not disclose what tests would be administered to Ms. T. and for what purpose.
- Did not disclose that Dr. Westcott had no tests and no norms for the performance of elementary school teachers that she could reasonably use to compare Ms. T’s scores to.
- Did not disclose that Dr. Westcott would be using decades obsolete IQ or General Mental Ability (GMA) tests (e.g., GATB CDN, Nelson, 1986) and data (Career Handbook) to form her opinions about Ms. T ability to perform her teaching duties.
- Did not disclose that Dr. Westcott would be using obsolete tests (e.g., GATB CDN and Career Handbook) for purposes they were not designed for and for purposes the test manuals (e.g., Career Handbook) specifically stated it should not be used for.
- Did not disclose to Ms. T that Dr. Westcott believed that elementary school teachers had to have a certain number of IQ points, that she had no idea what that minimum number of IQ points for the SD5 elementary teachers was, and that the SD5 did not give her any minimum number of IQ points elementary school teachers in the SD5 have to have to perform their teaching duties.
- Did not disclose to Ms. T that Dr. Westcott was no expert on psychological tests (the fact Dr. Westcott admitted 14 years later during her under oath cross-examination).
- Did not disclose to Ms. T that Dr. Westcott would be extensively plagiarizing her report from other sources, including computerized reports, her supervisor Dr. Allan Mandel, peer-previewed articles, etc., lifting phrases, sentences and even paragraphs from these sources without quotation marks and without acknowledgment.
- In general, did not disclose how Dr. Westcott would determine whether or not Ms. T could perform the duties of an elementary teacher.
Notably, when the testing started, Dr. Mary Westcott has not yet even met with Ms. T, had no communication with Ms. T., and did not even decide which tests would be administered to Ms. T. Dr. Mary Westcott wrote to the CAP:
According to file records, Ms. T completed the consent form 8:30am on 29 July 2010. During the remainder of the morning, she completed measures of academic, intellectual, and emotional functioning with Ms. DN. I had advised Ms. DN as to what tests to start with and conducted my interview that afternoon, after which I formulated the rest of the test battery administered to Ms. T following the interview.
Dr. Mary Westcott, Response to Ms. T’s Complaint to the CAP
According to Dr. Westcott herself, Dr. Westcott formulated what would be assessed and how only hours after the 5-minute consent procedure was administered by her technician, Ms. DN rather than by Dr. Westcott, a psychologist.
Dr. Troy Janzen’s failure to understand that informed consent cannot be obtained by a technician
Ms. T filed several complaints against Dr. Mary Westcott as well as Dr. Allan Mandel, Dr. Westcott’s employer and supervisor, including Dr. Westcott’s failure to obtain informed consent.
On September 27, 2022, Dr. Troy Janzen, Deputy Registrar and Complaints Director, dismissed Ms. T’s complaint against Dr. Mary Westcott, Dr. Allan Mandel and Dr. J. Braxton Suffield. In particular, Dr. Janzen deemed the 5-min consent and the “Consent Form” obtained by Ms. DN, Dr. Westcott’s technician, sufficient. Dr. Janzen quoted as “possible relevant sections of the Standards” only the Standards of Practice (2005) Sections 2(1) to 2(6). Dr Janzen ignored or was unaware of all other relevant sections detailed above, including the definition of “psychologist” and sections 8(1), 8(2), 18(2), 20, 21(1), 21(2) and 43. Dr. Janzen also ignored all of the relevant Ethical Principles from the Canadian Code of Ethics for Psychologists (2000) noted above.
However, it is clear that Dr. Janzen was aware of the following:
- The Consent Form was obtained by Ms. DN, the technician, and not by Dr. Westcott, the psychologist. Ergo, Dr. Janzen knew or should have known that the consent was obtained in violation of the Standards of Practice (2005) 2(1), 2(3) and 2(4), 43, and many others.
- Dr. Mandel discussed Ms. T’s private and confidential information prior to July 29, 2010, with Ms. Stuart during the “initial intake” without Dr. Mandel obtaining any consent whatsoever from Ms. T, ever. Ergo, Dr. Janzen knew or should have known that Dr. Mandel was providing psychological services in violation of the Standards of Practice (2005) 2(1), 2(3), 2(4), 18(1), 18(2), 20, 20(1), and 20(2), and many others.
- Ms. DN obtained the July 29, 2010 consent in less than 5 minutes. Ergo, Dr. Janzen knew or ought to have known that Ms. DN never had enough time (nor knowledge) to comply with the Standards of Practice (2005) 2(1), 2(3), 2(4), 18(1), 18(2), 20, 20(1), and 21(2) in obtaining informed consent.
- Dr. Mandel shared Ms. T’s private and confidential information with Dr. Mary Westcott prior to July 29, 2010, without obtaining any consent whatsoever. Ergo, Dr. Janzen knew or ought to have known Dr. Mandel did so in violation of the Standards of Practice (2005) 2(1), 2(3), 2(4), 18(1), 18(2), 20, 20(1), and 20(2), and many others.
- Dr. Westcott shared Ms. T’s private confidential information with Dr. Mandel without obtaining any consent for this sharing and without informing Ms. T about such sharing. Ergo, Dr. Janzen knew or ought to have known Dr. Westcott did so in violation of the Standards of Practice (2005), in particular 18(1), 18(2), 21(1), 21(2), and others.
Dr. Troy Janzen ought to review ALL of the relevant standards and ALL of the relevant Ethical Principles before considering complaints. If Dr.Janzen is unwilling to enforce the Standards of Practice, the Code of Ethics, and the Health Profession Act. Dr. Janzen ought to resign from his Complaints Director position.
Quite obviously, there CANNOT BE and there is NO informed consent if:
- No consent for psychological services was ever obtained (e.g., Dr. Mandel never obtained any consent whatsoever for his involvement in Ms. T’s assessment, discussions with the SD5, and access to Ms. T’s private confidential information).
- The only consent was obtained by a non-psychologist, Ms. DN, Dr. Westcott’s technician. Non-psychologists such as technicians, employers, express train conductors, and garbage collectors, do not have the required qualifications, do not have the required knowledge, and do not have direct access to the minds of psychologists who may be conducting the actual assessments.
- Consent for specific activities such as the consent for Dr. Westcott to share Ms. T’s confidential information with Dr. Mandel was never obtained by anyone.
Dr. Troy Janzen’s failure to understand that informed consent cannot be obtained by an employer
Dr. Troy Janzen does not appear to understand (or he pretends not to understand) the very basic standards and ethics principles. For example, Dr. Janzen wrote:
… the investigator [Dr. Acton, Falcongate] confirmed that you signed another consent through the School Division No. 5 to release Dr. TK’s report… the evidence of the signed document demonstrates that you understood you were attending an assessment with Dr. Westcott, you understood the rationale and questions the assessor was asked to have addressed and you signed indicating consent…
Dr. Troy Janzen, September 27, 2022 (p.000976)
Here is the “consent” dated July 13, 2010, Dr. Janzen refers to, verbatim — it is titled “Employee’s Authorization for Release of Information”:
School District 5 Southeast Kootenay Human Resources Department
Employee’s Authorization for Release of Information
I, Ms. T. hereby authorize (Neuropsychologist — to be determined) from the clinic, Mandel and Associates to follow up with a full neuropsychological assessment, and to release the assessment results to my Employer.
I agree that the Psychological Assessment Report completed by Dr. TK, may be released to the neuropsychologist prior to the assessment. Please also see the questions asked of Dr. TK prior to the completion of this assessment.
Please bill the School District for the cost of the assessment and provide a copy of the results to the District, Attention: Cynthia Stuart, when available. Contact information is provided below.
Employee’s Signature [Signed Ms. T] Date July 13, 2010
Employee’s Authorization for Release of Information, dated July 13, 2010
It is obvious that the Employee’s Authorization is not and cannot be “informed consent” that “a psychologist” must obtain themselves. Moreover, Dr. Janzen was hallucinating (seeing things that were not objectively there) if he thought that “the signed document demonstrates that you understood you were attending an assessment with Dr. Westcott.” Dr. Mary Westcott is not mentioned anywhere in the document and the document explicitly states: “Neuropsychologist — to be determined”.
Neither School District No 5 nor Ms. Stuart were psychologists registered in Alberta and neither was conducting the assessment. Notably, in a rare moment of clarity, even Dr. Acton, the CAP investigator, wrote: “The Client [SD5 — Dr. Acton was mistaken when he believed the client was the SD5] cannot provide informed consent by Ms. T, as the psychologist must obtain that consent themselves…”
Dr. Troy Janzen, the CAP Deputy Registrar and Chief of Practice/Complaints Director, apparently has no idea (or pretends to have no idea) that informed consent must be obtained by the psychologists themselves even though even Dr. Acton reminded him of that obvious fact.
Which is it? A failure to comprehend what informed consent is, a hallucination of the informed consent, or sweeping things under the rug?
Dr. Mary Westcott never obtained Ms. T’s informed consent. Dr. Troy Janzen may be unable to comprehend the requirements of informed consent detailed in the Standards of Practice (2005) and the Code of Ethics (2000); he may be hallucinating and erroneously perceiving the SD5, Ms. Stuart, and/or Ms. DN to be psychologists; and he may be trying to sweep things under the rug. Given that Dr. Troy Janzen presents himself as the “Experienced Clinical Supervisor … Skilled in Clinical Supervision, Psychological Assessment,… with a Ph.D. focused in Counselling Psychology from University of Alberta”, it seems inconceivable that Dr. Troy Janzen, Ph.D. educated professional, was unable to comprehend the requirements of informed consent or that he was hallucinating. It seems far more likely that he was attempting to sweep things under the rug.
In any case, Dr. Troy Janzen‘s decisions and reasoning mocks informed consent requirements, the Standards of Practice, the Code of Ethics, and the Health Profession Act. Dr. Janzen himself brought the profession of psychology into disrepute by demonstrating that the College of Alberta Psychology is unable or unwilling to regulate the profession, and unable or unwilling to enforce the Standards of Practice (2005), the Code of Ethics (2000), and the Health Profession Act.