College of Respiratory
Therapists of Ontario





May 2021


Ethical decisions arise daily for Respiratory Therapists (RT) and it is not possible for the College of Respiratory Therapists of Ontario (CRTO) or the RT’s employer to provide specific guidance for each scenario that a practitioner may encounter.  Therefore, it is essential an RT practice within an ethical framework that will help guide decision-making when providing care.  The CRTO’s A Commitment to Ethical Practice is a first building block among a series of guidance and support documents aimed at helping practitioners deliberate on the choices that face them and discern the best option available.

The “code of ethics” for the practice of Respiratory Therapy was originally interwoven with the CRTO Standards of Practice document, which was first drafted in 1996 and revised in 2004. In 2010, a working group of RTs from various practice settings across the province gathered to revise the Standards of Practice document. Working with a Medical Ethicist, they used current literature and accepted principles and practices to build this distinct guideline for ethical RT practice. The final document was published on the CRTO website in December 2010.

College of Respiratory Therapists of Ontario (CRTO) publications contain practice parameters and standards that should be considered by all Ontario Registered Respiratory Therapists (RRTs) in the care of their patients/clients and in the practice of the profession. CRTO publications are developed in consultation with professional practice leaders and describe current professional expectations. All Members are required to abide by these CRTO publications. The “A Commitment to Ethical Practice” guideline is to be used in conjunction with the Regulated Health Professions Act (RHPA), the Respiratory Therapy Act (RTA) as well as all other CRTO Professional Practice Guidelines, Position Statements and Policies. Together, these documents provide a framework for achieving safe, effective, and ethical Respiratory Therapy practice. Although comprehensive, this document is not inclusive, and the failure to specifically identify a practice scenario does not negate the existence of these expectations and responsibilities. It is important to note that all these documents will be used in determining whether appropriate standards of practice and professional responsibilities have been maintained.

This guideline will be reviewed regularly and revised every five years at minimum or as required.

Note that words and phrases denoted by bold lettering can be cross-referenced in the Glossary at the end of the document.


The CRTO wishes to acknowledge the following working group members who assisted in the development of this revision of the CRTO Standards of Practice:

Commitment to Ethical Practice Review 2010

Tony Raso, RRT – William Osler Health Centre, Brampton
Christina Sperling, RRT – St. Michael’s Hospital, Toronto
Daniel Fryer, RRT –Windsor Regional Hospital, Windsor (CRTO Registration Committee Member)
Judy Dennis, RRT –Children’s Hospital of Eastern Ontario, Ottawa
Joelle Dynes, RRT –VitalAire Healthcare, London
Sue Jones, RRT – Royal Victoria Hospital, Barrie
Lily Yang, RRT – Holland Bloorview Kids Rehabilitation, Toronto
Lorella Piirik, RRT – Thunder Bay Regional Health Sciences Centre, Thunder Bay (CRTO Council Member)
Patrick Nellis, RRT – University Health Network, Toronto

Mary Bayliss, RRT – CRTO Deputy Registrar
Carole Hamp, RRT – CRTO Professional Practice Advisor

The CRTO would gratefully like to acknowledge the assistance of Kevin Reel BSc (OT), MSc; Medical Ethicist for Southlake Regional Health Centre & York Central Hospital, Toronto.

In fond memory of Gary Tang, RRT.

The CRTO would like to acknowledge Gary’s contribution as part of the Standards of Practice working group.


While seldom contemplated explicitly, there are ranges of values that are commonly considered to uphold the practice of healthcare. Many of these values would be seen as underpinning civil society in general – like honesty, courtesy and respect. Others among them are particularly relevant to professional practice – such as compassion, transparency, and accountability. Most healthcare organizations have an explicit list of values considered most salient for them. Given the lengthy list of values that might be considered relevant, the CRTO has chosen not to specify any particular combination.

Values are such fundamental notions that they do not offer much precision in guiding practice. To attend appropriately to values in day-to-day practice, we need to turn them into something more usefully substantive. Principles are general guides for decision-making and action. They are not precise guides, as rules might be, but rather they leave room for judgement based on the specific case at hand. They embody one or more of the values that inform them but work more usefully to keep the values explicit in our decision-making.


    This document will be updated as new evidence emerges or as practice
    evolves. Comments on this document are welcome and should be
    addressed to:

    College of Respiratory Therapists of Ontario, 180 Dundas Street West, Suite 2103, Toronto, Ontario M5G 1Z8
    Phone 416-591-7800 | Toll Free 1-800-261-0528 | Fax 416-591-7890 | E-mail