End of Life Doula Practice: Scope of Practice & Code of Ethics

Vision: To raise the standard of End of Life Care. Mission: To promote high quality End of Life Doula services 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: A. In alignment with our Doula Code of Ethics and Standards of Practice, we will welcome and embrace our strengths and differences, encourage involvement, and provide equal access to opportunities and information for all members and clients. B. We recognize the diversity of personalities and skills that each individual brings. We will be respectful and inclusive to all members and clients, regardless of their identities. C. We will promote beneficence in care by adhering to our Scope of Practice, ensuring we promote good and prevent harm.

I. Scope of Practice: A. The End of Life (EOL) Doula provides emotional, educational, and practical support in accordance with the Doula Code of Ethics, empowering clients to make informed decisions regarding their end of life care. The Doula communicates in a respectful, non-judgmental, encouraging manner to ensure that the client’s wishes are both heard and fully understood. B. The Doula also offers support and resources to primary caregivers and individuals assisting the client. II. Limits to Practice: End of Life Doulas do not possess the qualifications to prescribe treatment, perform medical or clinical tasks, distribute medication, or diagnose clients. A. If an EOL Doula has qualifications in alternative or complementary modalities (such as nursing, massage therapy, etc.), it is essential to clarify that these are additional services and fall outside the scope of practice for an End of Life Doula. B. It is important for both clients and the EOL Doula to recognize that Doulas are present to advocate for the client but are never to make decisions or impose their own beliefs on others. C. Should an EOL Doula identify that a client’s needs exceed their training scope, referrals will be made to appropriate resources. III. Continuity of Care: The Doula should establish backup arrangements with another Doula to guarantee that services continue for the client in case the primary Doula is unavailable due to life obligations or the need for self-care. If the Doula decides to discontinue services before the agreed-upon time, it is their responsibility to inform the client in writing, provide a replacement, and/or refund an agreed amount of funds. This can be achieved by: A. Introducing the client to the backup EOL Doula B. Recommending another EOL Doula or other pertinent resources. IV. Training and Experience: An End of Life Doula (EOLD) is required to stay updated with Government and Health agencies' policies and the resources available to both Doulas and their clients, while also gaining as much experience as possible. A. Completion of a recognized EOL education program (to be determined by the board) B. Demonstrating competency by submitting additional training every two years and engaging with other Doulas C. Providing references upon request D. Obtaining a criminal record check every two years E. Having a minimum of 40 hours of experience prior to applying to EOLDAC, which is not retroactive and requires at least 3 clients.

I. Rules of Conduct  A. Propriety: The End of Life Doula will uphold the highest standards of personal conduct in accordance with the Doula Code of Ethics. The doula should not accept monetary gifts that exceed what is explicitly stated in the contract.  B. Competence and Professional Development: The Doula will strive to become and remain proficient within the scope of practice through ongoing education, affiliation with related organizations, and collaboration with other Doulas.  C. Integrity: The Doula will act in alignment with the highest standards of professional integrity as outlined in the Doula Code of Ethics.  D. Law: The Doula will comply with the laws of the jurisdiction they are operating in.  E. Health Authority: If employed under a health authority, the Doula will adhere to the code of conduct set forth by that authority.  F. Conduct: The Doula will refrain from actions that may be construed as sexual or personal harassment.

III. Ethical Responsibility to Clients A. Primacy of Client’s Interests: The primary responsibility of the End of Life Doula, as outlined in the Doula Code of Ethics, is to prioritize the interests of their clients. B. Rights and Prerogatives of Clients: The End of Life Doula should make every effort to promote maximum self-determination for clients within their scope of practice. C. Confidentiality and Privacy: The EOL Doula must respect client privacy and maintain confidentiality regarding all information obtained during professional services. The only exception to this duty arises when there is a risk of danger, potential harm, or admission of a crime. Should a client disclose information necessitating communication with an external party, it is the responsibility of EOL Doulas to report ethically and respectfully. D. Obligation to Serve: The End of Life Doula should provide assistance to each client seeking support, whether through direct services or appropriate referrals, in compliance with the Doula Code of Ethics. E. Reliability: When an EOL Doula commits to working with a client, they must fulfill that obligation reliably for the entire term of the agreement or provide a suitable alternative for care. F. Fees: In establishing fees, the End of Life Doula should ensure that they are fair, reasonable, and reflective of the services provided, in alignment with the standards set forth in the Doula Code of Ethics. The EOL Doula must clearly communicate the fees to the client, outlining the services included, payment terms, and refund policies.

Maintaining the Integrity of the Profession: The EOLD should uphold and advance the values, ethics, knowledge, and mission of the profession in alignment with the Doula Code of Ethics. Community Service: The EOLD is encouraged to promote the Death Doula Association of Canada's vision of 'Raise the standard of EOLC' by providing End of Life Doula services at a reduced cost when 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 the Doula Code of Ethics. Additionally, the Society reserves the right to revoke membership for those who do not adhere to the Standards of Practice or the Code of Ethics. Every End of Life Doula has the right to work in a safe environment and will report any unsafe work environments and/or concerns.