Code of Ethics for SEESSQ Members

SOCIETY OF EXPERT EVALUATORS IN HEALTH SCIENCES OF QUEBEC- CODE OF ETHICS (Modified in 2025)

Preliminary Notes

a) In the following text, the terms "healthcare provider," "expert," and "expert evaluator" are inclusive of all health professionals working within a professional order recognized by Quebec, regardless of their field of practice: medicine, nursing sciences, physiotherapy, chiropractic, occupational therapy, psychology and neuropsychology, dentistry, pharmacy, and any other health discipline duly recognized by the Office of Professions.

b) To facilitate reading, the masculine gender is used here as a neutral gender and is fully inclusive.

c) This text is largely inspired by the foundational work and in-depth reflection of Dr. Pierre Legendre, orthopedist, who made it the subject of his DESS thesis. Dr. Legendre was also president at the time of SEEMLQ's ethics committee. We thank him wholeheartedly for his immense contribution.

1. PREAMBULE

1.1 Expertise in health sciences constitutes a full professional act. The expert remains subject to the provisions of the code of ethics of their professional order as well as the regulatory aspects submitted by it.

1.2 SEESSQ's code of ethics stems from its mission, notably "to promote the quality of medical expert services provided by Society members."

1.3 Expertise in health sciences is a field of practice in health sciences based on recognized scientific foundations of various organs and systems of the human body. It requires in-depth clinical experience specific to a particular field. It finds its application in various legal contexts. The expert's role remains to enlighten the parties on the scientific issues at stake.

1.4 The expert values respect for the person being assessed as well as the stakeholders in the file submitted to them, rigor, honesty and impartiality in the exercise of their act, independence and the courage that follows, and the competence to express their opinion clearly both in writing and verbally to the requester and the decision-maker.

1.5 At SEESSQ, a standing committee ensures compliance with ethical rules. It is entrusted with the mandate to:

Inform members of statistical and qualitative data relating to a particular issue;
Contribute to member training in accordance with the continuing professional development committee activities;
Transmit to the expert concerned any complaint that may have been addressed to SEESSQ;
Propose reflection activities on all relevant subjects;
Update the code of ethics as needed.

1.6 SEESSQ members must share the values stated in its code of ethics. Otherwise, they will signify their lack of interest in pursuing the same objectives as all SEESSQ members and their membership will no longer be desired or renewable.

1.7 A complaint by a SEESSQ member may be filed against another member for a breach of the code of ethics. This complaint will be analyzed by the ethics committee and a report will be submitted to the executive.

2. GENERAL DUTIES

2.1 The expert evaluator in health sciences is called upon to provide services of the highest quality. They maintain and continuously improve their knowledge, skills, and professional attitudes to meet the highest ethical standards of professional practice.

2.2 The expert evaluator in health sciences demonstrates self-criticism, taking into account their knowledge, abilities, and limitations. They refuse to execute an expert mandate that they consider outside the limits of their field of competence.

2.3 The expert evaluator in health sciences fulfills their professional obligations at all times with integrity, objectivity, and impartiality.

2.4 The expert evaluator in health sciences maintains, in all circumstances, the required professional independence from the person or organization that mandates them.

2.5 The expert evaluator in health sciences safeguards their professional independence and avoids any situation where there would be a conflict of interest or appearance of conflict of interest. Faced with a probable conflict of interest situation, they define the nature and meaning of their obligations and responsibilities in order to inform the mandating party.

2.6 By accepting a mandate, the expert evaluator in health sciences acknowledges that they must make themselves available to testify before designated bodies to explain and defend their understanding of the physical, mental, or functional problem at issue.

2.7 Before conducting an assessment, the expert evaluator in health sciences lists and mentions the medical, legal, and administrative documents they have studied and provides a faithful summary of relevant documents. These documents are the premises of their study. The expert must indicate the presence of documents in the file they maintain, their origin, and the possible absence of relevant documents as well as the consequences such an absence brings from the standpoint of the opinion issued. The expert will also mention documents that were brought to their attention but which they did not retain or study and the reasons for this decision.

2.8 The expert evaluator in health sciences, through their competence and independence, has the role of enlightening the decision-maker and must avoid arguing. It is the decision-maker who will assess the probative value of the expert's opinion. The expert must know the legal context in which their opinion fits and must communicate it clearly and comprehensibly. The expert instructs the decision-maker in their field of competence.

3. DUTIES OF COMPETENCE

3.1 The expert evaluator in health sciences recognizes as essential the notions of knowledge based on scientific evidence as well as relevant and in-depth clinical experience.

3.2 The expert evaluator in health sciences is called upon to provide services of the highest quality. They must maintain and continuously improve their knowledge, skills, and professional attitudes in their field of expertise and in medico-legal evaluation by meeting the requirements of the competence maintenance program(s) of the order and professional society of which they are a member.

3.3 The expert evaluator in health sciences must not issue an opinion in a field where they do not possess expert competence. In this event, they must inform the mandating party that part or all of the mandate should be entrusted to another expert.

3.4 The expert can formulate an opinion only following an appropriate and complete examination. Otherwise, they will limit themselves to presenting their observations and may request a complementary expert evaluation.

3.5 The expert must demonstrate rigor in their practice. Thus they will avoid being credulous toward the mandating party and the person being assessed. Validation of factual data will guarantee the probative value of their opinion.

4. DUTIES OF INDEPENDENCE

4.1 The expert, in their relations with the various stakeholders in a file entrusted to them, must avoid demonstrating behaviors and attitudes showing partiality.

4.2 In relation to the mandating party, the person being assessed, and the decision-maker, the expert evaluator in health sciences must demonstrate independence, impartiality, integrity, through the objectivity of their opinion. The latter is ensured by the relevance and validation of the facts retained by the expert, their knowledge, and their experience.

4.3 The expert, based on additional information or factual elements different from those they retained or of which they became aware, must be able to modify their opinion.

4.4 The expert evaluator in health sciences must not testify in the same file at the request of different mandating parties whether of similar or opposing interests, unless there has been a legal agreement between the mandating parties.

4.5 The expert is solely responsible for the opinion that concludes their report. If, in order to issue their opinion, the expert calls upon the expertise of a third party, the expert must reveal the identity and comment on the validity of this third party's conclusions before integrating them into their opinion.

4.6 In order to preserve their reputation for independence, the expert evaluator in health sciences must ensure, as far as possible, to have a diversity of mandating parties.

5. DUTIES TOWARD THE EXAMINED PERSON

5.1 Expertise requiring complete neutrality, the sole guarantee of objectivity and respect for the parties, the healthcare provider cannot act as an expert evaluator in health sciences for their patient. Similarly, the expert evaluator in health sciences cannot become the healthcare provider of the person being assessed, except in exceptional circumstances.

5.2 Unless otherwise provided by legal or contractual provision, the expert evaluator in health sciences has the right to require meeting the examined person alone. If deemed relevant, they may decide to accept the presence of a third party provided that this does not interfere with their professional freedom. Depending on the context, the presence of a third party may be required by the expert in order to obtain collateral information. If an interpreter is necessary, the expert may require the presence of a professional independent of the person being assessed.

5.3 During the meeting, the expert evaluator in health sciences introduces themselves, defines their specialty, and explains:

The purpose of the assessment and the mandate entrusted,
The use of information obtained,
The stages of the assessment process as well as the identity of the requester to whom the expert report will be sent,
Their obligation to the mandating party to provide an objective, independent opinion based on factual data.

5.4 They must inform the person being assessed of the procedure to follow to obtain a copy of the expert report. It is the expert's obligation to ensure that the person being assessed has understood this preliminary information and they must reassure the person being assessed of their professional independence. In order to demonstrate that the latter consents in a manifest, free, and informed manner, the signature of the person being assessed on a consent form is strongly recommended in addition to the explanations that will have been given verbally.

5.5 The expert evaluator in health sciences creates a climate of trust and collaboration throughout the meeting. They avoid creating a confrontational climate. They bring to the examined person all the attention and listening required and adopt a courteous and respectful attitude toward them. They create a climate conducive to exchanges and strive to maintain good communication throughout the meeting. They avoid showing indifference or exasperation in the face of suffering and expressed needs.

5.6 The expert evaluator in health sciences must inform the person being assessed of the option to temporarily or permanently interrupt the assessment process and explain the consequences of their decision. In the latter case, the mandating party must be notified.

5.7 The expert evaluator in health sciences must allow the person being assessed to answer questions asked and complete information they could not share during the interview. Knowing that the assessment process can be uncomfortable or even painful, the expert must minimize these obstacles while obtaining sufficiently valid data to fulfill their mandate.

5.8 Toward the patient, the expert evaluator in health sciences refrains from any verbal comment regarding the opinions of the healthcare provider or another professional.

5.9 A recording recognized as authentic of the assessment is legal for either party, but both the expert and the person being assessed have the right to refuse recording and this should be communicated at the beginning of the interview. The expert may terminate the evaluation process if they have proof of recording without their knowledge despite an initial agreement of non-recording. Moreover, an expert cannot make a recording without the knowledge of the person being assessed.

5.10 The expert evaluator in health sciences remains subject to the obligations imparted to all health professionals in their relations with a person questioned and evaluated physically, mentally, or psychologically. They do not use words, gestures, or behaviors contrary to ethics.

5.11 The expert evaluator in health sciences respects the modesty and privacy of the examined person by providing them with facilities, among other things, to undress and, at the request of the person being assessed, to cover themselves.

5.12 At all times, the expert evaluator in health sciences demonstrates empathy, politeness, and respect toward the examined person. They refrain from any mockery, insult, disgraceful words, or inappropriate comment likely to hurt or humiliate the assessed person.

5.13 During the physical clinical examination, the expert evaluator in health sciences anticipates movements that could cause pain. If such a maneuver proves necessary, they warn the examined person and subsequently verify the level of discomfort caused.

5.14 In fulfilling their mandate, the expert could perform certain painful or uncomfortable diagnostic maneuvers in the same way as if they were a treating provider. These maneuvers must be relevant and explained in advance to the person being assessed. Depending on the symptoms expressed by the person being assessed, the expert could be led not to proceed or to abort the maneuver. The expert will then have to describe the events and provide their expert interpretation.

5.15 Faced with a hostile or vindictive patient, the expert evaluator in health sciences presents neutral behavior, refers to the mandate entrusted, and specifies again the stages of the assessment process. They may end the interview, if deemed appropriate, after explanation.

5.16 In the case of a person being assessed demonstrating non-cooperative and even aggressive behavior, the expert, after having tried in vain to correct the situation in a constructive and professional manner, may terminate the process and notify the mandating party of their inability to provide a valid opinion.

5.17 The expert evaluator in health sciences refrains from using and writing any information not relevant to the mandate entrusted. Although the expert must be exhaustive during the assessment process, the report provided to the mandating party must contain only information relevant to answering the questions of the mandate. This includes elements that allow the expert to validate, in their field of expertise, the information retained. Other information collected during the evaluation process will remain in the expert's professional file and will be subject to professional secrecy.

5.18 The person being assessed has the right to request and obtain a copy of their file excluding correspondence between the mandating party and the expert, psychometric data, or any information whose disclosure could cause serious harm to the health of the person being assessed. The person being assessed also has the right to request correction or deletion of factual information in a file or report concerning them. The expert must, if they refuse to comply with such a request, justify in writing the reasons for their refusal and inform the person being assessed of their recourse.

5.19 When a person subject to assessment presents to the expert evaluator a written request to obtain a copy of their report, the expert must direct this request to the mandating party. If the mandating party refuses to grant this request, the person concerned by the report can then address the appropriate legal body, namely the Commission d'accès à l'information (CAI).

5.20 It is not the expert's role to follow up on their investigation or treatment recommendations. However, the expert may, in order to fulfill their mandate, obtain the results of a non-invasive investigation with the explicit permission of the person being assessed. If this is the case, the expert must inform the treating physician of the person being assessed of the results. Also, following an assessment, if the expert believes that certain important information must be communicated to the healthcare provider for the health of the person being assessed, the expert must do so with the consent of the person being assessed and by notifying the mandating party even if this exceeds the mandate entrusted to them.

5.21 In the event that an expert must testify on their expert report at the request of a party who is not the requester of said expert report, the expert must ensure that the requester of the assessment and the person being assessed consent to said testimony or that the judicial body before which the expert must testify orders them to testify.

6. DUTIES FOR WRITING THE EXPERT REPORT and/or TESTIMONY

6.1 The opinion issued by the expert evaluator in health sciences must be factual, objective, and based on generally accepted scientific principles and consistent with current scientific data and rules of the art.

6.2 The written report must contain relevant facts of the file, relevant conclusions, motivated medical opinion, and, where applicable, medico-administrative recommendations. An opinion motivated by facts, knowledge based on evidence, and the expert's experience must be composed to answer each of the mandating party's questions and according to the deadlines understood in the expert mandate.

6.3 Where applicable, the expert must inform the mandating party of missing elements for analysis and writing an opinion.

6.4 The writing of the expert report is done within reasonable timeframes and respects limitation periods.

6.5 The expert evaluator in health sciences communicates their report only to the mandating party, person or organization, who requested the assessment.

6.6 The expert evaluator in health sciences ensures confidential transmission of their report and respect for confidentiality thereafter. In case subsequent confidentiality to the production of their report cannot be ensured in a probable manner (for example a small employer), the expert ensures that their report includes an explicit note that their report is confidential and is addressed to only one person.

6.7 If the examined person wishes to review their assessment, the expert evaluator in health sciences advises them to contact the requester-mandating party.

6.8 The expert evaluator in health sciences has the obligation to keep the medical file of assessed persons for five years following the date of the last entry in the file.

6.9 Where applicable, the expert must know the schools of thought on subjects that are the object of their expertise. They must be able to explain to the mandating party and the decision-maker the preponderant value of their opinion and explain why an opinion based on the postulates of another school of thought is not retained.

6.10 The expert must consider video surveillance of the person being assessed conducted without their knowledge and legally acceptable as a validated test or tool of the lived experience of the person being assessed. Only viewing the video in its entirety by the expert will allow them to conclude on the usefulness of the latter to issue an opinion on the concordance or not of what they observed during their assessment in relation to the video. The fact of not having seen or not having been able to view a video whose existence is known to the expert must lead the latter to conclude in a non-definitive manner. Conclusions about the credibility or intentions of the person being assessed do not belong to the expert.

7. DUTIES TOWARD THE PROFESSION

7.1 The expert evaluator in health sciences is often called upon to give their opinion on therapeutic conduct but cannot intervene in patient treatment. However, if they note new facts or a serious error that could endanger the life or health of the examined person, they must obtain authorization from the requester to communicate with the treating professional to inform them of these new facts or this error.

7.2 The expert evaluator in health sciences expects their opinion to be challenged, even in court. To defend their opinion, they use only factual elements and scientific arguments recognized by the scientific community of their discipline.

7.3 At all times, the expert evaluator in health sciences acts with dignity, courtesy, and politeness. Thus, the expert evaluator must analyze and/or comment with moderation and objectivity in their report on the opinion of their colleagues but without denigrating the person: no ad personam attack can be tolerated from an expert.

7.4 The expert evaluator in health sciences acts toward the entire community to maintain their own reputation and that of their profession. They must not, through their comments or attitudes with the person being assessed, call into question the integrity of stakeholders in an expert file entrusted to them.

7.5 The expert evaluator in health sciences has, at all times, irreproachable personal conduct so as not to harm their own reputation as well as that of SEESSQ.

7.6 If a member is invited to a SEESSQ committee for any contentious reason, the expert evaluator in health sciences collaborates honestly and clearly so that a positive and informal discussion subsequently benefits all Society members.

7.7 In the event of having committed one or more derogatory acts, according to the assessment of their peers, a member must expect to have to explain themselves before the Society's concerned bodies. This code of ethics has no disciplinary aim. However, in cases where a SEESSQ member deviates from this code without showing recognition of their action or desire to remedy the breach, the Board of Directors or by vote of all members may permanently remove their member status.

7.8 Any uncontested or confirmed radiation by their professional order results in automatic withdrawal of SEESSQ member status.

8. DUTIES TOWARD THE MANDATING PARTY

8.1 The expert may, at the request of the mandating party, modify certain factual elements that are false or poorly presented and will modify their opinion only if this new information has an impact on their analysis of the facts. The expert may, upon submission of new factual elements, modify their opinion.

8.2 The expert's report must be transmitted securely and unalterably to the mandating party only. Any request by a third party to obtain a copy of the report must be transmitted to the mandating party.

8.3 The expert evaluator in health sciences agrees with the mandating party on the characteristics and foreseeable costs of their professional services. At no time should notions of result or reward modulate the agreed fees. The expert will remain available to explain their fees to the mandating party.

8.4 The expert evaluator in health sciences requests reasonable remuneration for their services, according to the duration and complexity of the assessment.

8.5 With the exception of agreed remuneration, the expert evaluator in health sciences refrains from accepting any advantage or special commission relating to their expert work.

8.6 Fees paid in advance may be required when the expert commits to appearing before a court.

8.7 The expert evaluator in health sciences provides the mandating party with the explanations necessary for understanding their fee statement.

Document approved by the general assembly of SEEMLQ on April 8, 2021 and endorsed by the SEESSQ board of directors on October 9, 2025.