PRACTICE PARTNER
protect privacy at every level should
be considered and regularly conveyed to all members of the healthcare team, including front line
administrative staff. In this case, the
administrator should take the chart
with him/her to confer with the
nurse and not leave it unattended
where it could accessed by others.
Scenario 3
There may be situations where it
is necessary for a doctor to not be
alone with a patient behind a closed
door. This may be due to the safety
concerns of the physician or the
comfort level of the patient. Physicians are responsible, to the best
of their abilities, for keeping full
control of personal health information at all times. When a door is left
open, personal health information
is no longer contained and may
be received by anyone in the area.
Other measures can be considered
for these situations, such as having
another member of the team present in the room, in order to achieve
the goal of providing additional
supervision without losing control
of the patient’s private narrative.
Scenario 4
As law abiding citizens, we generally respect the authority of police
officers; when they ask questions,
we cooperate. In many situations,
this would be the appropriate thing
to do, however as guardians of
personal health information our
duty is to maintain confidentiality
unless another imperative exists. Is
there a subpoena? A court order? Is
someone imminently as risk? Both
As technologies evolve,
already complex legal
requirements regarding
confidentiality become
even more daunting.
the Confidentiality of Personal
Health Information policy and
the CPSO’s Mandatory and
Permissive Reporting policy help
to clarify these scenarios, bearing
in mind that confidentiality is the
default position. For example, physicians are not required to provide
the police with a patient’s personal
health information unless the police
produce a summons, subpoena,
court order or other legal document
requiring the disclosure. Only the
specific information required needs
to be disclosed.
The CPSO’s Confidentiality of
Personal Health Information
policy states: Situations may arise
where physicians are asked by a
family member or friend about the
condition of a patient. Patients are
permitted to restrict the disclosure of such information. For this
reason, physicians will be required
to obtain express consent from the
patient before they are able to disclose the patient’s personal health
information. Where the patient
is not capable of providing the
required consent, physicians must
seek consent from the patient’s
substitute decision-maker.
The College, however, recognizes
that there may be situations where
it will not be possible to obtain
consent from the patient or the
substitute decision-maker. In
this situation, the College advises
physicians to exercise caution and
to use their best judgment when
providing information. Discussions
with friends and family ought to be
limited to basic information about
the patient’s general state of health.
A person subject to a form-1 may
indeed be unable to provide consent and the College advises physicians to exercise caution and to use
their best judgment in these cases.
Discussions with the family and
friends of patients in these circumContinued on page 38...
Physician Advisory Service 1-800-268-7096 ext. 606
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DIALOGUE • Issue 2, 2014