Dialogue Volume 10 Issue 2 2014 | Page 36

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 36 DIALOGUE • Issue 2, 2014