Confidentiality

Question 1

True or False: The level of confidentiality between physician and patient is the same as that of a solicitor (Lawer and patient?

Answer 1

• False
• Physician cannot promise absolute confidentiality as there are legal requirements to breech confidentiality in certain circumstances

Question 2

List the 6 instances when breeching confidentiality due to statutory reporting is obligated. Who do you report them to?

Answer 2

1) Suspected child abuse or neglect
- Must report to child welfare authority
2) Fitness to drive or fly
- Must report to ministry of transportation
3) Communicables diseases
- To local public health authority
4) Improper conduct of a health professional
- College or regulatory body
5) Reporting of vital statistics (Ontario live and stillbirths, Death certificates)
- To municipal authorities
6) Reporting to coroners
- When circumstances around death require investigation
7) Long term care homes
- If improper care, financial abuse
8) Gunshot wounds
- Must report to police

Question 3

What is the duty to warn? What is the name of the legal case which set this president?

Answer 3

• Duty to protect public from a known dangerous patient and can involve:
• involuntary detainment of violent pt for clinical assessment
• Informing police
• Warning potential victim if pt expresses intent to harm
• Tarasoff v. Regents of the University of California
• Smith v. Jones - Canada

Question 4

The duty to warn applies in which situations? List 3 criteria

Answer 4

1) Clear risk to an identifiable person
2) Risk of serious bodily harm or death
3) Danger is imminent (more likely to occur than not)

Question 5

Under which circumstances can health records be disclosed for legal proceedings?

Answer 5

• Court Order
• Warrant
• Subpoena

Question 6

What legislation establishes the principals for the collection, use and disclosure of information that is part of commercial activity (Dr records, pharmacy, labs)?

Answer 6

• PIPEDA (federal)
• Personal Information Protection and Electronic Documents Act
• OPHIPA (ontario)
• Ontario personal health information protection act
• Applies more specifically to health info

Question 7

What is a lock box?

Answer 7

• Applies to situations where pt has expressly restricted his or her physician from disclosing specific aspects of their health info to others, even those in circle of care.

Question 8

True or False: You must obtain consent prior to sharing health information within a patients circle of care

Answer 8

• False

- Unless patient has withdrawn consent to this and wishes to have parts of chart in a “lock box”

Question 9

What is the Tarasoff case? Generally what happened

Answer 9

• Man told his psychologist he wanted to kill Tarasoff
• Reported to campus police who questioned him and released him
• The man killed Tarasoff, no one had ever warned her

Question 10

what is the Smith v. Jones case?

Answer 10

• Accused changed w aggravated assault on prostitute
• A psychiatrist, part of legal defense, assessed and was told that accused planned on kidnapping, raping and killing more prostitutes soon
• Psychiatrist argued that public safety at risk by not advising public of this statement and won the case