Law #4 - Confidentiality and disclosure

Question 1

Qc charter right to non-disclosure?

Answer 1

If bound to professional secrecy by law, cannot disclose info even in court. Unless authorized by person or express provision in law.

Question 2

CCQ about files?

Answer 2

Gathering info only relevant to objective of the file.

Question 3

What is personal information?

Answer 3

1. Info allowing person to be identified.
2. It is confidential
3. A persons name is not confidential on its own. It is when it appears in conjunction with other information concerning him.

Question 4

What is public information?

Answer 4

1. INfo of a person in a party in a contract with public body
2. Name and address of person deriving economic benefit granted by public body
3. Name and address of holder of a permit issued by public body, which is carried by law to practice an activity = the practice of a profession or the operation of a business.

Question 5

Exception to confidentiality?

Answer 5

Person consent to release. If minor parents can consent
Public information: personal info that is public by law is not confidential information
Urgent situation: Life threatened, or to prevent act of violence
Qualified persons: Access to info is necessary for the discharge of his duties.
Specific persons: Disclosure to police, lawyer is permitted under specific conditions. Usually permitted to avoid imminent danger (eg. suicide)

Question 6

Disclosure of confidentiality, code of ethics of nurses?

Answer 6

If consent is obtained the pt must know:

The reason for disclosing info and the purpose for which the info will be used.

Question 7

IMproper disclosure =?

Answer 7

w/o consent falling outside of statutory exceptions. Considered professional misconduct and a civil liability

Question 8

Pt right to access his medical record?

Answer 8

YEs. INfo is property of pt, the actual record is owned by the hospital

Question 9

Pt right to correct inaccurate/incomplete to ambiguous info in his records?

Answer 9

Yes

Question 10

Right to access absolute?

Answer 10

No, if there is significant likelihood of adverse effect on pt physical, mental or emotional health or harm to a third party.

Question 11

Disclosure when deceased pte?

Answer 11

Yes, if info is necessary for the exercise of their right. Spouse, ascendants can know the cause of death. Unless the user entered in writing in his record his refusal to grant such right access.
If under 14 = parents can know. But not if info of a psycho social nature.
Blood relative, can know if existence of genetic disease.

Question 12

Confidentiality issues specific to minors?

Answer 12

Parents can.
Access by other bodies to minors health info.
Statutory duties of disclosure.

Question 13

Confidentiality issues specific to minors EXCEPTIONS?

Answer 13

1. Under 14 and intervention undergoing of youth protection act
2. > or =14, Refuses communication by hospital to parents

Question 14

Commision des droits de la personne et de la jeunesse can?

Answer 14

Investigate

Enter an institution and Consult records and make copies

Question 15

Director of Youth Protection can?

Answer 15

File application of file disclosure for Youth Protection Act

Enter an institution and Consult records and make copies

Question 16

Professionals duty regarding “signalement”? With Eg?

Answer 16

The have to if they have reasonable ground to believe security or development of a child may be in danger w/o delay
Eg: abandoned/negleted; psy or physi or sexual abuse; serious behavioral disturbance; child leave home.rehab, hospital w/o authorization; does not attend school

Question 17

Consent <14 and >14

Answer 17

1. Parents/tutors

2. Can give consent alone. Parents must be inform if >12 hours in esthablishment

Question 18

Court order required with minors when?

Answer 18

1. > 14 to undergo care they refuse. Except if ER, tutor or parent consent enough
   2.

Question 19

AC et AI v. Manitoba (2009)?

Answer 19

Facts: C admitted at 14 due to lower GIT bleeding, Jehovas, signed no transfusions. Court ordered transfusion b/c in her “best interest”.
Decision: Treatment order is constitutional. Balance between individuals right and law protecting vulnerable child. Flexible concept of best interest is what makes this constitutional.

Question 20

Rights and obligation in Act Respecting Health Services and Social Services?

Answer 20

1. Entitled to receive EB care
2. Pt entitled to choose the professional from whom he receives care. Within the limits of human and material resources.
3. HCP can refuse to treat person

Question 21

Jasmin c Cite de la sante laval (CS)?

Answer 21

Facts: Plaintiffs ask to declare null regulations adopted by hospital regarding obs accessibility and Dx services. Due to overwhelming demand, hospital was restricting services only to residents of certain municipalities.
Decision: Hospital cannot refuse pt on reference of where they live. Deemed discriminatory. Can refuse if services not available. But if available to one pt, must be available to all pts.

Question 22

Noel-Voizard c. CSSS Lasalle et Vieux-Lachine

Answer 22

Facts: Pt broke wrist at home. Waited 6 hours before seeing Doctors and received no pain meds between that time. Suing for inappropriate care and abnormally long wait in ER.
Decision: case dismissed. Reasons, no legal obligation to follow time line after receiving “cote de triage”. Delays must be evaluated on basis of how busy is the ER with given resources.

Question 23

J.O. vs. Hopital Royal Vic.

Answer 23

Facts: JO dialysis, known to be verbally aggressive by staff. Staff refused to put him on kidney transplant list due to behavioral issues. JO sued.
Decision: Cannot force team to be put back on waiting list. MOtion to have dialysis care transferred granted.
Reasons: JO destoyed therapeutic RS with team. Hospital had obligation to do dialysis but not to perform transplant. His behavior made it impossible to continue care at that hospital.