Shoot to Tell Flashcards
What is the framing of this problem
They are extremely rare but more in rural areas
Disease prevention is facilitated when good data is collected
Public health is declaring violence to be an issue of concern to public health and important determinant of health
What are some ideas surrounding this issue
Indvidualism vs collectivism
Making communities safer vs avoiding treatment
Public health concern vs criminality
Whos job was it before the act was passed
HCP to use professional opion when it should be reported to police
What is the difference between proactive vs retroactive
Prevention - put money towards programs and policy that help reduce gunshot wound inguries
Treatment - put money towards treating gunshot wounds and police reosurces
What does HPPA
These diseases or suspected occurrence of these diseases must be reported to the local Health Unit by physicians laboratories administrators of hospitals schoolas and institutions reley on these reports of communicable disease to monitor the health of the community and to provide basis for preventive action
What is under mandatory reporting legislation
Gunshot wounds
Child abuse or neglect
Suspected elder abuse or death
Health conditions that make it dangerous to drive operate rail equipment
Birth stillbirths and deaths
Communicable disease or adverse reacations to immunizationtion
Fraud in health cards
Sexual abuse
What does the law say about gunshot wounds
Gunfire poses serious risk to public safety prevent further violence injury and death
Must be reported as soon as possible
What is the federal firearms act
Required individuals to obtain a license to purchase a firearms and or ammunition
Mandatory traning program when purchasing of firearms
Tougher border control
What does the Personal Health information protection act and regulate health professions act
Both acts required that all regulated health care providers in Ontario have duty to respect patient confidentiality unless the individual consented to disclosure or unless disclosure was permitted in limited circustmases
Whats the difference between ontario and saskatchewan
Saskatchewan is mandatory gunshot and stab wounds
What are some policy options to reduce violent crime
- Mandatory reporting of all cases of criminal activty
- Mandatory reporting of certain types of criminal activity
- voulntary reporting of criminal acts with or without the consent of the indivdual invovled
- Increased educational support to address the connection between the social determinants of health and gunshot wound reporting
- Increased support of healthcare provider confidentality
What are the two sets of arguments being made for reporting gunshot wounds
Protection of the public
violence prevention
What are issues with shoot and tell
Fiduciary duty - highest standards of care at law - requires physicians to act in good faith for the sole benefit and best intrests of their patients
Confidentiality - owe patients a physical legal ethical and professional duty to not disclose PHI expect in a limited circumstance
Autonomy - patients have a right to make decisions about their care without influence of their physican
Who si for this and who is against it
Public policy people for and HCP are against it
What are some ethical considerations that HCP say
Retaliation by the perpetrator and concern re: breached confidentiality this can damage trust relationships between victim and the HCP
Compromise of trust deters victims from seeking help or returning
Law removes ability to exercise judgment and make decisions
What is exceptions to duty of confidentiality include
Patient consent
Duty to warn - patient poses a foreseeable risk to an idnetifiable 3rd party
Public safety exception clear serous and imminent threat of physical or psychological harm
What is PHIPA
Establishes rules for the collection use and disclosure of personal health information while at the same time facilitating the effective provision of health care
What is PHI
Any indetifiable information about an individual either living or deceased and includes information about their health
Includes information collelcted in the course of providing health services to the individual
What are examples of identifiable patient information
Name, medical record number or health card number
What is circle of care
A person/ group of persons providing care to the individual
Episode of care
Informal refrence and is not defined under PHIPA but can include
What is information that when used in conjucation with other information could re-identify an indivual
Date of birth + surgical procedure + name of surgeon + date of surgery
Postal code + diagnosis/condition
Who or what is HIC
Person or organizatio who has custody and control of personal health information
Legally responsible for personal health information on all of its patients regardless of the purpose for which the PHI is used
What are examples of HIC
Include a hospital an independent health facility, a physician in a private practice, a physician as part of a family health team
Who or what is an agent
A person that with authorization of the custodian acts for or on behalf of the custodian in respect of personal health information for the purposes of the custodian and not for the agenst own purpose
Examples of an agent
Employees physicians third party vendors voulnteers students
What is the use of PHI by the HIC
For the purpose it was collected
Obtaning payment for providing health care
Risk management/ error management
Program planning / delivery
Education of agents to provide health care
Proceeding where the custodian/ agent or former agent of the custodian is expected to be a party or witness
Research conducted in accordance with PHIPA
What are acceptable reasons for disclosure
Within the circle of care
Chief medical officer
Prescribed entity
Significantly reduce the risk of harm
SDM or acting power attorney for care
The parent of a child
And other circumstance defined in the legislation
What is the disconnect between PHIPA and the Mandatory Gunshot Wound Reporting Act
Provider - patient relationships
Collection, use and disclosure of PHI
MGWRA becomes an acceptable reason for disclosure and supersedes PHIPA
Police do not have to abide by PHIPA
Accidental incidents still must be reported
Violence and a Public Health Approach
Aim: prevent the loss of lives and countless traumas
Violent behavior arises from contextual biological environmental
The public health approach to violence focuses on prevention through addressing the known factors that increase or decrease the likelihood of violence
What else does violence increase the risk of (APHA)
Diseases
Asthma hypertension cancer stroke
Psychiatric illness
Sleep poorley and smoe
Negative health outcomes seen in statistics releated to HIV maternal health
What are some Trade offs to think of
Who should report
Who should the report go to
Providers may be subjected to repercussions for their reports
What are some good examples that happend in the States
Chiago reduced homicides and shooting
Baltimore went over a yeat without a homicide
New york city almost have reudction in hun injuries
