EDITORIAL When patient privacy becomes secondary
OCTOR-PATIENT confidentiality is considered as sacrosanct as lawyer-client privilege or the seal of the confessional. We need to trust that both details about our health and our communications with medical professionals remain utterly private; to think otherwise might result in patients shying away from seeking the help they need.
In recent years and with the advent of electronic communication, in fact, those privacy rules under Manitoba’s Personal Health Information Act (PHIA) have become even stricter.
However, there are circumstances when we need to trust those same medical professionals to make a judgment about when the right to privacy is outweighed by a risk to a patient’s life, or the lives of others.
That’s what’s being recognized by a proposed amendment to the Mental Health Act and PHIA that would allow medical professionals, in exceptional circumstances, to contact family, designated friends or other individuals — without a patient’s consent, if necessary — to lower the risk of patients harming themselves or anyone else.
This isn’t a change that would be undertaken
Dlightly, as Health Minister Cameron Friesen indicated Tuesday at the legislature when Bill 5 was tabled.
Mr. Friesen pointed out that although the current system does allow for breach of patient privacy when absolutely warranted, the current legal threshold is limiting health-care workers from taking action in many cases; he stressed that there would be a learning curve for those in the system to adjust to new rules.
It will be essential for those in the medical field to understand how the unique demands of providing mental-health care affect the interpretation of the obligations they have as the custodians of health information.
The idea of standardized protocols for healthcare providers to follow — protocols that would specifically lay out the circumstances in which the Mental Health Act would take precedence over the terms of PHIA to allow for the collection, use and disclosure of personal health information without consent — is not new. British Columbia, Ontario and Nova Scotia have legislation similar to that proposed here, which meticulously outlines the situations in which a patient’s information may released and the means of documenting the decisions that were made and why.
Bill 5 seems eminently reasonable, even overdue. Suicide isn’t something we like to think about, let alone talk about, but it’s a major cause of premature and preventable death. Among Canadian males, it’s the seventh most common cause of death, with the highest rates of suicide occurring among people aged 40 to 59; if there is a way to reduce those numbers, it should be embraced.
Of course, the causes of suicidal ideation are complex and cannot be attributed to any one factor, but mental-health issues and drug addiction can be contributing factors; these are conditions that may detract from people’s ability to make decisions in their own best interest.
We trust medical professionals to keep our counsel. We should also trust them to judge when we need help that we’re not capable of seeking ourselves.
No one wants to get a call from a doctor or therapist about a loved one who wants to harm herself or a friend who’s suicidal.
The only thing worse? Not getting that call at all.
Health Minister Cameron Friesen says patient privacy won’t be violated easily.