ED­I­TO­RIAL When pa­tient pri­vacy be­comes se­condary

Winnipeg Free Press - - OUR VIEW -

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.

DAVID LIPNOWSKI / THE CANA­DIAN PRESS FILES

Health Min­is­ter Cameron Friesen says pa­tient pri­vacy won’t be vi­o­lated eas­ily.

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