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GUIDELINE - Confidentiality of patient information
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GUIDELINE - Confidentiality of patient information
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College of Physicians and Surgeons of SaskatchewanGuideline
Confidentiality of Patient STATUS:
Approved by Council:
APPROVED
November 2014
Information Amended:
To be reviewed:
November 2019
November 2024
Introduction .................................................................................................................................................. 2
Purpose of this Guideline .............................................................................................................................. 2
Code of Ethics and Professionalism .............................................................................................................. 2
Code of Conduct ........................................................................................................................................... 3
Saskatchewan Privacy Legislation ................................................................................................................. 3
Patient consent to disclosure of their health information and exceptions where consent is not
required ............................................................................................................................................... 4
Mandatory reporting........................................................................................................................... 5
Who, other than the patient, can access patient health information? .............................................. 5
Disclosure to a child’s parents or guardian ......................................................................................... 6
Disclosure to police ............................................................................................................................. 6
Conversations with, or about, patients in the health care setting ..................................................... 7
Technology .......................................................................................................................................... 7
Voice messaging .................................................................................................................................. 7
Mandatory Reporting.................................................................................................................................... 8
Frequently Asked Questions ....................................................................................................................... 15
cps.sk.ca
, GUIDELINE-Confidentiality of Patient Information
Introduction
Physicians have an ethical and a legal obligation to maintain confidentiality over their patients’
information.
It is not possible to provide appropriate medical care to patients if patients withhold relevant
information out of concern that the confidentiality will not be maintained. Any breach in confidentiality
reduces the faith and trust of members of the public in the medical profession and in the confidentiality
of health information.
Generally a physician cannot provide a patient’s health information to someone other than the patient
without the patient’s consent. There are some circumstances in which physicians are permitted or
required to disclose their patient’s health information to others without patient consent.
Purpose of this Guideline
This guideline is intended to help physicians understand their legal and professional obligations to
maintain patient confidentiality and to identify situations where patient confidentiality is not required.
This guideline cannot address every situation in which physicians will be required to determine their
ethical and legal responsibilities relating to patient confidentiality.
Physicians who are uncertain about their obligations in a specific situation are encouraged to contact
the College, Canadian Medical Protective Association, Saskatchewan Health Authority Privacy and
Access Office Contacts or their legal counsel for advice. The Privacy Commissioner for Saskatchewan
may also be able to assist in some circumstances.
Code of Ethics and Professionalism
The Canadian Medical Association Code of Ethics and Professionalism, with two modifications, one
unrelated to confidentiality of patient information, is part of the College’s bylaws. It sets out ethical
expectations for physicians. The College’s Code of Ethics, based upon The Code of Ethics and
Professionalism states:
18. Fulfill your duty of confidentiality to the patient by keeping identifiable patient information
confidential; collecting, using, and disclosing only as much health information as necessary to
benefit the patient; and sharing information only to benefit the patient in a manner consistent
with The Health Information Protection Act. Exceptions include situations where the informed
consent of the patient has been obtained for disclosure or as provided for by law.
19. Provide the patient or a third party with a copy of their medical record upon the patient’s
request, unless there is a compelling reason to believe that information contained in the record
will result in substantial harm to the patient or others.
cps.sk.ca November 2019 2
, GUIDELINE-Confidentiality of Patient Information
20. Recognize and manage privacy requirements within training and practice environments and
quality improvement initiatives, in the context of secondary uses of data for health system
management, and when using new technologies in clinical settings.
21. Avoid health care discussions, including in personal, public, or virtual conversations, that could
reasonably be seen as revealing confidential or identifying information or as being disrespectful
to patients, their families, or caregivers.
Code of Conduct
The College has adopted a Code of Conduct which set out in College Regulatory Bylaw 7.2. It establishes
additional expectations for physicians. The Code of Conduct states:
Confidentiality
The CPSS expects that physicians will:
(a) Regard the confidentiality and privacy of patients, research participants and educational
participants, as well as their associated health records, as a primary obligation.
(b) Ensure confidentiality by limiting discussion of patient health issues to settings appropriate for
clinical or educational purposes and to caregivers with a need to know that information.
Discussion with others will occur only with explicit patient consent or as permitted by legal and
ethical principles.
(c) Know and comply with applicable legislation regarding confidentiality and health information.
Saskatchewan Privacy Legislation
The Health Information Protection Act and The Health Information Protection Regulations establish legal
requirements in Saskatchewan for “trustees”. Physicians who are in “custody or control” of patient
health information are trustees under the legislation with duties and obligations to protect patient
health information.
The obligations are set out in The Health Information Protection Act and include:
a) An obligation to inform patients about the anticipated use and disclosure of the information
which the physician gathers (section 9)
b) An obligation to have policies and procedures to assist patients to understand their rights,
including the right to request access to their information (section 9)
c) An obligation to take reasonable steps to be able to advise patients if their personal health
information was disclosed to a third party without their consent. That does apply if the
disclosure was made to another health care provider or a family member under the authority of
section 27(2) of the Act (section 10)
d) An obligation to give patients access to their personal health information if the patient requests,
subject only to very limited exceptions (section 12, 31 to 38)
cps.sk.ca November 2019 3
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