Patient confidentiality and the law
CMAJ 1997;157:870
Re: "From Hippocrates to facsimile" (CMAJ 1997;156:847-52 [abstract / résumé]), by Daniel Y. Dodek and Arthur Dodek
In response to: M.A. Ross
We appreciate Margaret Ross's comments. The article was not meant to be a comprehensive guide to patient confidentiality but rather a selection of the many direct and indirect ways in which patient confidentiality can be betrayed.
There are some very specific legal limitations on patient confidentiality, and physicians certainly must abide by them. We wanted to point out how easy it is to violate patient confidentiality.
Health and legal statutes do vary from province to province. In British Columbia physicians are not required to report patients who test positive for antibodies to HIV. We certainly do not suggest keeping 2 sets of records or charts: we advised that only the medical information pertinent to a request be sent to the interested party. For instance, medical information requested by an automobile insurance company should be specific to the area of concern.
There was no documentation or intent in our article to indicate that if a patient with a heart condition applied for life insurance an abridged or modified version of the chart should be sent to an insurance company. Where life insurance is concerned, all medical information must be divulged.
There is no misunderstanding here. The physician must be the patient's advocate and abide by the CMA Code of Ethics.
Daniel Y. Dodek, BSc
Arthur Dodek, MD
Vancouver, BC
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