Communication
Statutory Regulations
Statutes allow disclosure of confidential information contained in medical records for the purposes of:
- Protection of public health
- Assessment of standards of health care
- Improvement of procedures
- Fostering of medical research and teaching
- To obtain vital data such as deaths and births
- Workers compensation
Driving:
The patient who is or may be unfit to drive is dealt with by specific statutory law in many provinces.
In British Columbia for example, there is a duty (a legal obligation) for a doctor to report the fact that a patient is still driving when they have been advised medically not to do so.
Cases exist where injured parties in a motor vehicle accident have brought actions against doctors, alleging that the crash was caused in part by the medical disability of their patient, who should not have been allowed to continue driving.
Doctors have been found liable for failing to report in those provinces and territories with mandatory requirements.
Wasserman v. Spillane
A man with a long history of seizures was involved in a road traffic accident. The ruling was against the 2 physicians who had treated him. There was a finding of civil liability because of their failure to report the man’s condition.
The CMA has developed educational material as a guide to physicians on reporting of patients assessed to be unfit to drive. It does not replace legal counsel. This CMA guide is reproduced here:
Regulations governing reporting of medically unfit drivers and protection for physicians:
| Jurisdiction | Reporting | MD protection for reporting | Admissibility of reports as evidence in legal proceedings |
| Alberta | Not directly addressed, but interpreted as discretionary |
Protected | Reports confidential |
| British Columbia | Mandatory for MD if the unfit driver has been warned of the danger and still continues to drive |
Protected unless physician acts falsely or maliciously |
Not addressed Subject to the provisions of access to information legislation |
| Manitoba | Mandatory | Protected | Privileged Not admissible as evidence except to prove compliance with reporting obligations |
| New Brunswick | Mandatory | Protected as long as physician acts in good faith |
Not addressed |
| Newfoundland and Labrador |
Mandatory | Protected | Privileged Not admissible in evidence in trial except to prove compliance with reporting obligations |
| Nova Scotia | Discretionary | Protected | Not addressed Subject to access to information legislation |
| Nunavut | Mandatory | Protected unless physician acts maliciously or without reasonable grounds |
Not admissible in evidence or open to public inspection except to prove compliance with the reporting provision and in a prosecution of a contravention of section 330 (making false statements or submitting false documents). The person who is the subject of the report is entitled to a copy of the report upon payment of a prescribed fee. |
| Ontario | Mandatory | Protected | Privileged Not admissible in evidence except to prove compliance with reporting obligations |
| Prince Edward Island |
Mandatory | Protected | Privileged Not admissible in evidence except to prove compliance with reporting obligations |
| Quebec | Discretionary | Protected | Not admissible in evidence except in cases of judicial review of certain decisions of the motor vehicle licensing authority |
| Saskatchewan | Mandatory | Protected as long as physician acts in good faith |
Privileged Not admissible in evidence except to show that the report was made in good faith in accordance with reporting obligation |
| Yukon | Mandatory | Protected | Not addressed |
NB. The table above is meant only for educational purposes as a guide to physicians on reporting of patients assessed to be unfit to drive. It does not replace legal counsel.
A similar duty exists regulating aviation in federal legislation.
Child Welfare:
Child welfare legislation mandates a statutory duty to disclose confidential information.
If a HCP has reasonable grounds to believe that a child is in need of protection (for example as a victim of sexual or physical abuse) then the doctor MUST report this to the proper authorities, even though this involves disclosing confidential information.
Failure to report suspected cases of child abuse may result in both criminal and civil liability.
