Ethical Dilemmas

FAQs: Ethical Dilemmas

• I believe my patient is having suicidal thoughts, can I call their Doctor and share my concerns about the patient?

  PTs are expected to maintain the patient’s confidentiality of their health information. Discuss with the patient that you want to involve other members of their team in their care and get their consent to do so. However, if you have reasonable concern that the patient or the public is at risk of significant harm and the patient has not provided consent to share their health information, privacy laws have caveats allowing health care providers to disclose the information.
  
  If you believe your patient is having suicidal thoughts consider the following:

  • You might be the only person the patient feels comfortable disclosing this information to, do not ignore the comments. 
  • You should stop treatment and be empathetic. e.g. I’m really concerned about your safety.
  • Probing questions can help determine the patient’s level of risk – gauge responses accordingly. e.g. Will the patient follow up with their Dr. or is there a need to alert 911?
  • Be ready to connect them to resources. Offer hotline numbers or offer to call together with the patient, provide rapid access service locations. 
  • Reach out to an emergency contact if needed. 

  Additional Resources:

  • Personal Health Information Protection Act (PHIPA)
    
  • Information and Privacy Commissioner
    
  • Disclosure of Information Permitted in Emergency or other Urgent Circumstances
  • Centre for Addiction and Mental Health Resources
  • Crisis Resources

• Are PTs required to report patients with medical, cognitive or physical conditions which might cause unsafe driving?

  No. However, effective July 2018, physicians, optometrists and occupational therapists have been given the authority and responsibility for discretionary reporting of potentially unsafe drivers to the Ministry of Transportation. 
  
  A new list of reporting conditions defines the medical conditions, functional impairment or visual impairment that may make it dangerous for a person to operate a motor vehicle. The duty to report prevails over any duty of confidentiality to the patient for these professionals. 
  
  As a physiotherapist, you do not have this duty to report, but if you have concerns you should discuss them with the patient and their physician. 
  
  If you still have questions feel free to contact the Practice Advisor to talk it through. Email practiceadvice@collegept.org or call 1-800-583-5885 or 647-484-8800.
  

   

• A patient has confided to me that they have been experiencing sexual abuse in their personal life, but they have asked me to keep the information confidential. What should I do?

  This is a difficult situation to be in, but if the patient is capable, and there is no risk of immediate harm, you need to respect their wish for confidentiality. 
  
  You might want to consider offering the patient some supportive resources. Visit the College's strategies to support patients page for a list of organizations and their contact details.  
   
  However, it is important to remember that if the person is being sexually abused by a regulated health professional you would have an obligation to break confidentiality and make a mandatory report to the College of the health professional is committing the sexual abuse. See a complete list of health regulatory colleges.
  
  If in doubt, feel free to contact the College Practice Advisor to seek advice. Contact advice@collegept.org or 1-800-583-5885 ext. 241.
  
  Additional Resource: Strategies to Support Patients at Risk Webinar