When a Patient is Suicidal—Privacy Considerations & Your Obligations
There is an expectation that all health care providers, including physiotherapists, understand the importance of protecting a patient's privacy. This includes getting patient consent for collection, use and disclosure of all personal health information.
Ontario's privacy laws are in place to allow patients to have control over who has access to his or her personal health information. However, they are not meant to prevent health care providers from immediately disclosing personal health information in specific and limited circumstances.
One such circumstance is when an physiotherapist has a patient who has expressed suicidal thoughts.
If the PT has reasonable grounds to believe that the patient may seriously harm him or herself, or possibly others, the Personal Health Information Protection Act (PHIPA) permits this disclosure without getting the patient's consent.
The physiotherapist is expected to use his or her professional judgment when assessing the situation to determine if there are reasonable grounds to believe that serious harm will occur and if it is appropriate to disclose this information.
The courts have set out circumstances in which concern for public safety may warrant the disclosure of information gotten by a health care provider to reduce or eliminate risk of harm. The factors for consideration are as follows:
- there is a clear risk to an identifiable person or a group of persons
- there is a risk of serious bodily harm or death and
- the danger is imminent
There are no restrictions on the types of persons this information can be disclosed to—the PT should use his or her best judgment to determine who would be the most appropriate person to contact.
Depending on the situation, a family member or the patient's family doctor or mental health care provider would be appropriate. In some urgent cases, it may be more appropriate to call 911 for emergency services.
If the physiotherapist is uncertain as to whether disclosure should be made, he or she should contact a lawyer or the Information and Privacy Commissioner.
Important: all disclosures should be documented in the patient chart.