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Publications & Resources > The Standard > September 2004   

  Last modified August 31, 2004  

Reporting gunshot wounds

The College stands by its position that nurses have a professional duty to maintain confidentiality.

The College of Nurses of Ontario does not support proposed legislation introduced by the Ontario government that would make it mandatory for hospitals to report gunshot wounds to police.

Rather, the College stands by its position that nurses have a professional duty to maintain confidentiality. However, their professional competence qualifies them to determine when it is in the public interest to report gunshot wounds.

“The College recommends a continuance of voluntary reporting by its members,” says Ann Frances Allen, RN, CNO’s Manager of Policy, “when the need for maintenance of confidentiality is outweighed by a reasonable concern for public safety.”

On June 23, Community Safety and Correctional Services Minister Monte Kwinter announced a new bill that would require public hospitals to report the name of a gunshot victim being treated, if it is known, and the location of the facility. On June 30, the bill went for second reading.

But CNO believes the proposed law is unlikely to achieve its intended purpose, which is to “make Ontario communities safer,” because there is no evidence on the number of gunshot wounds treated at health care facilities that are unknown to police.
“Mandatory legislation to deal with what may be very few incidents will not necessarily contribute to the greater public good,” says Allen.

CNO’s support of voluntary reporting is detailed in its Ethics document and Confidentiality Fact Sheet: “At times, nurses learn information which, if not revealed, will result in serious harm to the client or others. Nurses need to consult with the health care team and, if appropriate, report the information to the person or facility affected.”

CNO’s stance is supported by a law proclaimed earlier this year (section 39 of the Health Information Protection Act) that gives doctors and nurses the option of telling police about gunshot victims, but it does not mandate it.

“But this new prescriptive legislation will take away the ability of competent health care professionals to exercise judgment and make decisions,” Allen says.

Senior CNO staff members have met with ministry officials and have expressed the College’s additional concern that the legislation might deter individuals with reportable injuries from seeking treatment because of their fear of being investigated by the police.

“Besides the potential threat to confidentiality and trust in the patient/provider relationship, CNO’s Executive Committee is particularly concerned that nurses and physicians not be perceived as mere extensions of the police force,” says Executive Director Anne Coghlan, RN.

The proposed legislation requires oral disclosure “as soon as it is reasonably practicable without interfering with the treatment of the patient or disrupting the normal operation of the facility.”

If the bill passes into law, Ontario will be the first province in Canada to require hospitals or health care professionals to report gunshot wounds to police.

CNO is following up with the ministry and watching closely as the bill goes through a consultation process. The College will communicate updates to members as they become available.

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