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Publications & Resources > The Standard > June 2005

   Last modified: June 6, 2005

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Use judgment to apply new privacy Act

The implementation of the Personal Health Information Protection Act (PHIPA) in November 2004 has resulted in a flurry of activity on the College’s practice line. Nurses are asking about the practice implications of the Act and their professional obligations regarding the College’s new Confidentiality and Privacy — Personal Health Information practice standard.

Nurses should always use their professional judgment when making decisions about the use of clients’ personal health information. As client advocates, nurses should take action if privacy practices are impeding care or compromising confidentiality. This can involve informing clients of their rights, bringing issues to the attention of the organization’s privacy officer, and consulting with the College or the provincial Information and Privacy Commission.

Privacy should not be used as an excuse to withhold needed care or to prevent regulated health professionals from fulfilling their legislated obligations, such as reporting abuse to their regulatory college. Nurses do not need clients’ permission to report abuse; however, they also must not breach clients’ privacy and use information against their clients. For example, if a nurse at a sexual health clinic disagrees with a teen client’s behaviour and reports the behaviour to the client’s parents, it is a breach of the Act and the College’s practice standard.

When nurses disagree with clients’ lifestyle or care decisions, and experience ethical conflicts, they must demonstrate regard for client choice (see the Ethics practice standard) and assess whether their personal values are influencing their practice. In the situation described here, the nurse should explore the teen’s sexual health practices and determine whether the teen has the type of relationship with his/her parents that would make discussions about sexual activity feasible.

Protecting and respecting the client’s confidentiality is essential to building a long-standing therapeutic relationship by establishing mutual trust and respect.

Generally speaking, neither PHIPA nor the Confidentiality and Privacy — Personal Health Information practice standard change the College’s expectations about current privacy practices of nurses.

The legislation contains provisions that protect clients’ personal health information from disclosure while allowing nurses and other health professionals to provide safe, effective and ethical care.

The practice standard outlines circumstances under which a nurse could disclose personal health information outside the health care team without a client’s express consent. Nurses should not be concerned about having consent forms signed when health information is being used within an organization, or goes outside of an organization, as long as the information is being shared only with other members of a client’s health care team and is being used to provide care.

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