When a Patient Is Suicidal – Privacy Considerations and Your Obligations
All health care providers, including physiotherapists, must 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 allow patients to have control over who has access to their personal health information. However, they do not to prevent healthcare providers from immediately disclosing personal health information in specific and limited circumstances, including when a patient has expressed suicidal thoughts.
If a physiotherapist has reasonable grounds to believe a patient may seriously harm themself, or others, the Personal Health Information Protection Act (PHIPA) permits this disclosure without getting the patient's consent.
The physiotherapist is expected to use their professional judgment when assessing the situation to determine if there are reasonable grounds to believe 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 by a healthcare provider to reduce or eliminate risk of harm. The factors for consideration are:
- 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 people this information can be disclosed to – the PT should use their 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 healthcare 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, they should contact a lawyer or the Information and Privacy Commissioner.
Important: All disclosures should be documented in the patient chart.