In this podcast you will hear about a situation in which patient confidentiality comes into play. Let’s see if you understand what you can do and what you cannot do.
Teacher: A client presents at ER inebriated; he cannot stand, has very slurred speech, and he cannot tell us what he has taken in the past few hours. He smells of alcohol and is rather aggressive. He is known to the ER staff; he resides at the Union Mission and has no identified next of kin on the chart. The worker from Union Mission is on the phone giving a list of his current medications. He is asking for a patient status report. What information can you give?
Student: I don’t think I can give any unless the client authorizes us to.
Teacher: Even though this person on the phone knows the client well?
Student: I could ask the client if he’d like me to give information to this person.
Teacher: Yes, you could. But it might not be a good time to do that if he is belligerent and uncooperative. And if the Staff at Union Mission knows him well, they also know the limits of the PIHPA.
Student: What if the client was asking you to contact them?
Teacher: Unless the client specifically authorizes you to provide information, it is not express consent per se. Things can get a little dicey here.
Student: What do I do if I am unsure?
Teacher: You speak with your supervisor or with the staff coordinator. Most people who have been working here know the law well and can explain the “best practices” to you.
Student: When can I break confidentiality?
Teacher: When it’s about protecting the welfare of an individual --protecting a patient from harm. For example, if a patient admitted to you that he or she was contemplating suicide, it may in some cases be appropriate to disclose that information to others. For example, the Child and Family Services Act requires people to inform a Children's Aid Society if they believe on reasonable grounds that a child may be at risk of harm.