When physicians wish to record a clinical encounter, they should first obtain express consent from the patient and have in place security measures to ensure confidentiality.
Physicians supervising medical trainees must keep in mind their responsibilities to patients when delegating tasks to trainees.
Physicians owe patients a duty to keep their personal health information confidential, yet there are times when this conflicts with other statutory duties or with concerns for public safety.
Physicians may release a patient’s medical records to lawyers only with patient authorization or where required by law.
A review of the legal duties and ethical considerations for physicians to report their reasonable concerns about the professional competency, conduct or behaviour of another physician to health care institutions/hospitals, public health officials or regulatory authorities (Colleges).
How to respond to queries seeking to verify the authenticity of doctors’ certificates.
End-of-life treatment decisions can be difficult for both physicians and patients, but many issues can be avoided by following the key concepts outlined.
A discussion of physicians’ obligations when certifying a patient’s death.
An update on the evolving rules and processes around MAID.
Suggested ways that physicians can reduce the risk of privacy breaches when using fax to communicate confidential patient information.
An exploration of privacy and consent issues when using clinical images or recordings of patients to teach medicine.
Physicians participating in clinical research studies should be aware of their relevant legal, ethical, and professional obligations.
If physicians have reason to believe a child is in need of protection, they are responsible for informing the appropriate authority in a timely manner. Planning what to say to the family is important.
An overview of a physician's duty to maintain confidentiality and protect the privacy of patients' personal health information in instances of disclosure requests from third parties, including the police or other authorities.
The physician's role in providing a child's medical information to a parent.
A complaint to a medical regulatory authority (College) initiates a process that warrants a physician's attention and timely response.
Physicians can take reasonable steps to maintain the best interests of the patient in the midst of family disputes concerning the care of children or of elder patients.
Documentation in clinical notes and reports to third parties should be factual, objective, and use a suitable tone of medical professionalism.
Steps that physicians can take to reduce the risk of dental injury to patients.
The increased availability of genetic testing raises a number of medico-legal questions that physicians should consider.
Highlights from CMPA discussion paper “The role of physician leaders in addressing physician disruptive behaviour in healthcare institutions.”
Individuals have a general right to access their personal information in independent medical examination files, but there are exceptions to what must be produced
Considerations for ending the doctor-patient relationship.
A summary of key principles relating to safe delegation.
Addressing privacy breaches has become more complex as the rules around notifying and reporting have recently changed or are about to change across the country.
Tips for physicians to help prevent drug diversion and related unlawful prescription activity, and avoid potential medical-legal difficulties.
Physicians can be better prepared to transfer patient health information when they understand who has custody of and access to medical records.
Considerations for physicians when responding to requests for deceased patients’ medical records.
A discussion of the principles of access, the challenges with access, and managing the risks.
Physicians can take steps to mitigate the medical-legal risks of patients taking photos and making video and audio recordings during healthcare encounters.
An overview of how to reduce medico-legal risks when completing fitness to participate forms.
Guidance for providing disclosure following harmful incidents in which more than one patient is affected.
Physicians should understand the role of coroners and medical examiners in Canada,
and how and when to provide information to them.
An overview of the principles of retention, sharing and transferring of medical records.
The circumstances under which physicians can treat themselves, family and friends are limited.
Responsibilities of physicians when planning to close or leave a practice due to retirement, illness, or other reasons.
This article explores the role of physicians in promoting the exchange of information and active decision-making by patients. It also examines the relationship between decision-making and consent.
Protecting the privacy of patient information when using digital communication channels, including email, portals, and social media platforms.
Greater clarity in patient care can be achieved through healthcare directives, and when physicians understand their purpose and the rules governing them.
How doctors can help protect their information technology systems from cybersecurity threats and what they should do in the event of a cybersecurity incident.
Explanation of physicians’ mandatory and discretionary obligations to report patients who have a medical condition that may make it dangerous for them to drive.
Certain provinces have legislation to prevent apologies for adverse events from being used in court proceedings.
A review of CMPA medico-legal cases showed opportunities for physicians to improve their communication and coordination of care for patients undergoing non-urgent in-hospital surgery.
The Colleges outline expectations for continuity of care, and physicians can enhance continuity when they are aware of their professional obligations, and have the necessary systems in place for managing tests, patient transfers, and availability and coverage.
Physicians should try to accommodate patients’ requests to limit access to their personal health information.
Advice for physicians on applying resource allocation and ethical decision-making protocols when rationing scarce healthcare resources amid COVID-19.
An overview of communication strategies physicians can use to help resolve conflict with other physicians or other healthcare providers.
The practice of marking transcribed reports or entries “dictated but not read” gives rise to medical-legal risks and can create uncertainty for those relying on that information in providing patient care.
Actions physicians can take to mitigate potential risks of using patient portals to communicate clinical information with patents.
Changes to the Criminal Code have raised the age of consent for sexual activity. Physicians should be guided by legislation in each province and territory on their duty to report such activity to the appropriate authorities if there are reasonable grounds to believe the child is being abused.
Physicians providing emergency care as good Samaritans often have questions about their legal and ethical obligations and the liability protection available to them.
The CMPA advises on how to reduce medico-legal risks from vaccination, and how to address vaccine hesitancy and refusal.
Effective communication and awareness of legal requirements are key to obtaining consent for treatment of children.
Physicians regularly encounter patients or family members who behave aggressively and make demands that may be unrealistic and potentially harmful. In their medical practice, physicians need strategies and tools to manage conflict and such challenging behaviours.
Physicians who are familiar with regulatory requirements governing organ and tissue donations can more effectively meet their obligations and mitigate the potential for complaints.
Professional and ethical obligations to keep in mind when considering offering medical services through online virtual clinics.
Physicians should use their professional judgment when determining whether a virtual assessment, an in-person assessment, or a hybrid of both is best for individual patients.
Ambulance offload delay results from ED crowding and can present unique medico-legal risks for ED physicians.
A discussion of consent issues that may arise when caring for adults with diminished mental capacity (competency).
When patients make requests for specific care providers, treatments, or services, physicians should assess whether they can reasonably accommodate such requests.
A review of CMPA medico-legal cases and research literature describing the non-technical factors contributing to diagnostic errors by surgeons in hospital operating rooms.
An overview of ways in which physicians can use patient decision aids (PDAs) to encourage shared decision-making.
An overview of issues physicians need to consider when conducting treatment or non-treatment capacity assessments.
Physicians can take steps to address bullying and other abusive behaviours they may be subjected to by patients and their families, colleagues and other healthcare workers, and third parties.
Physicians may face a privacy breach when viewing personal health information that is not required for current clinical care and without the patient’s or information custodian’s consent.
Practising physicians, particularly those at the beginning of their career, should ensure they have enduring access to medical records after leaving a practice for medical-legal purposes.
A look at how the legalization of recreational marijuana may affect physicians’ practices, including whether it will eliminate patients’ requests for medical marijuana.
Guidance for specialists on their ethical and professional responsibilities in accepting to care for new patients.
An overview of information privacy considerations when using electronic medical records in practice.
Physicians who respond affirmatively to a request for a medical-legal report should prepare the report with care and in keeping with their College’s policies and guidelines.
Text messaging offers the potential for improved communication among physicians and healthcare teams, and using it appropriately can mitigate some of the inherent risks of this channel.
Physicians can successfully manage online ratings using a reasonable and measured approach.
Physicians should consider encouraging patients to engage in advance care planning and appointing a substitute decision-maker early, before the patient no longer has the capacity to consent to end-of-life care.
Guidance for physicians on assessing whether a chaperone is right for their practice.
CMPA gives advice to physicians travelling across international borders and having border agents search mobile electronic devices, such as smartphones, that may contain confidential patient information.
Strategies for managing the stress associated with transitioning to a new EMR system for managing patient records.
Physician leaders who foster a culture of accountability in their teams and institutions help promote learning from undesirable behaviours that include human error, and at-risk and reckless behaviour.
This publication provides guidance and good practices about physician communications with patients concerning the disclosure of harm stemming from healthcare delivery, and aligns with the Canadian Patient Safety Institute’s (CPSI) Canadian Disclosure Guidelines (2011).
DISCLAIMER: The information contained in this learning material is for general educational purposes only and is not intended to provide specific professional medical or legal advice, nor to constitute a "standard of care" for Canadian healthcare professionals. The use of CMPA learning resources is subject to the foregoing as well as the CMPA's Terms of Use.