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Privacy and confidentiality


Protecting patient information

Mandatory reporting


Male physician on phoneIn Canada, provincial, territorial and federal statutory requirements mandate that physicians must report specific patients to the appropriate agencies.

In some instances if the physician fails to report confidential information to a public authority and thereby fulfil the statutory obligation, the physician may be prosecuted, fined, or face imprisonment.

Some examples of mandatory reporting situations include:  
  • a child in need of protection (to prevent physical, sexual, or emotional harm, or abandonment)
  • concerns about a patient's fitness to drive (e.g. cars, airplanes, trains, boats — requirements vary by province or territory)
  • patients with certain communicable diseases

Case: Mandatory reporting of suspected child abuse
Child being carried into an emergency department by father

Background

A father brings in his four-year-old child because the child is not weight bearing following a "fall from a swing."  

X-rays of both lower extremities reveal a new fracture and other healing fractures. The father denies the child has ever been injured.

Think about it

In addition to providing clinical care for the fracture, what is your best next step?

Outcome

Report your suspicion that the child may be in need of protection to the child protection authorities. The purpose is protection, not accusation. The authorities will investigate further.
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  • If a physician has reason to believe a child is in need of protection, the physician is responsible for seeing that the appropriate authority is informed in a timely manner.
  • The child should not be put at risk by any delay or delegation of the act of reporting.

Every Canadian province and territory has enacted legislation requiring physicians to report children who may be in need of protection, including instances of suspected child abuse, to the child welfare authorities or the equivalent agency in the province or territory. The duty to report is mandatory even though the information reported may otherwise be confidential.