There are a lot of situations in which your consent is not needed to collect, use or disclose your personal health information.
Health care providers are allowed to collect, use and disclose your personal health information if it is clearly in your interest to do so and consent cannot be obtained in a timely way, or if it is necessary for your medical treatment and you are unable to give consent.
This allows them to see your personal health information in an emergency, even if you have previously given instructions not to disclose certain records or information, and they can get access to Pharmanet and see what medication you've been prescribed, even if you have put a keyword on your pharmanet record. You can find out more about keywords on the Pharmanet page of this website.
Billing and Administrative Purposes
When your personal health information is collected by your health care provider, it is routine and necessary for some of it to be shared with your insurance provider for billing and payment purposes. Generally, your health care provider will do this without asking you specifically.
More rarely, your health information might be disclosed or used for regulatory purposes if there is a complaint or an investigation involving your health care provider.
Research (private sector)
Independent health care providers are allowed to disclose personal health information if getting consent is impracticable, which means next to impossible (such as if the patient has moved with no forwarding address or has died) and the receiving organization signs an agreement that requires it to:
Comply with the Personal Information Protection Act (PIPA);
Follow the confidentiality policies and procedures of the organization that collected the personal information; and
Agree to specific conditions having to do with security and confidentiality, including to remove or destroy individual identifiers at the earliest reasonable opportunity, and prohibit any subsequent use or disclosure of that personal information in individually identifiable form unless the provider that disclosed the information has been told and has agreed.
Finally, the health care provider must get the approval of a research ethics board, which is an oversight body composed of professionals who assess the proposed research to make sure it is ethical and safe. If the research ethics board does not give approval, the information cannot be disclosed.
Hospitals, Health Authorities, Ministries, other public bodies
Hospitals, health authorities and other government agencies and other health care providers (such as therapists or clinics working for a government agency) are allowed to collect, use and disclose personal health information for a stewardship purpose if the Minister of Health has authorized them to do so. This is because the Minister of Health has the authority under the Ministry of Health Act, to collect personal information from a public body, use personal information and disclose personal information to a public body. if he or she is satisfied that the information is reasonably needed to fulfill a stewardship purpose.
This law is designed to allow government agencies within the health sector to share personal health information for any purpose that meets the definition of a stewardship purpose.
Sexually Transmitted Diseases and HIV/AIDS
In BC some sexually transmitted infections are reportable. Anonymous testing for HIV/AIDS is available so that it is possible not to have your name reported if you are positive and the new case is reported. For more information about clinics for testing, click here.
Other Legal Reporting Requirements
There are several other situations when a health care provider is required by law to report personal health information to a government agency or police authority.
If the health care provider has reason to believe that a child is in need of protection because of abuse, neglect, exploitation, deprivation of care or refusal to consent to treatment, the provider is required to report that belief.
Psychologists, Optometrist and doctors are required to report the patient's name, address and medical condition to the Superintendent of Motor Vehicles when the patient has a medical condition that makes it dangerous to the patient or to the public for the patient to drive a motor vehicle, and the patient continues to drive after being warned of the danger. See Motor Vehicles Act.
A similar report must be made by optometrists and doctors about pilots and air traffic controllers under the Aeronautics Act. See Aeronautics Act.
Doctors have an ethical duty if a patient tells them something that leads them to believe that another doctor has behaved improperly with the patient. The doctor must either tell the patient how to make a report to the College of Physicians and Surgeons of BC or offer to make the report on the patient's behalf. No report will be made without the patient's consent (except if the doctor believes that the other doctor poses a danger to the public). See Ethical Duty to Report.
Doctors, hospitals, medical clinics and health authorities must report all gunshot wounds to police regardless of origin. Stab wounds that are not self-inflicted or accidental must also be reported. The report must be made as soon as possible without compromising the individual's treatment. The information in the report must include the patient's name if known, the fact that they were treated for a gunshot or stab wound, and the name and location of the place where the patient was treated. See Gunshot and Stab Wound Disclosure Act.
Certain communicable diseases must be reported to the Centre for Disease Control. The list of diseases is quite long and can be found here.
More information about reporting communicable diseases can be found here