Confidentiality
Confidentiality is considered a cornerstone of the profession of psychotherapy and is embedded in its core values.
The Personal Health Information Protection Act, 2004 (PHIPA) establishes the rules relating to confidentiality and privacy of personal health information in Ontario. PHIPA requires that personal health information be kept confidential and secure.
In compliance with PHIPA, practitioners must ensure that the professional relationship with the client and the client’s personal information are kept confidential, within legal limitations.
Limits to confidentiality
In law, there are a limited number of circumstances where disclosure of personal health information is required without consent. Notable limits to confidentiality include:
- where the practitioner believes on reasonable grounds that disclosure is necessary to eliminate or reduce significant, imminent risk of serious bodily harm (includes physical or psychological harm) to the client or anyone else, e.g. suicide, homicide. Note: If a significant, imminent risk of serious bodily harm exists (this includes physical or psychological harm), there may be a professional and legal duty to warn the intended victim to contact relevant authorities, such as the police, or to inform a physician who is involved in the care of the client.*
- where disclosure is required under the Child and Family Services Act, 1990 for example, where there are reasonable grounds to suspect that a child is in need of protection due to physical harm, neglect or sexual abuse by a person having charge of the child;
- where necessary for particular legal proceedings (e.g. when the practitioner is subpoenaed);
- for the purpose of contacting a relative, friend or potential substitute decision-maker of the individual, if the individual is injured, incapacitated or ill and unable to give consent personally.