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PHIPPA and Death

Question# 779

I am curious on the PHIPPA guidelines surrounding a deceased patient that may be known to the paramedic's social circle.

I appreciate that protecting patients health information is critical during 911 calls, does that change if the patient has died?

For example, paramedic responds to a VSA in the community for a patient who is a client at a health clinic that the paramedics brother works at.
Knowing it would be an impactful death for their brother to hear and it would be important for that clinic to know this client has died. Is the paramedic allowed to share that information to their brother?

Does that rule change if the paramedic was not involved in the call and simply heard it through the grapevine while on shift?

Answer:

Upon review of the Personal Health Information Protection Act (2004), there is language that speaks to the sharing of all types of personal information, including if a patient has passed away. Paramedics are considered “custodians” to the information that patients share with us, whether alive or dead. Therefore, “subject to limited exceptions, custodians cannot rely on implied consent when disclosing personal health information to a person or organization that is not a custodian, or when disclosing personal health information for a purpose other than providing or assisting in providing health care.”3 So while the deceased patient provided implied consent to their care, this consent cannot be utilized to disclose of their information unless it is to another custodian that is actively involved in providing care at that moment. The term circle of care has also been used to help make it simpler in recognizing who custodians can share information with. The PHIPA FAQs state “the ‘circle of care’ is not a defined term under PHIPA. It is a term of reference used to describe the provisions of PHIPA that enable custodians to rely on an individual’s assumed implied consent when collecting, using, or disclosing personal health information for the purpose of providing or assisting in providing health care.”3 Additionally, PHIPA states that the circle of care does not include custodians who are not part of the direct or follow-up treatment of an individual and and/or non-custodians.

In conclusion, “a custodian is prohibited from collecting, using or disclosing personal health information unless consent has been obtained and the collection, use and disclosure is, to the best of the custodian’s knowledge, necessary for a lawful purpose or is permitted or required by PHIPA.”3

We highly recommend reviewing the attached reference documents, especially the PHIPA FAQ document as it outlines a lot of situations paramedics are often faced with regarding consent, capacity, and personal health information.

References

[1]- Your health privacy rights in Ontario - IPC

[2]- [SO 2004, c 3, Sch A | Personal Health Information Protection Act, 2004 | CanLII|https://www.canlii.org/en/on/laws/stat/so-2004-c-3-sch-a/latest/so-2004-c-3-sch-a.html]

[3]- phipa-faq.pdf (ipc.on.ca)

[4]- [SO 1996, c 2, Sch A | Health Care Consent Act, 1996 | CanLII|https://www.canlii.org/en/on/laws/stat/so-1996-c-2-sch-a/latest/so-1996-c-2-sch-a.html]

Medical Directive Category

Consent

Published

12 February 2024

ALSPCS Version

5.2

Views

61

Please reference the MOST RECENT ALS PCS for updates and changes to these directives.