Running Heading: PRIVACY AND CONFIDENTIALITY

Privacy and confidentiality: Can the access to the electronic health record by all the health
care professionals breach privacy and confidentiality?
Kushanvir Gill
820 420 024
Humber College

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Privacy and confidentiality: Can the access to the electronic health record by all the
health care professionals breach privacy and confidentiality? According to an article
published in the Star, states that, Three hospital workers have been charged under Ontarios
health privacy law for snooping into former mayor Rob Ford medical records after he was
diagnosed with cancer. The allegations include willfully collecting, using or disclosing
personal health information at the University Health Network (UHN) Princess Margaret
Cancer Centre in January. It is being said that his medical files were inappropriately accessed
first at Humber River Regional Hospital and then at Mount Sinai Hospital in October. (Carville,

2015) Clients privacy and confidentiality is a major issue and it needs to be protected by the
nurses and the healthcare providers. The privacy and confidentiality law does not give the
permission to the health care professionals to disclose any information of the patient to the
third person without the clients consent. (PHIPA, 2004) It is an essential right of the patient to
have his or her information secure and confidential. So now the question is: Is privacy and
confidentiality of the patient secure with the employees? Can people snoop around and see
personal information? Of course people can if guidelines are not set in place to protect them.
The recent violation of Rob Fords health privacy law has led to an ethical nursing
controversy. As a result, most of the privacy authorities, have developed and implemented
the importance of ethical behavior in the working environment. I believe that nurses should
have ethical and legal responsibilities to preserve the privacy and confidentiality of clients'
personal health information. This can be attained by understanding the importance of
obligations in protecting the information as a nurse, prevention of professional misconduct,
and potential harm in regards to the disclosure of information without consent.
The development of technology has changed the way we communicate; electronic
records are used to retrieve and share patient information which has increased privacy risks.

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(Personal Health Information Protection Act, 2004) It has been noticed that an unauthorized
access to the clients information has been a growing problem. Privacy and confidentiality are
two distinct but interconnected issues in the healthcare system. The right to privacy goes hand
in hand with the right to confidentiality. A nurse should respect the clients right to privacy
and confidentiality. The information collected during the caring phase should be kept
confidential in order to maintain the nurse-client therapeutic relationship. (CNO, 2009) In
order to do that, standards are set in place which act as a useful tool to help nurses what they
should or shouldnt do. The Personal Health Information Protection Act sets guidelines for
the collection, use, and disclosure of personal health information of the clients. (PHIPA,
2004) This legislation gives the clients his/her right to privacy. Under the Personal Health
Information Protection Act all the health care providers are required to protect their clients
information and not use or disclose it; intentionally or unintentionally, for the purposes which
are not related to their care and treatment. (PHIPA, 2004) As in Rob Fords case just because it
was a high profile case the nurses were curious to snoop into his personal health information.
Nurses should always reflect on their practice before breaching any health standards that are
set in place for them. In my opinion, it is the ethical responsibility of a nurse to keep client
health information confidential. Discussing clients information outside of the health care
team is a breach of confidentiality. (CNO, 2009) It is important for the nurses to maintain
privacy and confidentiality of the clients as a fundamental standard of professional practice
in order to maintain trust in the health system. (CNO, 2009)
The need to keep privacy and confidentiality of personal information is often weighed
against the need to share the information which can benefit the people for their own good.
Under the standard of Professional Misconduct, it has been said that, the obligation of
confidentiality outlasts the nurse relationship and continues inconclusively even after the
termination phase of the care. (CNO, 2014) The obligation may not make a difference to the

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data about which the public is already aware about; yet a nurse should guard against
participating or commenting on speculation related to the clients health. Such unauthorized
disclosure of the rumors can unintentionally breach the Privacy and Confidentiality of the
clients information. Maintaining privacy and confidentiality establishes trust between the
nurse and client, the patients feels respected, it maintains the dignity of the client and it
promotes autonomy. (CNO, 2009) The security system should ensure that the access to the
information of the patient should only be disclosed to the people who are authorized and have
a legitimate purpose for accessing that information. (Information and Privacy Commissioner
of Ontario, 2015). Privacy and confidentiality have two different meaning. Privacy refers to
the right of an individual to keep their personal information from being disclosed to anyone.
Whereas, confidentiality on the other hand refers to the act of limited disclosure of private
information. For example: Commenting on Rob Fords health information caused
unauthorized disclosure of information, which lead to violation of privacy and confidentiality
of the clients information. Once the clients information is disclosed to the nurses, its the
duty of the nurse to keep the information private and confidential. I believe that the access to
the patients information should be only limited to the patients nurse itself in order to reduce
the chances of unauthorized disclosure of that information. However, the personal
information can be disclosed to the public only with the patients consent in order to avoid
any professional misconduct by the nurses and to maintain the trust between the client and
the nurse.
The role of a nurse is multifaceted. Depending on the scenario, the nurse may work
directly or indirectly with wide variety of staff on the health care team such as doctors,
physiotherapist, occupational therapist, dietitian and social support workers, etc. Nursing
being an interdisciplinary profession, its easier for the nurses and other member of the health
care team to know the information from each other. (PHIPA, 2004) Nurses have a

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professional obligation not to view power as a negative concept. Privacy and confidentiality
has been considered one of the major hallmarks of the nursing profession and nurses should
consider it their responsibility to empower these standards. In my opinion, leaking Rob
Fords health information, disempowered nursing. This lead to an insignificant view of nurses
to the public. A nurse should never assume that they have the right to look at any type of
health information unless they need it in order to do their job. (Information and Privacy
Commissioner of Ontario, 2015). Assumptions in nursing are a big NO and failure to follow
proper procedures regarding the release of patients health information should result in the
termination of employment or suspension of nursing privileges. (PHIPA, 2004) If you put
yourself in the patient's place, you'll concur that this raises serious questions against
healthcare about the employee's commitment to patients confidentiality. Its easy to violate
laws than to protect them. Nursing is a profession, where nurses have the primary
responsibility to provide nursing services. Yet some nurses appear to have difficulty
following the Nursing Standards that comes along with this position. Its the responsibility of
the nurses to follow these standards and set examples where nursing can be seen as an
honorable profession.
In conclusion, if the occurrence of breach of privacy and confidentiality continues, it
can result in a serious loss of trust in the nursing profession. It is important for the authorities
to consider what steps to be taken when such issues prevails in the profession. The nurses
should understand the importance of protecting patients personal health information and
what negative impact privacy and confidentiality breach can have on the healthcare system.
Nurses should refrain from crossing professional boundaries. Before disclosing any
information nurses should consider why they are sharing the data and whether they are
revealing any information which is confidential. Inherent in the role of the nurses in Ontario

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is about following the Ethics and Standards of CNO and maintaining those standards
throughout the nursing practice.
References

Carville, Olivia. (2015, July 08). Govt. prosecutes health workers for snooping into Rob
Fords medical records.thestar.com. Retrieved September 20, 2015 from
http://www.thestar.com/life/health_wellness/2015/07/08/govt-prosecutes-healthworkers-for-snooping-into-rob-fords-medical-records.html
College of Nurses of Ontario. (2009). Practice Standard: Confidentiality and

Privacy

Personal Health Information. Retrieved September 20, 2015, from

https://www.cno.org/Global/docs/prac/41069_privacy.pdf
College of Nurses of Ontario. (2009). Practice Standard: Ethics. Retrieved September 22,
2015, from https://www.cno.org/Global/docs/prac/41034_Ethics.pdf
College of Nurses of Ontario. (2014). Professional Conduct: Professional Misconduct.
Retrieved September 20, 2015 from
https://www.cno.org/Global/docs/ih/42007_misconduct.pdf
Information and Privacy Commissioner of Ontario. (2015). Detecting and Deterring
Unauthorized Access to Personal Health Information. Retrieved September 23, 2015,
from https://www.ipc.on.ca/images/Resources/Detect_Deter.pdf
Personal Health Information Protection Act, 2004, S.O. 2004, c.3. Retrieved September
23, 2015, from http://www.ontario.ca/laws/statute/04p03

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