Exceptions to Professional Secrecy

Compelling and Just Grounds

Under review

The different exceptions provided for in the Code of Ethics of Physicians as well as in other specific laws consider the responsibilities of the physician—not only toward his or her patient, but also toward those who have a relationship with the patient and whose health and safety may be in danger. In the Code of Ethics, the lawmakers did not deem it useful to further specify the notion of “compelling and just grounds related to the health and safety of the patient or of others,” thus entrusting the latter to the physician’s good judgment.

However, certain laws are more explicit; they authorize or even order the disclosure of certain items of information in situations  where health and safety are at issue. For example, many legislative provisions have recently been amended in Québec so that certain essential items of information could be communicated to persons concerned or implicated in acts of this kind, when there is a risk of acts of violence, among them, suicide. As a result, the Code of Ethics was amended so as to specify the terms and conditions to be respected in similar cases:

“A physician who communicates information protected by professional secrecy in order to prevent an act of violence, including a suicide, must, for each communication, indicate in the patient's record the following items:

 (1) the date and time of the communication;
 (2) the identity of the person exposed to danger or of the group of persons exposed to danger;
 (3) the identity of the person to whom the communication was made, specifying, according to the case, whether it was the person or persons exposed to danger, their representative or the persons likely to come to their assistance;
 (4) the act of violence he aimed to prevent;
 (5) the danger he had identified;
 (6) the imminence of the danger he had identified;
 (7) the information communicated. (sec. 21)"