The Physician’s Obligations under Certain Laws

Public Health Act

Under review

The purpose of this law is to protect the health of the public and to establish conditions conducive to maintaining and improving the health and well-being of the population at large. The intent of certain measures in this Act is to enable public health authorities to engage in health monitoring activities and to give them the necessary powers to take action in cases where the health of the population is threatened.

Thus, under section 82 of the Act, the physician must report to the public health director any infection, disease or intoxication included in the list of diseases that must be reported (MADO). Also, a physician who suspects the presence of a threat to the health of the population, other than MADO, must notify the public health director in the region. One should emphasize that this reporting is mandatory, and physicians who neglect to do so commit an offence and are liable to a fine.

The reporting methods and MADO list are regularly updated. Certain illnesses such as scarlet fever have been left off the list,  whereas others have been added, notably infections caused by the West Nile virus (WNV), severe acute respiratory syndrome (SARS), and outbreaks of methicillin-resistant staphylococcus aureus (MRSA) and vancomycin-resistant enterococcus (VRE). Only tuberculosis remains a disease requiring mandatory treatment. And there is only one reporting form, the AS-770, which was also changed (A sample form is available in the Appendix.). In addition to the usual information, one must now write the medical insurance number, the name of the laboratory to which the sample was sent, and the date of the sample-taking, if applicable, and for blood-borne diseases, information on the giving or receiving of blood, blood products, tissues or organs. This form is also used for nominal reporting of sexually transmitted infections. However, to promote detection of sexually transmitted and blood-borne diseases, there are integrated services providing screening on an anonymous basis to vulnerable populations.

Physicians must forward their reports to the public health division in their territory in the 48 hours following the consultation. In cases of high alert diseases, these must be reported immediately by telephone or fax to the national director of public health as well as to the public health director in the territory.

In Québec, AIDS and human immunodeficiency virus (HIV) are diseases that must be reported only when they involve the giving or receiving of blood, blood products, tissues or organs. In these cases, physicians must complete an AS-770 form. However, the collection of epidemiological information for monitoring purposes is mandatory for all positive anti-HIV tests. A worker in the public health division collects the information by telephone from the physician who prescribed the screening test. To promote screening in vulnerable populations, there are integrated services providing screening for sexually transmitted and blood-borne infections on an anonymous basis. The physician who has made a diagnosis of an illness indicative of AIDS, must complete the SP-100 form used for collecting epidemiological information, a sample copy of which is found in the Appendix.