Breaching confidentiality in the public interest: Guidance from Canada?

Abstract

The importance of confidentiality in relationships between health professionals and patients has been justified on a number of ethical grounds. However, ethical guidelines for health professionals and certain legal judgments view confidentiality as “relative”. That is, health professionals may breach confidentiality in “the public interest” where the patient is at risk of harming others and this risk could be averted by the breach. This article examines the recent Supreme Court of Canada decision in Smith v Jones that considerably broadens the circumstances in which confidentiality may lawfully be breached. It assesses the three-step test set out by Cory J that may be of assistance to health professionals in countries other than Canada in deciding whether or not to breach confidentiality.