Why does the Nova Scotia government need access to the individual medical records of every patient in the province?
Medical privacy in Nova Scotia no longer exists now that the province’s House of Assembly has passed Bill 419, giving the government access to the entirety of patients’ medical records.
The government’s stated pretext is “planning and management of the health system, resource allocation and creating or maintaining electronic health record programs and services.” Sounds innocuous enough, but this goal can be accomplished easily without giving politicians and bureaucrats access to personal information about a patient’s medical problems and treatments.
Hospitals and clinics can create and maintain general anonymous data about how many patients are seen across the province, the conditions which prompted those patients to seek medical help, the numbers and types of surgeries performed, and how often various drugs are prescribed, all without giving politicians access to patients’ individual health records.
According to Nova Scotia NDP MLA Claudia Chender, “The provision is quite clear.”
The College of Physicians and Surgeons of Nova Scotia initially opposed Bill 419. Its CEO, Dr. Gus Grant, stated:
“This law requires all physicians to enable access to their medical records to the Minister. For physicians, this creates a new professional, legal duty. For patients, it means that the entirety of their medical records will be accessible to government. This new legislation will have a profound effect on medical practice and on the nature of the patient-doctor relationship which is based on trust and confidentiality. The College … supports the rights of patients to privacy and the duty of physicians to maintain confidentiality, which is a cornerstone of medicine. The obligation set out in [this Bill] runs contrary to these rights and duties, or is, at the very least, in tension with them.”
However, Dr. Grant has since changed course. For incomprehensible reasons, he now appears to believe promises from politicians who claim they won’t abuse their new authority. Dr. Grant was easily impressed by a Nova Scotia government “commitment” to create “a Standing Committee to inform regulations and data governance, particularly as they pertain to access and use of personal health information.”
Trusting politicians not to use the powers that are clearly granted by legislation is like believing the scorpion’s promise not to sting the frog as she carries the scorpion across the river to safety, according to that well-known story. “I can’t help it,” says the scorpion after stinging the frog midstream, ensuring that both creatures will drown, “it’s my nature.”
When the law itself authorizes politicians and bureaucrats to access personal and private information, it is naive to think that they won’t use their legal powers, to the detriment of patients. Like the scorpion, it’s their nature to do so.
Patients need and deserve privacy protection so that they can speak candidly to their doctors about all physical, mental, and psychological aspects of their being. Patients who fear privacy violations, and therefore hide information from their doctors, are sure to receive inferior medical care. This will cause all manner of damage, including death.
Nova Scotia Health Minister Michelle Thompson claimed that the government is “not interested in individual information, we’re interested in that big number that tells us how many people are utilizing and moving through the system at any given time.” If that is true, she and her colleagues would have amended the legislation to address patients’ privacy concerns before passing it.
The right to “life, liberty and security of the person” protected by Section 7 of the charter includes a right to privacy. Section 8 of the charter guarantees citizens’ rights to be secure against “unreasonable search and seizure.” Stay tuned for a court challenge.
