Ferris L E, Barkun H, Carlisle J, Hoffman B, Katz C, Silverman M
Faculty of Medicine, University of Toronto, Ont.
CMAJ. 1998 Jun 2;158(11):1473-9.
Ontario's Medical Expert Panel on Duty to Inform was formed to consider the duty of Ontario physicians in circumstances where a patient threatens to kill or cause serious bodily harm to a third party. The panel was concerned about the implications of any duty to inform on the integrity of the physician-patient relationship, particularly with respect to confidentiality. The panel agreed that regulations safeguarding the confidentiality of patient information ought to be changed only if there is a critical reason for doing so, but, after deliberation, the panel members concluded that the need to protect the public from serious risk of harm is a paramount concern that should supersede the duty of confidentiality. The recommendations reported here were endorsed in principle by the panelists and the groups they represented (the Royal College of Physicians and Surgeons of Canada, the Canadian Medical Protective Association, the College of Physicians and Surgeons of Ontario, the Ontario College of Family Physicians and the Ontario Medical Association) and are being implemented by the College of Physicians and Surgeons of Ontario.
安大略省告知义务医学专家小组的成立,是为了考量在患者威胁要杀害第三方或对其造成严重身体伤害的情况下,安大略省医生所应承担的义务。该小组担心任何告知义务会对医患关系的完整性产生影响,尤其是在保密方面。小组一致认为,只有在有关键理由的情况下,才应更改保护患者信息保密性的规定。但是,经过审议,小组成员得出结论,保护公众免受严重伤害风险的必要性是首要关切,应优先于保密义务。此处报告的建议原则上得到了小组成员及其所代表的团体(加拿大皇家内科医师与外科医师学院、加拿大医学保护协会、安大略省内科医师与外科医师学院、安大略省家庭医师学院以及安大略省医学协会)的认可,并且安大略省内科医师与外科医师学院正在实施这些建议。