Dialogue Volume 11 Issue 3 2015 | Page 7

FROM THE REGISTRAR’S DESK When public interest trumps confidentiality T Rocco Gerace, MD Registrar photo: D.W. Dorken There exist special circumstances where physicians are required to report particular events or clinical conditions he actions of a Germanwings co-pilot who flew his plane into a rocky valley in the Alps, in an apparent mission to kill himself and the other 149 people on board, has served as a tragic reminder of the role that mandatory reports can play. Although, an investigation revealed that Andreas Lubitz – the co-pilot – had a medical note covering the day of the plane crash, his employer says it was never informed of his depression. It is only natural to wonder if a tragedy like that could ever happen in Canada. Certainly, we have, in statute, clear reporting expectations for doctors. However, the best designed system is only going to be as good as the level of vigilance exercised by all those involved. So I ask you all to be aware of your obligations and fulfill your duty. If you provide care to any pilot, air traffic controller or flight engineer that has a medical condition which may be a hazard to flight safety, you must make a mandatory report. We have an article on page 46 of this magazine, prompted by Transport Canada’s recent reminder to the profession. As physicians, we are ingrained with the legal and professional obligation to maintain the confidentiality of patient information. But there exist special circumstances where physicians are required to report particular events or clinical conditions to the appropriate government or regulatory agency in order to serve a greater societal good. The importance of reporting a pilot who may pose a risk to air safety is such an example. Another example is suspected child abuse. Abuse and other forms of neglect are enormous health hazards for children, and our cover story makes the point that physicians may not always have the luxury of certainty in such situations. The threshold for reporting is reasonable grounds to suspect a child is or may be in need of protection. If you do have reasonable grounds to suspect a child is in need of protection, you must immediately report the suspicion, and the information upon which it is based, to the Children’s Aid Society. I’d like to also outline some of the mandatory reports that physicians must provide to this College Issue 3, 2015 Dialogue 7