Confidentiality: Medical and Legal

• Author: Judith A.B. Wahl
• Pages: 47-76



Condentiality

MEDICALANDLEGAL

JudithABWahl*

  

YourclientorpatientisanolderadultYouareahealthprofessionalora

legalprofessionalandyouknowthatyouhaveadutytokeepconden-

tialanyi nformationthat youreceivefromac lientorpatientun lessthe

clientorpatientconsentstodisclosuretoath irdpartyThereareexcep-

tionstothi srulesodoyouknowwhen andunderwhatcircu mstances

youmustormaysharewithothersinformationaboutyourclientpatient

orreceivedfrom yourclientpatientDoyouknow ifandwhen youei-

therhave aduty todiscloseinformat ionor whetheryou mayconsider

disclosing information that isot herwise condentialA ndif you may

ormustdisclosesomeinformationwhatisthescopeoftheinfor mation

thatyoumayormustdisclose

Areyourequiredorpermiedtobreachthatdutyofcondentiality

ifyouthinkthatyourolderclientisatriskofharmOrthatsheisbeing

taken advantageof bya third part yOr that shei sbei ngabusedi n

someway If disclosure of information is notma ndatoryin thes ec ir-

cumstances would disclosure without consent if permissiveda mage

thetrustb etweenyouandyourpatientorcl ientHasitthepotentialof

causingotherha rmsIsiteverappropriatetoactin thebestinterest s

 ExecutiveDirectora ndSeniorLawyerAdvocacyCentrefort heElderlyMsWahl

isalsoSession alLecturerLawandAg ingFacultyofSoc ialWorkUniversityof

Tor ont o.

JABW

of a clientpatient rather than according to their in structions or with

theirconsent

Doyouhaveconcernsaboutta lkingwith yourclientaboutdisclos-

inginformationtothepoliceortosomehea lthorsocialservicebecause

youthi nk thatt heymay refuse consent tothis disclosure leaving you

withanethica ldilemmabecauseofyourknowledgeaboutanabuseex-

periencedbyyourclientpatient

Some lawyers and health practitioners may think t hat they have

a duty to report to some health or socia l service agency if they be-

lievet hatt heir olderclientpatient is a victim of abuse Some lawyers

andhealth professionals maybe underthe belief thatolderadults are

likechildrenparticularlyiftheyareofanadvancedageorphysically

frailorarebeing victimizedi nsomewayandthereforecondentiality

should be treated dierently because they need protection of some

typeThisisadangerousroadtogodownasitmayleadlegalandhealth

practitionerstoactina mannerthatis ageistandunfairto theclientor

patientaswellaslegallyandprofessionallyinappropriate

OurexperienceattheAdvocacyCentrefort heElderly withclients

whohavebeen victims ofabuse isthat peoplegenerallywant helpbut

theywant thehelpon their ownterms andat theirown direct ionjust

asany other clientwa ntsOlderc lientsare not lookingfor lawyersor

healthpractitionersto actintheirbestinterestsas opposedtoacti ng

attheir directionor with an informed consent The olderclients want

theprofessionalstoprovidetheadviceandassistancewithprofessional

skillbuteventhe clientwhohasbe envictimi zedwantstochoos ehow

thatadviceisappliedtotheirown personand theirown personalsitu-

ationA ssumptions about vulnerability of an older person may unin-

tentionally providesupport to persons who may be taking advantage

of the older person becaus e the legal or health practitioner has failed to

recognize that the socalled loving and interested relativeor friend of

theolderpersonisactuallyanabuserAlmostallthecasesofelderabuse

onwhichtheAdvocacyCentrefortheElderlyhasprovidedadviceoras-

sistancetoanolderadulthasidentiedtheclosefamilyorfriendsasthe

parties that are the caus e of the abuse.

 TheAdvocacyCentrefortheElderlyACEisacommunitylegalclinict hatprovides

arangeofelderlawservicesi ncludingclientadvicea ndrepresentation public

legaleducationcommunitydevelopmentandlawreformactivitiesforlowincome

seniorsinOntarioACEhasbeeninoperationsinceACEisanongovernment

charitablenonprotcorporationwitheightstavelawyersthreesupport

stamanagedbyaBoardofDirectorsoftenandfundedprim arilybyLegalAid

OntarioACEwastherstlegalc linicinCa nadaspeciali zinginelderlawserv ices