Foreword

• Author: Halyna N. Perun; Michael Orr; Fannie Dimitriadis
• Pages: 33-35

Foreword

Anecdotal evidence exists that flagrant abuses of patients’ privacy and breach-

es of confidentiality are not things of the past. These abuses were first brought

to light during the proceedings of a public inquiry, the Commission of Inquiry

into the Confidentiality of Health Information, and described in its three-vol-

ume report in September 1980, a quarter of a century ago. It is true that some

of them ended because of the glare of publicity associated with the inquiry, and

that institutional and administrative practices were introduced to prevent or

discourage others. Memories are short, however, and bad habits difficult to

suppress permanently. The need to implement many of the inquiry report’s

170 recommendations, though undeniable, did not result in comprehensive

legislation in Ontario until the Personal Health Information Protection Act came

into force on 1 November 2004.

A fundamental purpose of law is to attempt to reconcile conflicting inter-

ests that inevitably arise in society, and conflicts abound in the fields of priva-

cy and confidentiality, the importance of which, in a free society and in health

care, needs no elaboration here. The practical difficulty in effecting this recon-

ciliation is probably the chief reason for the failure of the earlier attempts to

enact legislation that was obviously highly desirable. At the several conferences

and symposiums convened over the years to consider the announced immi-

nence of remedial legislation, all speakers representing the many affected

interests were unanimous in the view that privacy and confidentiality were

essential values that must be protected but many, if not most, of them assert-

ed a “right to know” that required an exception to be made in their cases. If all

of these claimed exceptions were legislated, the result would be, not a protec-

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