BC Opt Out News

March 18, 2009:
Bill 52 could compromise medical privacy
The Edmonton Journal

Are Albertans in danger of having our most private medical details open to scrutiny by strangers? If a bill currently before the legislature passes without amendment, the answer could be "yes."

Nearly everyone agrees in principle that creating comprehensive electronic health records (EHRs) is a desirable and overdue tool for improving health outcomes. As in virtually every other area of endeavour, accessing important information digitally is vastly superior to storing and retrieving paper files or other faded remnants of the past. Given the pressing need to modernize our patient histories in North America, and governments' current recessionary commitment to stimulus programs, the timing couldn't be more propitious to get things moving in earnest. Alberta is but one jurisdiction wisely contemplating just that.

While efficiencies are welcome and can even make the difference between life and death, however, we must remember that assembling electronic medical trails is a far different business than, say, transferring auto parts inventories or media archives to databases. In the case of EHRs, we are talking about what can be the most sensitive material imaginable, our intimate life stories writ large. Surely it must remain a fundamental right of Canadians to have this sort of information kept private, and our trusted health-care professionals bound by statute and solemn oath to respect that privacy.

DATA COULD AFFECT JOBS

Imagine what outside sources might do with the knowledge of past divorces, treatment for emotional difficulties, pregnancy termination, drug use in the distant past, and a long list of other afflictions, suspected or real, "major" or "minor." Lives could be ruined, jobs could be lost, and insurance, travel or adoptions denied.

Of course, certain EHRs are available now and have been for some time. But access to them is currently governed by Alberta's Health Information Act, which strictly limits who can be privy to the data and faithfully records exactly who has been peeking in. Citizens currently have the right to -- if admittedly not without some difficulty -- seek out the names of those who engage in such legal "disclosures" any time a request for private medical information is made.

If, on the other hand, the government's current Bill 52 is enacted without amendment or a fundamental re-think, all that will change.

While it promises to streamline the spawning of EHRs, the new legislation also contains at least two odious changes that all of us should fear. First, unlike existing law, there will be no traces or audits available to identify who is accessing individual electronic medical records. And second, information will be shifted from the watch of doctors to government control. Physicians who refuse to share the personal details of their patients will be liable for non-compliance fines ranging from $200,000 to $500,000 per patient.

WILL PATIENTS HOLD BACK?

Aside from the obvious horrors of such a near-Orwellian system, a myriad of other negative consequences come to mind.

For example, faced with the possibility that certain maladies might become public, it's only natural some patients will refuse to divulge them to their doctors, endangering themselves and others. Also, in the event that private health insurers are one day allowed into our provincial mix, companies might be able to cherry-pick the "best" clients.

And perfectly honest and committed health-care professionals could find themselves forced to choose between obeying an unjust law and honouring their oaths along with the bedrock foundation of doctor-patient privilege.

Why is a professed conservative government with populist roots floating such patently big-brother-style corporatist nonsense without serious consultation? The least disturbing explanation is that controlling instincts of an individual minister or two, or their bureaucrats, are at work. Rumour has it that the battle on Bill 52 may boil down to an internal PC party struggle between caucus and some cabinet bigwigs.

MEDICAL ASSOCIATION WANTS SECOND EFFORT

For its part, the Alberta Medical Association, hardly a radical socialist outfit, is about to engage in one of its most aggressive lobbying efforts ever to oppose Bill 52. Physicians and their patients are being lobbied to contact MLAs and the premier, following a scathing, effective submission made to the standing committee on health last month. That body has three options at its disposal -- passage of the bill as written, sending it back for amendments or not proceeding.

Sensibly, the AMA supports the third position, counselling for a fundamental redrafting of a new bill that will bring Alberta into the 21st century of health care without compromising the hard-won rights and freedoms of patients.

Other jurisdictions from Europe to Australia have accomplished this balancing act, and the U.S. Congress is already taking steps to do so in its fast-track program. There is absolutely no reason why Albertans should expect any less diligence.
© Copyright (c) The Edmonton Journal