Physicians must follow established protocols for drugs not approved by Health Canada
The Inquiry Committee received a report from a health authority alleging that a medical subspecialist had personally carried a drug not approved for use in Canada from another country and provided it to patients.
The committee’s investigation revealed the following:
- No attempt had been made to obtain the medication through Health Canada’s Special Access Program, something the hospital pharmacy would have assisted with. No information was submitted to suggest that the medication could not have been obtained through proper means.
- The drug is approved for use in the United States.
- The medication was not concealed in any manner when it was brought through Canada customs (it was carried in full view, in a small cooler), but it was not declared either.
- The medication was provided at no cost to the five patients who received it.
- There was no indication that the physician was motivated by anything other than a sincere desire to secure this therapy for his patients.
Notwithstanding the registrant’s good intentions, the committee concluded that his conduct contravened his ethical and professional obligations as a College registrant. Physicians are reminded that it is not acceptable to bring unapproved medications into Canada outside of the Health Canada protocol.
At the direction of the committee, the registrant consented to an unpublished reprimand, which will remain on his record. The committee stated its expectation that the registrant’s future conduct be beyond reproach in every respect.
When police officers request patient information…
The College is regularly contacted by registrants seeking guidance about responding to requests for information from the police. The issues are primarily legal in nature and College registrants are directed to consult the Canadian Medical Protective Association (CMPA). This article on the CMPA website, Physician interactions with police, is a good starting point. The bottom line is that, in general, patient information should not be disclosed to any third party without either the consent of the patient or as required by law.
It is helpful to consider four circumstances where patient information may be disclosed:
- With the explicit consent of the patient.
- In response to a court order, typically a search warrant. Physicians must release information specified in a search warrant, but must also take care not to disclose other information. A subpoena is an order to appear in court, often including direction to bring records along. Unlike search warrants, subpoenas do not allow physicians to release information without consent in advance of proceedings.
- Where specified in law. Typical examples include duty to report legislation concerning child protection or (in some jurisdictions) gunshot or stab wounds.
- Where the physician has reason to believe there is an imminent risk of serious bodily harm to an identifiable person or group.
These restrictions do not apply if the information sought is not personal health information. The example given in the CMPA article is a request to confirm whether a signature on a prescription is authentic.
As in most aspects of medical practice, communication is paramount. It is natural to want to co-operate with the police, and registrants are obliged to respectfully explain their unwillingness to release information inappropriately.