Can a health service provider refuse to give a patient access to their medical record on the basis that it would pose a threat to someone’s life or health?
Generally, health service providers are required to give a patient access to their health information. However, in some situations, health service providers may refuse to give access (see National Privacy Principles 6).
For example, access can be denied when letting a patient see their records would pose a serious threat to the patient's life or health, or the life or health of someone else (such as a relative, the health service provider, staff or other patients).
The threat must be significant, for example where there is a serious risk the patient may cause self-harm or harm to another person if they saw the information.
The threat can be to physical or mental health, but does not need to be imminent - it can be a serious threat that would occur some time after access is granted.
In some places (such as Victoria and the ACT), state laws may actually require a health service provider to deny access if there is a serious threat to life or health.
What if giving access would threaten the relationship between patient and provider?
A health service provider can't deny a patient access to their records just because giving access might lead the patient to end the therapeutic relationship with that provider.
The key consideration for the provider is what are the likely consequences of the therapeutic relationship breaking down? If there is a reasonable basis for believing that the patient may stop getting critically important treatment altogether, then this may constitute a serious risk to the patient's life or health and access may be denied.
However, if the provider thinks that the patient may simply be upset or confused by the information, or might even change doctors, then this wouldn't be grounds to deny access, as there would generally be no serious risk of harm.
Can an intermediary be used to arrange access?
If access is denied, then the health service provider must still consider if it is reasonable to use an intermediary (such as a relative, friend or another provider) to help give the patient some form of access to their information. The patient and provider have to agree on who the intermediary should be.
If a patient believes they have been unfairly denied access to their medical record, they can make a complaint http://www.privacy.gov.au/complaints/#complaint.
- Can I get access to my medical records?
- How should a request for access to medical records be made?
- Is a document in a patient's record accessible by them, if it has been written by a health professional from outside your organisation and it includes a statement that it was provided to you 'in confidence'?