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Health Care Users and Professionals
Jocelyne is feeling pretty confused - she didn’t think her life insurance questionnaire would be so detailed! Jocelyne has a good idea of her medical history, but she does not necessarily remember all the treatments and illnesses that might be important to her insurer. She would like to consult her medical file to have a clear conscience. She wonders if it is possible to do so and what to do if the clinic where she usually goes refuses to let her see her file.
In this Infosheet, Éducaloi attempts to answer the main concerns about access to medical records and the options available in case of a misunderstanding.
No. In principle, only you, as well as the professionals and staff members who treat you, have access to your medical file. Other people can have access to your file if the law allows, or if you have given them your permission.
For example, the law allows the heirs of a deceased person to have access to the medical records if it is necessary for them to be able to exercise their rights. A life insurance or disability insurance policy could also include an authorization of this kind for the insurer. Also, if you file a lawsuit in which your claim is related to your physical or mental health, the other party can request access to relevant information contained in your medical records.
A reasonable fee may be charged if you wish to copy all or part of your record.
You need to address your request to the person in charge of access to the records at the hospital. This person’s name and phone number can be obtained by calling the hospital directly, or by contacting the Commission d'accès à l'information or Communication-Québec. The hospital must reply to your request as soon as possible.
The hospital or the clinic can refuse you access to your file in specific situations provided by law. This might be the case when the doctor worries that access to the information may have serious effects on your mental or physical health.
It is also possible to refuse to send you information from your file that has been provided by a person other than a health professional, if it could be used to identify that person. If the person in question consents in writing, the information can be given to you.
If a private clinic fails to reply to your request within thirty (30) days from when it receives your request, or refuses access to your records, you can fill out a request for review of the grievance with the Commission d’accès à l’information. The Commission will then decide if the clinic was right to refuse you access. If not, the Commission can force the clinic to give you access. You must submit your request to the Commission within thirty (30) days of the clinic's refusal to grant you access or of the expiration of the period within which they had to reply, whichever comes first. For example, if the clinic received your written request on the 1st of May, it will have until the 31st of May to answer you. If the clinic does not answer your request, you have thirty (30) days from the 31st of May to submit your complaint to the Commission. On the other hand, if the clinic tells you on the 4th of May that it does not plan to give you access to your file, then from the date of that refusal you will have thirty (30) days to make a request for review of the grievance.
If the hospital does not respond quickly (by law it should be as soon as possible), or if you are refused access to your file, there are many options open to you. You can:
A request to the Commission d'accès à l'information must be made in writing. Contact the Commission without delay to obtain the appropriate form by mail, or download it from the Commission website. The Commission d'accès à l'information does not require a fee for filing such a request.
A request to the Administrative Tribunal of Quebec must be made by way of a motion. You can contact the Administrative Tribunal of Quebec or the clerk of the Court of Quebec, Small Claims Division to obtain a “motion to institute a proceeding” form. You can also download the form from the website of the Tribunal. The Administrative Tribunal of Quebec charges no fee for filing the motion, and the staff of the Tribunal can even help you complete the motion. If you prefer to go before a judge of the Superior Court or the Court of Quebec, you also have to file a motion. The fees and the steps to follow are the same as for an ordinary legal proceeding. For more information, consult Côtécour.
First, you must send a written request to the hospital or clinic outlining the desired corrections or additions. A hospital has thirty (30) days from receiving your request to respond, while a clinic has twenty (20) days. If they refuse to make the corrections or if they do not answer you within the time limit, you can contact the Commission d’accès à l’information.
Under certain very specific circumstances, your employer can gain access to some of your medical information. For example, if you are absent from work for a period of time due to illness, your employer may ask for a medical report justifying your absence. However, only the person in charge of personnel (e.g.: the personnel director) is allowed access to this information.
Also, your employer can ask you to undergo a medical examination if he has reasonable grounds to believe that you are physically incapable of performing the duties required by the job. He would then have access to the report on that medical examination. On the other hand, an employer cannot require you to provide a copy of your medical record during the hiring stage. He can only ask questions regarding your physical ability to perform the tasks required by the job.
During your lifetime, if you are 18 years of age or older, your family cannot, in principle, have access to your medical records without your consent.
However, if you are incapacitated (you become unable to take care of yourself and your property) the person you designated in a mandate in case of incapacity, your tutor, or your curator can have access to your record. In the situation of a mandate in case of incapacity, the mandate must be homologated or the mandatary must promise under oath that he intends to seek homologation. After your death, your heirs, legatees, and legal representatives have the right to receive correspondence and information contained in your file if this is necessary to enable them to exercise their rights. The same is true for the beneficiary of your life insurance policy or your retirement plan. The spouse, parents, grandparents, children, and grandchildren of a deceased person also have a right of access to information about the cause of death, unless the deceased included a written refusal to let them have this right in her file. The refusal is ignored when a blood relative of the deceased needs to verify the existence of a genetic illness or another condition that travels in families.
In principle, only people 14 years of age or older have independent access to their medical record. A person under 14 can still have access to the file through a lawyer during a legal proceeding.
In theory, parents also have access to their child's medical record if the child is under 18 years old. However, the hospital or clinic is still not allowed to send the contents of the medical record of a child 14 years of age and older if the child refuses after being consulted. For the refusal to be respected, the doctor also has to conclude that sending the file to the parent could harm the minor’s health. If the doctor decides that sharing the information does not endanger the health of the minor, the parent can have access to the file despite the adolescent’s refusal. When a child under 14 years old is involved in a measure under the Youth Protection Act, the establishment consults with the Director of Youth Protection and refuses to allow the parents to access the file if it believes that this could harm the minor’s health.
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