Rights and Responsibilities
Legal and ethical framework
In Quebec, it is possible to provide health care, or to pursue training in this field, while being a blood-borne infection carrier (HIV, HBV, or HCV), on the condition that the caregiver be assessed by the SERTIH and that, following an assessment by an independent committee, he/she follows the recommendations approved by his/her professional order or educational institution.
Several organizations are responsible for protecting the public in terms of the practice of caregivers whose health may constitute a risk. This responsibility lies first of all with professionals themselves. Their code of ethics indicates that they must not practice under conditions or in situations likely to impair the quality of their acts.
Furthermore, the Professional Code and the Act Respecting Health Services and Social Services attribute responsibilities for controlling the quality of the practice of caregivers to various bodies (professional orders, directors of professional services, directors of nursing care, council of physicians, etc.). The Act Respecting Health Services and Social Services establishes an organizational structure of resources designed to “ensure users the safe provision of health services and social services” (section 2). This law also creates the obligation to report any incident or accident as soon as possible after becoming aware of it (section 233.1).
Finally, section 54 of the Professional Code states that: “Every professional must refrain from practicing his profession or performing certain professional acts to the extent that his state of health is an obstacle thereto.” The SERTIH complements these mechanisms for protecting the public.
Confidentiality and protection of privacy
All information of confidential nature (in particular personal information of medical nature) collected by the SERTIH is kept in a file locked within the premises of the Institut national de santé publique du Québec (INSPQ). The Act Respecting the Institut national de santé publique du Québec protects the confidentiality of this file in the same manner as the Act Respecting Health Services and Social Services protects the confidentiality of user files. Lastly, provisions are made to ensure the security of computer records. Each caregiver is given a reference number. Access to information of a nominative nature within the INSPQ is restricted exclusively to individuals so authorized within the SERTIH.
Everyone at the INSPQ with access to confidential information must take an oath not to disclose or communicate the information unless duly authorized to do so.
Members of assessment committees are not informed of the identity of the caregiver involved.
Beyond the INSPQ, only individuals with the responsibility of implementing the recommendations issued by the SERTIH (in professional orders, educational institutions, public health branches, or health care institutions) will have access to nominative information. Access is restricted solely to the information required by these individuals to carry out their respective mandates.
Voluntary participation and right to withdraw
The caregiver’s participation is voluntary. He or she is free to withdraw from the process at any time.
Caregivers must be aware of their responsibilities regarding the risks of transmitting their infections to their patients in the context of their practices or training. They must also respect their codes of ethics which indicate if they must refrain from practicing under conditions or in situations likely to impair the quality of their acts.
If the SERTIH, the assessment committee or the caregiver’s attending physician sense a threat to public health, even if the caregiver withdrew from the process, the situation will be reported to public health authorities who will make a decision regarding the appropriate measures to be taken.