Canada: Can Paramedics Learn About Their Patient's Diagnosis? The Law On Patient Disclosures And Paramedics

Last Updated: December 23 2016
Article by John Schuman

The relationship paramedics have with patients is only supposed to last one day. Every day, paramedics are exposed to first time patients suffering new challenges under different conditions. As time progresses and paramedics are exposed to more and more patients, paramedics begin to see trends in the similar problems them and become better able to alleviate their patient's needs. The thinking is, once a paramedic has seen a problem once, they are better able to identify that problem when they see it again.

As a paramedic's relationship with their patients ends as soon as the patient leaves their care, the paramedics cannot follow up on the wellbeing of their patients. The consequence is that paramedics often never know what their patients are suffering from. If paramedics are supposed to benefit from repeat exposure to different problems so they can learn from the experience, there is a huge deficiency if paramedics are often left in the dark as to what the patient are actually experiencing.

If paramedics learn the details on what their patient's are really experiencing, they would have a better understanding of what that condition looks like enabling them to better diagnose those problems going forward. The issue is, how can they get this information disclosed to them.

Medical records are an intensely private, and personal set of documents. Medical professionals are only capable of sharing personal health details under a very limited set of circumstances, or with those the patient consents to sharing the information with. The limits on who and when medical professionals can disclose patient's health concerns with is set out in the Personal Health Information Protection Act1.

Section 37(1) of the PHIPA says that a health information custodians may disclose personal health information about patients for the purpose of education.

The College of Nurses of Ontario issues a Practice Standard called the Confidentially and Privacy – Personal Health Information2 which addresses these concerns. In it, it says of the PHIPA:

"PHIPA permits the sharing of personal health information among health care team members to facilitate efficient and effective care. The health care team includes all those providing care to the client, regardless of whether they are employed by the same organization.".

Despite this, paramedics are still not able to access medical records for educational purposes.

In Bluewater Health v. Ontario Nurses' Assn.3, the arbitrator ruled that just because a health care worker was previously involved in a file and her hospital was still dealing with the patient, she lost the right and ability to learn about the patient's health care records as soon as she stopped working with the patient, even if it was educational to her.

In the same case, the arbitrator ruled that individuals can only access personal health information for the purpose of education if the hospital gives them explicit permission to do so.

In Ontario Nurses' Association v Norfolk General Hospital4, the court determined that: "The circle of care does not include:

  • A physician who is not part of the direct or follow-up treatment of an individual;"

In North Bay Health Centre v Ontario Nurses' Ass'n. (McLellan Grievance)5, Arbtirator Abramsky stated:

"40 Further, if accepted, the Association's argument that all "health care practitioners" are health information custodians entitled to rely on Section 37(1) would undermine the goals and purposes of the legislation. If a nurse (or any health care practitioner – and there are many health care practitioners at a hospital) is a health information custodian and may freely access patient health information for personal educational purposes, the privacy of patient health records could be significantly undermined. The Act does allow for the use of health information for "educating agents to provide health care" but it must be done by the health information custodian, not by an agent for his or her own purposes."

PHIPA states in regards to agents in section 37(2) agents can only access health care information for educational purposes if its on behalf of the heath care custodian. This would indicate that paramedics are not able to learn about health care records for educational purposes, as they are not being educated for the goal of implementing the custodians service. As paramedics do not work for hospitals, they cannot be seen as their agents.

Under the provisions of the PHIPA paramedics are only able to learn about their patient's diagnoses if they receive consent from their patients to do so. The Act provides the following requirements for consent:

Elements of consent

  1. (1) If this Act or any other Act requires the consent of an individual for the collection, use or disclosure of personal health information by a health information custodian, the consent,

    1. must be a consent of the individual;
    2. must be knowledgeable;
    3. must relate to the information; and
    4. must not be obtained through deception or coercion.

The Act goes on to further state that if the disclosure is not for the specific purpose of providing another health care worker assistance in providing care, then the consent given must be explicit. Based on this, it seems clear that if paramedics want to learn about the diagnosis of their patients, they must receive express consent from their patients. The act does not make clear what classifies as express consent, but the most obvious form of consent would be the patient writing a note, providing clear evidence of their explicit consent.

This is problematic and is unlikely to assist paramedics in obtaining the knowledge they require. When a patient is with a paramedic, things are hectic and the patient often is in great distress. The last thing a patient wans to think about, if it is even possible, is to sign a form allowing their medical information to be disclosed.

It would be very helpful for paramedics to learn about their patient's diagnosis, but under the current framework of the PHIPA, paramedics are prohibited from learning this valuable information.




[3] Bluewater Health v. Ontario Nurses' Assn. (Hardy Grievance) [2010] OLAA No. 660

[4] Ontario Nurses' Association v Norfolk General Hospital, 2015 CanLII 62332

[5] North Bay Health Centre v Ontario Nurses' Ass'n. (McLellan Grievance) [2012] O.L.A.A. No. 11, 216 L.A.C. (4th)

The content of this article is intended to provide a general guide to the subject matter. Specialist advice should be sought about your specific circumstances.

To print this article, all you need is to be registered on

Click to Login as an existing user or Register so you can print this article.

In association with
Up-coming Events Search
Font Size:
Mondaq on Twitter
Register for Access and our Free Biweekly Alert for
This service is completely free. Access 250,000 archived articles from 100+ countries and get a personalised email twice a week covering developments (and yes, our lawyers like to think you’ve read our Disclaimer).
Email Address
Company Name
Confirm Password
Mondaq Topics -- Select your Interests
 Law Performance
 Law Practice
 Media & IT
 Real Estate
 Wealth Mgt
Asia Pacific
European Union
Latin America
Middle East
United States
Worldwide Updates
Check to state you have read and
agree to our Terms and Conditions

Terms & Conditions and Privacy Statement (the Website) is owned and managed by Mondaq Ltd and as a user you are granted a non-exclusive, revocable license to access the Website under its terms and conditions of use. Your use of the Website constitutes your agreement to the following terms and conditions of use. Mondaq Ltd may terminate your use of the Website if you are in breach of these terms and conditions or if Mondaq Ltd decides to terminate your license of use for whatever reason.

Use of

You may use the Website but are required to register as a user if you wish to read the full text of the content and articles available (the Content). You may not modify, publish, transmit, transfer or sell, reproduce, create derivative works from, distribute, perform, link, display, or in any way exploit any of the Content, in whole or in part, except as expressly permitted in these terms & conditions or with the prior written consent of Mondaq Ltd. You may not use electronic or other means to extract details or information about’s content, users or contributors in order to offer them any services or products which compete directly or indirectly with Mondaq Ltd’s services and products.


Mondaq Ltd and/or its respective suppliers make no representations about the suitability of the information contained in the documents and related graphics published on this server for any purpose. All such documents and related graphics are provided "as is" without warranty of any kind. Mondaq Ltd and/or its respective suppliers hereby disclaim all warranties and conditions with regard to this information, including all implied warranties and conditions of merchantability, fitness for a particular purpose, title and non-infringement. In no event shall Mondaq Ltd and/or its respective suppliers be liable for any special, indirect or consequential damages or any damages whatsoever resulting from loss of use, data or profits, whether in an action of contract, negligence or other tortious action, arising out of or in connection with the use or performance of information available from this server.

The documents and related graphics published on this server could include technical inaccuracies or typographical errors. Changes are periodically added to the information herein. Mondaq Ltd and/or its respective suppliers may make improvements and/or changes in the product(s) and/or the program(s) described herein at any time.


Mondaq Ltd requires you to register and provide information that personally identifies you, including what sort of information you are interested in, for three primary purposes:

  • To allow you to personalize the Mondaq websites you are visiting.
  • To enable features such as password reminder, newsletter alerts, email a colleague, and linking from Mondaq (and its affiliate sites) to your website.
  • To produce demographic feedback for our information providers who provide information free for your use.

Mondaq (and its affiliate sites) do not sell or provide your details to third parties other than information providers. The reason we provide our information providers with this information is so that they can measure the response their articles are receiving and provide you with information about their products and services.

If you do not want us to provide your name and email address you may opt out by clicking here .

If you do not wish to receive any future announcements of products and services offered by Mondaq by clicking here .

Information Collection and Use

We require site users to register with Mondaq (and its affiliate sites) to view the free information on the site. We also collect information from our users at several different points on the websites: this is so that we can customise the sites according to individual usage, provide 'session-aware' functionality, and ensure that content is acquired and developed appropriately. This gives us an overall picture of our user profiles, which in turn shows to our Editorial Contributors the type of person they are reaching by posting articles on Mondaq (and its affiliate sites) – meaning more free content for registered users.

We are only able to provide the material on the Mondaq (and its affiliate sites) site free to site visitors because we can pass on information about the pages that users are viewing and the personal information users provide to us (e.g. email addresses) to reputable contributing firms such as law firms who author those pages. We do not sell or rent information to anyone else other than the authors of those pages, who may change from time to time. Should you wish us not to disclose your details to any of these parties, please tick the box above or tick the box marked "Opt out of Registration Information Disclosure" on the Your Profile page. We and our author organisations may only contact you via email or other means if you allow us to do so. Users can opt out of contact when they register on the site, or send an email to with “no disclosure” in the subject heading

Mondaq News Alerts

In order to receive Mondaq News Alerts, users have to complete a separate registration form. This is a personalised service where users choose regions and topics of interest and we send it only to those users who have requested it. Users can stop receiving these Alerts by going to the Mondaq News Alerts page and deselecting all interest areas. In the same way users can amend their personal preferences to add or remove subject areas.


A cookie is a small text file written to a user’s hard drive that contains an identifying user number. The cookies do not contain any personal information about users. We use the cookie so users do not have to log in every time they use the service and the cookie will automatically expire if you do not visit the Mondaq website (or its affiliate sites) for 12 months. We also use the cookie to personalise a user's experience of the site (for example to show information specific to a user's region). As the Mondaq sites are fully personalised and cookies are essential to its core technology the site will function unpredictably with browsers that do not support cookies - or where cookies are disabled (in these circumstances we advise you to attempt to locate the information you require elsewhere on the web). However if you are concerned about the presence of a Mondaq cookie on your machine you can also choose to expire the cookie immediately (remove it) by selecting the 'Log Off' menu option as the last thing you do when you use the site.

Some of our business partners may use cookies on our site (for example, advertisers). However, we have no access to or control over these cookies and we are not aware of any at present that do so.

Log Files

We use IP addresses to analyse trends, administer the site, track movement, and gather broad demographic information for aggregate use. IP addresses are not linked to personally identifiable information.


This web site contains links to other sites. Please be aware that Mondaq (or its affiliate sites) are not responsible for the privacy practices of such other sites. We encourage our users to be aware when they leave our site and to read the privacy statements of these third party sites. This privacy statement applies solely to information collected by this Web site.

Surveys & Contests

From time-to-time our site requests information from users via surveys or contests. Participation in these surveys or contests is completely voluntary and the user therefore has a choice whether or not to disclose any information requested. Information requested may include contact information (such as name and delivery address), and demographic information (such as postcode, age level). Contact information will be used to notify the winners and award prizes. Survey information will be used for purposes of monitoring or improving the functionality of the site.


If a user elects to use our referral service for informing a friend about our site, we ask them for the friend’s name and email address. Mondaq stores this information and may contact the friend to invite them to register with Mondaq, but they will not be contacted more than once. The friend may contact Mondaq to request the removal of this information from our database.


This website takes every reasonable precaution to protect our users’ information. When users submit sensitive information via the website, your information is protected using firewalls and other security technology. If you have any questions about the security at our website, you can send an email to

Correcting/Updating Personal Information

If a user’s personally identifiable information changes (such as postcode), or if a user no longer desires our service, we will endeavour to provide a way to correct, update or remove that user’s personal data provided to us. This can usually be done at the “Your Profile” page or by sending an email to

Notification of Changes

If we decide to change our Terms & Conditions or Privacy Policy, we will post those changes on our site so our users are always aware of what information we collect, how we use it, and under what circumstances, if any, we disclose it. If at any point we decide to use personally identifiable information in a manner different from that stated at the time it was collected, we will notify users by way of an email. Users will have a choice as to whether or not we use their information in this different manner. We will use information in accordance with the privacy policy under which the information was collected.

How to contact Mondaq

You can contact us with comments or queries at

If for some reason you believe Mondaq Ltd. has not adhered to these principles, please notify us by e-mail at and we will use commercially reasonable efforts to determine and correct the problem promptly.