1 Feb 2003, 09:00

A seaman injured his finger on board ship. The captain sent him to a doctor who stitched the finger and certified the seaman unfit for work for 10 days. Later that day, the shipping line manager contacted the doctor to see if the seaman could undertake watch duties. The doctor agreed he was fit for light duties. The seaman complained to me about the doctor discussing the injury with the manager without his permission.

Rule 11(2)(a)

I investigated the complaint as a possible breach of rule 11 of the Health Information Privacy Code 1994. This rule limits the disclosure of health information, subject to certain exceptions.

One exception (rule 11(2)(a)) covers situations where a health agency believes, on reasonable grounds, that it is not desirable or practicable to obtain the individual's authorisation and the disclosure is for a purpose directly related to one of the purposes for which the information was obtained. The disclosure must be only to the extent necessary (rule 11(3)).

I accepted the doctor's argument that the disclosure was for a purpose directly related to providing treatment and, moreover, that it was only to the extent necessary. However, in my view it would have been both practicable and desirable for the doctor to obtain the seaman's authorisation before disclosing his health information to the manager. I found a breach of rule 11.

Had the doctor contacted the seaman and explained to him that he was changing his diagnosis from 'unfit to work for a period of 10 days' to 'fit for light duties,' then the seaman would have had an opportunity to question the doctor about the change in diagnosis and to have obtained a second medical opinion if he wished.

I looked at the practicality of obtaining the seaman's authorisation. The ship was in port at the time. Even if he was unaware of the seaman's contact details, the doctor could have contacted the ship's master and requested the seaman to contact the doctor.

I considered whether the seaman suffered some form of adverse consequence as a result of the breach of rule 11 (section 66).

Harm

The seaman said that he had to remain at sea while suffering trauma from the injury. He told me that he had constant throbbing and pain, and that he found it difficult to move around the ship and carry out light tasks such as showering. The seaman thought that the doctor's recommendation of 'fit for light duties' should not have been made without discussing the matter with him first. I accepted that this would have given him an opportunity to persuade the doctor that he could not be adequately protected aboard ship.

The injury to the seaman's hand would cause discomfort, but I was not persuaded that the harm he described was caused by the doctor's disclosure. To my mind, there was no causal link between the doctor disclosing that the seaman was able to perform light duties, and the nature of the seaman's injury. Rather, I believed the adverse consequences he complained of were as a result of his physical injury.

I thought that the requirements of section 66 had not been met and that there was no interference with the seaman's privacy. I advised the seaman of his right to take the matter to the Human Rights Review Tribunal and closed the file.

April 2003

Indexing terms: Disclosure of personal information - Health agency - Doctor discussed diagnosis with employer without patient's authorisation - Practical and desirable to obtain authorisation - No causal link between breach and harm - Health Information Privacy Code 1994, rule 11(2)