When is a person legally required to tell other people about his or her hepatitis C infection? | CATIE - Canada's source for HIV and hepatitis C information

Hepatitis C: An In-Depth Guide

When is a person legally required to tell other people about his or her hepatitis C infection?

This FAQ answers some questions you may have about privacy, hepatitis C infection and the law. As a general rule, people have a right to keep their health information private, including information about their hepatitis C virus (HCV) infection or disease. As a general rule, people have a right to keep their health information private, including information about their hepatitis C virus infection or disease.Generally, they do not have to disclose health information to other people unless they choose to do so.

Also, healthcare professionals and staff cannot tell other people about someone’s health information unless they are given permission (known as “consent”) to disclose the information.

But there are exceptions to these general rules, such as situations where there may be a legal duty for a person to disclose his or her HCV infection, or where someone else may have the legal power to disclose such information.

Read the entire FAQ below, or click on a link to skip to a specific situation:

a) Public Health:

Hepatitis C is a reportable disease. This means that when a person is diagnosed with HCV his or her name (and likely other information) is given to local, provincial or territorial Public Health. Public Health officials have a responsibility to monitor cases of infectious diseases, including hepatitis C. Public health laws require certain health professionals (and sometimes labs and other people) to report cases of HCV infection to Public Health.

Public Health may keep a record or database of people who have been infected with infectious diseases such as hepatitis C. The database may include each person’s name, date of birth, gender, infection(s) and contact information. The type of information that gets reported to Public Health and stored in a database depends on the law and practice in that region. There are rules in place to protect the privacy of personal information stored by Public Health. For the rules in your region, contact your local Public Health office.

b) At home:

The hepatitis C virus is not transmitted by casual contact, such as sharing dishes, shaking hands and hugging. But blood and items that come in contact with blood may be infectious to other people. So it is important to be careful around blood and to avoid exposing other people to infected blood. As long as a person follows proper precautions there is really no risk of passing on HCV to the people he or she lives with, so there is no legal duty to disclose his or her hepatitis C infection to them. (See below for information about “Sharing drugs and drug equipment” and “Having sex.”)

c) At work:

Because HCV is not transmitted through casual day-to-day contact, employees do not have to disclose to employers or unions that they have hepatitis C. Employers cannot ask about a hepatitis C infection during the application or interview process.

Hepatitis C infection is considered a “disability” under antidiscrimination law in Canada. It is illegal for an employer or union to harass or discriminate against a person because of a “disability,” even if the only thing that limits the person’s ability to do the job is prejudice or stereotypes about the disability.

Employers and unions cannot fire or treat a person negatively because he or she is infected with HCV or needs some time off because of symptoms of hepatitis C or side effects of hepatitis C treatment. If a person is sick because of the virus or medications used to treat HCV, the employer or union may need to make “accommodations” so that the employee can continue to do the essential duties of the job. For example, this may mean working out a different work schedule or shifting some job duties to other employees. The employee will have to ask the employer (and union) to accommodate his or her disability but does not have to tell them that he or she has hepatitis C.

For more information about hepatitis C and work, see the pamphlet “Hepatitis C in the Workplace.”

d) Accessing healthcare:

People can choose whether or not to tell healthcare providers about their HCV infection. People with hepatitis C do not have a legal duty to tell them. However, people are encouraged to think about the benefits of disclosing to healthcare staff.

For example, it may be important for the healthcare provider to know about the hepatitis C infection in order to provide high-quality healthcare that will take into account the existing liver disease. If hepatitis C is not disclosed to a healthcare provider and the treatment provided causes harm because of the hepatitis C, it will be more difficult to hold the healthcare provider responsible for making a mistake.

It is not legal to refuse to provide services to people because of a “disability” and this can include healthcare services. For example, doctors should not discriminate against a person, refuse them as a patient or end the healthcare provider-patient relationship because of a “disability.” However, a healthcare provider may not have the skills or knowledge to treat a patient effectively, so they may refer that patient to another care provider and must clearly communicate the reasons to the patient.

If you believe that a medical professional has discriminated against you, there are at least three places you can find information on your options and rights. You can seek legal advice from a lawyer, contact the human rights commission or tribunal in your province or territory, or contact the provincial or territorial college (the governing and licensing agency) of the professional in question. You can find more information at the Canadian Human Rights Commission.

e) Insurance:

 An insurance policy is a contract. When you apply for various types of insurance coverage (including health insurance) you may be asked to provide personal health information so that the insurance company can determine whether you are eligible for insurance and how much it will cost to get insurance. If you do not answer questions truthfully—for example, if a person does not report the he or she has the hepatitis C virus—and the insurance company finds out, the insurance policy will be void and the insurance company may claim that fraud was committed. Not all insurance policies require that you provide medical information in order to become insured. Policies that insure large groups of people, like insurance benefits that come with a job, often do not require this type of information.

f) Having sex:

Under Canadian criminal law, a person with a sexually transmitted infection has a legal duty to tell his or her partner about that infection before they have sex if the sex will involve a significant risk of serious bodily harm. It is unclear whether people infected with the hepatitis C virus have a legal duty to disclose to their sex partners before sex. However, until the courts figure this out, disclosure beforehand may be the safest way to avoid prosecution. As far as we know, there has only been one criminal prosecution in Canada involving hepatitis C. The accused person was acquitted because the judge decided that the evidence did not prove there was a significant risk of hepatitis C virus transmission during oral sex or sexual intercourse. However, until the courts figure this out, disclosure beforehand may be the safest way to avoid prosecution.

Under public health law in some provinces and territories, people have a legal obligation to not pass on infections like HCV—in other words, to protect sex partners from becoming infected through sex. That is why Public Health (or physicians and nurses working in cooperation with Public Health) often counsel people living with hepatitis C to disclose their HCV infection to sex partners and to practice safer sex, including using condoms for intercourse.

For more information on the sexual transmission of hepatitis C, see Safer Sex.

g) Sharing drugs and drug equipment:

The criminal law in Canada is not clear about whether a person has a duty to disclose his or her hepatitis C virus infection when sharing drugs and drug equipment. As far as we know, there has not been a case where a person with hepatitis C virus has been criminally charged for exposing someone to the virus by sharing drugs or drug equipment.

There is a high risk of transmitting HCV when an infected person shares equipment used to inject drugs (e.g., needles, filters, cookers). There is also a risk—a lower risk—of transmitting HCV when a person with hepatitis C shares drug smoking and drug snorting equipment. (See the Staying Safe section for more information on risk.) Because of these risks of transmission, it is possible that people have a legal obligation to tell people about their hepatitis C before they share drug equipment or to use harm reduction measures to reduce the risk of HCV transmission to drug sharing partners. But because there has never been a case about this, the criminal law is not clear about it.

Because of these risks of transmission, it is possible that people have a legal obligation to tell people about their hepatitis C before they share drug equipment or to use harm reduction measures to reduce the risk of HCV transmission to drug sharing partners. But because there has never been a case about this, the criminal law is not clear about it.

Under public health law in some provinces and territories, people have a legal obligation to not pass on infections such as HCV—in other words, to protect drug-sharing partners from becoming infected. That is why Public Health (or physicians and nurses working in cooperation with Public Health) often counsel people living with hepatitis C to avoid sharing drug use equipment. And many public health departments and community agencies provide access to harm reduction supplies, such as sterile needles and clean mouthpieces for crack pipes.

h) Exposure by accident or during a crime:

Five Canadian provinces have laws that can be used to force a person to get tested for hepatitis C after his or her blood or other bodily substance comes into contact with another person. The provinces are Alberta, Manitoba, Nova Scotia, Ontario and Saskatchewan. These laws say that a person can only be forced to take a blood test if a judge or medical officer of health orders the person to be tested. Before a judge or medical officer can make an order, he or she must be satisfied that there was a real risk of HCV transmission. Only certain people can apply for an order forcing someone to get tested—police, EMS workers, firefighters, other people who provide assistance during an accident or emergency, and victims of crime. These laws also apply to other infections transmitted by blood and other bodily substances, including hepatitis B and HIV.

Disclaimer / For more information and advice:

This FAQ is designed to provide you with basic information about HCV disclosure and the law. The difference between legal information and legal advice is important. Legal information can help you understand the law and legal options, but it is basic and general. Legal advice is specifically about your situation and can help you to decide what to do. If you want legal advice you should talk to a lawyer. The information in this FAQ was written in January 2011. But the law can change at any time, so contact a lawyer if you have a question.

If you want help finding a lawyer, you can call our toll-free telephone line at 1-800-263-1638 or email us at questions@catie.ca (but remember, email is not private or confidential).

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