The issue of confidentiality and professional secrecy
Definition of professional secrecy
Professional secrecy is the obligation imposed on professionals to keep information confidential that is obtained from a client when practising their profession.
“What the intervention workers need is to be more aware of what is going on. Of course, there are limitations with respect to confidentiality that must be respected, so we really try to either put training in place or put together case studies that the intervention workers can work on collectively.”
— Community stakeholder
Who must respect professional secrecy?
Respecting professional secrecy is an obligation for all people who are part of a professional association regulated by the Government of Quebec’s Professional Code.
Professional secrecy deepens the feeling of trust that the client has towards the professional person.
What type of information is protected by professional secrecy?
- Information is entrusted to the professional within the context of the professional’s role.
- Thus, according to Section 9 of the Charter of Human Rights and Freedoms, “No person bound to professional secrecy by law […] may […] disclose confidential information revealed to them by reason of their position or profession, unless they are authorized to do so by the person who confided such information to them, or by an express provision of law.” (Charter of human rights and freedoms, 1975 c. 6, a. 9).
Professional secrecy does NOT apply when
The professional deems that the information obtained could prevent an act of violence (death or serious bodily harm). In this case, the professional can disclose this information to provide assistance to the person or persons in danger;
A person discloses the intent to commit a crime;
If the development or safety of a child is threatened, the professional must notify the Director of Youth Protection;
The person who is confiding information voluntarily surrenders the protection of professional secrecy.
“Naturally, there is a relationship of trust with the youth and also a relationship of trust between intervention workers [with respect to sharing confidential information]. It’s so important to have these discussions around the table to get to know each other, but also to find out how we can work together without endangering that relationship.”
— Community stakeholder
Duty to report
In the case of youth, the Youth Protection Act (YPA), under Section 39, makes it mandatory for “Every professional who, by the very nature of their profession, provides care or any other form of assistance to children” to report any situation to the Director of Youth Protection (DYP) that causes them “to believe that the security or development of a child is or may be
considered to be in danger.”(Government of Quebec, 2018b). In October 2017, amendments to the YPA that were passed and assented to, specified that sexual exploitation is a form of sexual abuse and thus, compromises the safety or development of a child.
How to best facilitate the sharing of information without violating professional secrecy?
The dilemma of confidentiality constitutes a significant barrier to putting in place a continuum of services addressing at-risk youth or victims of sexual exploitation. In fact, the legal issues surrounding professional secrecy make it extremely difficult for intervention workers to share confidential information. However, “a professional might have confidential information about a youth which, if shared with the appropriate organizations at the right time, could avoid the continuation of prostitution activities and putting [youth] in danger from a safety or health perspective.”[approximate translation of a text
available in French only from CIUSSS de la Capitale-Nationale, 2018].
Intervention workers are generally reluctant to share confidential information regarding a youth, out of concern that this breach of trust could ruin the relationship they have established, or even end the contact they have with the youth in question. Thus, most intervention workers decide to only share confidential information when the safety, integrity or life of the youth is at risk. According to a survey conducted as part of the Alliances project, some intervention workers refuse to
share confidential information regardless of the situation, even if the youth is in a dangerous situation.
Here are a few potential solutions or courses of action
Allows for the sharing of information between partners through the signing of an agreement and the consent of the youth in question.
Allows for the sharing of certain information within multidisciplinary teams. This practice, implemented in Belgium, allows for the sharing of some information for cases subject to laws under The Youth Criminal Justice Act and the Belgian initiative Aide aux enfants victimes de maltraitance [available in French only, this translates approximately as “Assistance for children who are victims of abuse”].
When a youth’s file is transferred to another organization or another resource, it is recommended that relationships be consolidated in order to promote the development of good relations between the new intervention workers involved with the file and/or the youth. The feelings of trust thus established ensure that the intervention is tailored to meet the needs of the youth.
By being transparent about their intentions to violate confidentiality, the intervention worker leads the youth to question the potential danger they might be facing. By
encouraging the youth to seek help from other resources, the intervention worker does not necessarily have to break confidentiality.
It is essential that an intervention worker maintain a relationship of trust with a youth in a situation of sexual exploitation so that the youth can consult with this resource person if needed.
It is necessary that the limitations and obligations with respect to professional secrecy be understood without using them to justify the absence of collaboration between intervention workers. It is important to note that professional secrecy is put in place to protect the person who is at the centre of the intervention, and not to isolate this person.
- CIUSSS de la Capitale-Nationale. (2018). Manuel du formateur : Prévention et intervention en exploitation sexuelle et prostitution juvénile. Unpublished document. (Only in French)
- Éducaloi. (n.d.). The Duty of Confidentiality of Professionals.Recovered from (link)
- Éducaloi. (n.d.). Exceptions to the Duty of Confidentiality. Recovered from (link)
- Gouvernement du Québec. (2018b). Professional Code. LRQ – c. C-26. Recovered from (PDF)
- National Assembly of Quebec. (1975). Charter of Human Rights and Freedoms. Recovered from (link)
- National Assembly of Québec. (2017). Bill 99 : An Act to amend the Youth Protection Act and other provisions. Recovered from (PDF)