MDs question Eastern Health confidentiality order

The health authority at the centre of Newfoundland and Labrador's breast cancer scandal appears to want tighter control over what its doctors can say publicly.

CBC News has obtained a copy of a new confidentiality agreement that Eastern Health distributed to its staff this month. It forbids physicians, nurses and other staff from discussing the "business" of the authority, even after they have stopped working there.

The request comes in the midst of a judicial inquiry about flawed lab-test results given to hundreds of breast cancer patients, with some wrongfully steered from potentially life-saving treatment.

The inquiry's opening weeks of testimony have included numerous references to the secretive response some Eastern Health officials had to the testing errors.

Robert Ritter, executive director of the Newfoundland and Labrador Medical Association, said physicians will support the five-page document's call to protect patient privacy, but may be troubled by other elements.

"There are some references in it that relate to organization and operations, and that we're not sure belongs in this particular kind of agreement," Ritter said.

The NLMA is sending the document to a lawyer for review.

Ritter said the demands stick out in light of what has emerged at the Cameron inquiry. Just last week, the inquiry spent two days at a symposium that largely focused on transparency and public disclosure of medical errors.

"I don't want to prejudge, but on the face of it, it does seem to run against the general philosophy of what we've been talking about the last few days," Ritter said.

No intention to muzzle doctors: Eastern Health

Dr. John Guy, Eastern Health's director of medical services, said Monday the authority has never wanted to put a gag order on its staff.

"In no way was this document or the pledge of confidentiality, for want of a better word, in there to muzzle individuals from being patient advocates. Absolutely not," said Guy, who added Eastern Health with listen to what physicians have to say.

"We certainly would be quite prepared to change the policy if indeed there are changes to be made. So it is an evolutionary process," he said. "Nothing is carved in stone."

Guy said the "business" phrasing refers to things such as finances, tendering and contracts, and does not relate to patient care.

Guy said the confidentiality agreement — which replaces existing policies from hospital, nursing home and community health boards that were merged into Eastern Health in 2005 — is similar to policies adopted by regional authorities across the country.

Whistleblowers may not be protected: prof

The new privacy policy does allow for what it calls reasonable limits, such as the duty of doctors or staff to warn about problems.

But Geoffrey Reaume, a professor of health history and ethics at York University in Toronto, said it still leaves a grey area that he worries could restrict legitimate whistleblowers.

"It would be unethical to prevent a health-care worker [from] speaking out. They should be allowed to do so if they felt certain practices or treatment were not in the interest of their patient," he told CBC News.

Justice Margaret Cameron began hearing evidence in March on what went wrong with hormone receptor testing between 1997 and 2005. The tests are used to help determine the best course of treatment for breast cancer patients.

The erroneous test results meant some patients were wrongfully excluded from being considered for antihormonal therapy like Tamoxifen, which has been clinically proven to improve a patient's odds of survival.

The inquiry continues Monday, with Louise Jones, Eastern Health's acting chief executive officer, scheduled to testify.