When determining the primary purpose for which information was collected, health service providers should recognise that some individuals want to use health services in particular and limited ways. For example, an individual who goes to a sexual health centre seeking assistance in relation only to specific sexual health may have high expectations of privacy and confidentiality.
A patient’s reasonable expectations are what an ordinary person would expect to happen to the health information, in alignment with general community expectations of the way information flows through the health system. Reasonable expectation is particular to the circumstances, including what is discussed with the patient, the health service’s Privacy Notice and the patient’s reaction when told the way their health information will be handled.
Expectation is more than awareness – telling someone generally about proposed secondary uses or disclosures may not necessarily create a reasonable expectation. A healthcare service provider should consider the patient they are working with, what their understanding is and is likely to be and, therefore, what they may reasonably expect in the particular context. An individual’s negative reaction when made aware of a proposed secondary use or disclosure of their personal information would ordinarily indicate that they would not reasonably expect that this use or disclosure occur.
According to the Office of the Australian Information Commissioner’s resource: Disclosing information about patients with impaired capacity, disclosure of health information to a responsible person is also allowed in the following circumstances:
- The person is physically or legally incapable of consent.
- The disclosure is necessary to provide appropriate care or treatment of the individual or for compassionate reasons.
- The disclosure is not contrary to any wish expressed by the individual before he or she became unable to give consent (of which the carer is aware or could reasonably be expected to be aware).
- The disclosure is limited to the extent it is reasonable and necessary to provide appropriate care or treatment of the individual, or to fulfil the purpose of making a disclosure for compassionate reasons.
