CanMEDS Professional
Mandatory Reporting

Mandatory Reporting


The importance of confidentiality and trust as key elements in the therapeutic relationship between patient and provider have limits and there are circumstances that require us to speak outside of the bounds of confidentiality. " In order to maintain good communication, physicians are encouraged to inform their patients when they are required to make a mandatory report whenever it is prudent to do so."  Failure to report may result in penalties of fines or allegations of professional misconduct.


The CPSO clearly outlines the circumstances under which we are bound to report to government or regulatory bodies:

  • Suspected Child Abuse or Neglect

  • Suspected Elder Abuse or Death in Nursing Homes

  • Health conditions that take it dangerous for an individual to drive. Also fly an airplane, or perform the duties of an air traffic controller. Also operate railway equipment

  • Formal reports related to Occupational Health and Safety. Also related to Merchant Seamen

  • Births, Still-births and Deaths 

  • Certain communicable and reportable diseases, conditions or adverse reactions to immunizations 

  • Health Card Fraud 

  • Correctional Facilities Inmate Reports

  • Controlled Drugs and Substances, report of loss or theft

  • Community Treatment Plans 

  • Preferential Treatment

  • Gunshot Wounds

Permissive Disclosure

There are three instances when it is permissible to disclose confidential information but not obligatory to do so, this is called the Duty to Inform. These include:


Disclosure to prevent imminent danger

  1. There is a clear risk to an identifiable person or group of persons;

  2. there is a risk of serious bodily harm or death; and

  3. the danger is imminent


Incapacitated physician

If we are aware of another physician who is incapable of properly treating patients for physical or mental reasons we are expected to take action.  This may be done in conjunction with that physician’s colleagues and or loved ones or with the assistance of the Physicians Health Program at the OMA (PHP) or through the Registrar of the CPSO.


Disclosure of Harm

The flip side of confidentiality, the protection of the patient’s information, is the right of the patient to be informed about all aspects of care, including that required for informed consent and the disclosure of ’unintended outcomes’ or harm to health or quality of life during the course of receiving health care.[3]


A more comprehensive list and detailed explanation can be found on the CPSO website Policy on Mandatory Reporting. [5]


3. College of Physicians and Surgeons of Ontario. Disclosure of Harm. Policy Number: #5-10. Approved by Council: February 2003. Reviewed and Updated: May 2010

5. College of Physicians and Surgeons of Ontario. Policy #3-05. Mandatory Reporting. last updated June 2009. accessed June 24, 2011

All references for this section