A parent's access request, a former minor client, and a practice closing
Dr. Amara Osei, C.Psych., has practised in Ottawa for 22 years. From 2010 to 2013 she saw Jordan M. for anxiety and school refusal, from ages 14 to 17; therapy ended in June 2013 when the family moved. Services were billed to Jordan's mother, who signed the intake forms. Dr. Osei retires in eight months and plans to shred her paper files. Last week Jordan's mother emailed requesting "the complete file, including test scores and session notes," explaining that Jordan is now 29, has started therapy again in Toronto, and needs the file sent to the new therapist. She adds that she paid every invoice and is "the parent, so I have the right." Jordan then left a voicemail: they do not want any information released and do not want their mother to know they are in therapy again. Dr. Osei's office manager has already begun scanning the file into the electronic system so it "won't be lost." The mother has hinted she will complain to the College if refused.
1. How should Dr. Osei respond to the mother's request, and what does the law require her to consider?
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Start with the legal frame, not the emotional one. Dr. Osei is a health information custodian under PHIPA. The individual whose information it is - Jordan - is 29 and presumed capable. The right of access, and the right to consent to or refuse disclosure, belongs to Jordan, not to the person who paid the bills. Paying for services does not create a right of access, and being the parent of an adult does not either. Records created while Jordan was a minor do not transfer that right to the mother once Jordan became capable; a parent has access to a minor's information only with the capable minor's consent, or where the minor is incapable and the parent is the substitute decision-maker.
Practical steps: reply to the mother promptly and in writing, without confirming or denying any clinical content. State that you cannot release or discuss the file without the client's consent and that her request has been passed to Jordan. Do not debate her parental standing. Then contact Jordan directly, verify identity, and obtain written consent specifying what may be released and to whom; send the copy directly to the new therapist as instructed, and charge only a reasonable fee after providing an estimate.
The threatened College complaint is irrelevant to the analysis. A complaint is a legitimate avenue; the obligation is to comply with PHIPA and the College's confidentiality standard, and to document the request, the refusal, and every contact. If a complaint is filed, this record will show the decision was principled rather than reactive.
2. Can Dr. Osei scan and then destroy the paper file as she winds down her practice? What must she do before closing?
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Two separate issues: whether the minimum retention period has passed, and whether destruction is permissible now.
Retention: the College expects records to be kept for at least ten years after the last date of service, and where the client was a minor the clock generally runs from the age of majority. Jordan was last seen in June 2013 at age 17, so on either calculation the minimum period has run. That does not mean the file can go in the shredder tomorrow.
First, an access request is live. Destroying records while a request, complaint, or legal proceeding is pending - or reasonably anticipated - would make compliance impossible and could look like obstruction. Preserve the original until the request is resolved.
Second, digitization is allowed but must be done properly: the scan must be complete, legible, and accurate; the electronic record must be encrypted, backed up, and access-controlled; and a documented quality check should confirm nothing was lost before any paper is destroyed. Disposal must be secure (cross-cut shredding or a bonded destruction service) with a log recording date, method, and range of records.
Third, closing a practice is a planned event, not a reason to shred. She should notify current and former clients where reasonably possible, tell them where records will be held and how to access them, arrange transfer or continued custody with a named successor, keep the records secure for the remaining retention period, and ensure the College can reach them if a complaint arises.
3. What should Dr. Osei tell Jordan about the mother's request, and what if Jordan asks her to tell the mother "everything is fine"?
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Tell Jordan the truth about the request, and separate the two things Jordan is asking for.
Jordan's refusal is decisive: nothing goes to the mother without Jordan's consent, and Dr. Osei can honour that completely. She should tell Jordan plainly that the mother asked for the full file, that nothing was released, and what would happen if a request arrives in future - including that a subpoena or court order is a legal obligation that could change the picture, and that in that situation she would obtain legal advice and disclose only what the order requires.
What she cannot do is lie. If Jordan asks her to tell the mother "everything is fine," she can decline to give any information - "I have no information to share about anyone's care" - which achieves the same practical protection without a false statement. Fabricating a clinical opinion, even to protect a client, misrepresents the record and could mislead the mother about a real health matter.
Where duties collide, the minimum necessary response is the professional one: silence rather than a story. Document the conversation with Jordan, including the options offered and what Jordan chose. If Jordan is frightened of the mother's reaction, that is a clinical issue to work with, not a reason to misrepresent the file.