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Universities Grapple With Providing Health Services, Protecting Privacy

Meagan Fitzpatrick, Canwest News Service
Published: Saturday, April 26, 2008

OTTAWA - Nadia Kajouji has been laid to rest but the debate that has emerged out of her death, an apparent suicide, will likely go on for some time as universities continue to grapple with the challenge of providing health services to students and protecting their privacy rights.

The 18-year-old Carleton University student's parents are upset with the school for only informing them that their daughter was seeing a campus doctor and counsellor and was taking anti-depressants after she went missing from her dorm room on March 9.

Her body was found a week ago by a boater near the edge of Ottawa's Rideau River and an autopsy concluded no foul play was involved.

Mohamed Kajouji and Marc, father and brother of Brampton teenager Nadia Kajouji,

Mohamed Kajouji and Marc, father and brother of Brampton teenager Nadia Kajouji, mourn as her coffin is carried to a waitng hearse Saturday.

University officials say they followed procedures and couldn't tell Kajouji's parents about her mental health because of the province's privacy law. They also indicated universities that don't respect the privacy of their students' health information risk driving students away from the very services designed to help them.

Ontario's privacy commissioner, Ann Cavoukian, and several of her counterparts in other provinces, say universities need to have a clearer understanding of what privacy laws allow and they cautioned that too often privacy laws are the automatic target of blame when controversy arises.

Cavoukian's office provided a fact sheet several years ago to universities explaining the law allows them to disclose personal health information in "compelling circumstances" and if they believe on reasonable grounds it would eliminate or reduce the risk of bodily harm.

Determining whether a situation warrants disclosure is a judgment call, Cavoukian said in an interview, though the law affords protection to the decision-maker as long as he or she acted in good faith.

"If you are a health-care practitioner or a university professional and you have information relating to a student that is considering suicide and you fear for that person and want to reduce the risk of suicide, absolutely you are allowed to release that information," she said. "It's not an easy decision but it is one that is permitted under our privacy laws and I'm sick and tired of people saying that it's the privacy laws that prevented the counsellors from contacting the girl's parents. That's incorrect," she said.

Kajouji 's family says the young woman was struggling in school and not acting like herself but they didn't know the extent of her depression or that she had expressed suicidal thoughts. Her father, who says the school should have done more for his daughter, is not ruling out legal action against Carleton.

A spokesperson from Carleton wasn't available for a phone interview, so it's not clear whether the school discussed informing Kajouji's parents and decided it wasn't necessary.

Suzanne Blanchard, vice-president for student support services, said in an e-mail message the university has specific procedures to deal with students who are in "imminent danger of doing harm to themselves or others."

"Carleton University has reviewed its actions in the aftermath of Nadia's tragic death. We believe that we followed all proper procedures and provided all the support services we could for Nadia," she said. "Carleton University is always diligent in its compliance with Ontario's privacy laws and we believe that we acted, and continue to act, in accordance with those laws."

Cavoukian said some universities take their obligations under the privacy law seriously, but there is still a lot of confusion. She plans to convene a meeting with the Council of Ontario Universities in an attempt to clarify any lingering questions.

Saskatchewan's privacy commissioner agreed there is a "significant need for more education" about the flexibility that is built into privacy laws.

"Sometimes you have people who don't want to do the wrong thing and so therefore you get a kind of paralysis and they don't share information even when the law allows them to and it's appropriate to do so," said Gary Dickson.

Dickson said Kajouji's death, while tragic, provides incentive for universities to ensure they are prepared to deal with students' mental health issues and with situations where informing the parents is up for debate. "Decisions will have to be made and then there have to be people with the appropriate training and judgment who can then make that discretionary decision," he said.

Frank Work, Alberta's privacy commissioner, said it has to be kept in mind Kajouji was an adult and the university may have felt her situation was under control. All the law asks is that a standard of reasonableness be applied, said Work.

"I think it's true in just about every privacy law, the standard is always reasonableness, not perfection," he said.

People will disagree on whether Carleton made the right decision, but one thing the privacy commissioners all agree on is the decision needs to be given due consideration.

"The worst case scenario is if it's just neglect. They saw the bus coming and they didn't yell: 'Get out of the way.' We don't know here. Hopefully in this case they made a judgment call," said Work.

Ontario's commissioner similarly said university officials have to take the time to make the difficult determination and should not rely on privacy laws as the default reason for not disclosing personal information.

"I would urge people to resist the knee-jerk reaction of automatically blaming privacy laws," Cavoukian said.

Reproduced from http://www.canada.com/vancouversun/news/story.html?id=d81a0350-e3e5-4d54-9704-f7aa2e4aaecf&k=61033

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