Medical privacy is important

As noted in a recent “News @ a Glance” item,¹ the use and abuse of oxycodone is a growing concern in Canada, particularly in Nova Scotia.²The lay press has reported that police and pharmacists in that province would like a province-wide database to be established to track users of narcotic medications prescribed for pain relief, especially drugs containing oxycodone;³ it is believed that such a database would help to prevent “double-doctoring.”

Drug databases can certainly be used by primary care physicians to improve the quality of patient care and to ensure that patients are not exposed to dangerous drug interactions.⁴ However, it is important that patients' privacy be protected. If patients think that the police may have access to such a database, those suffering from legitimate chronic pain may be less likely to seek appropriate medical care.

Before consideration is given to violating patients' privacy, a good first step would be a study to determine the effectiveness of such a database in detecting double-doctoring. The seriousness of the problem of drug addiction does not justify the unethical violation of medical privacy, even when it is done with the best of intentions.

Andrei S.P. Brennan Research Ethics Quality Assurance Officer Research Institute of the McGill University Health Centre Montréal, Que. J.A. Chris Delaney Statistician Division of Clinical Epidemiology Royal Victoria Hospital Montréal, Que.