Tuesday, 16 September 2014

MANDATORY REPORTING ABOUT EVERYBODY AND EVERYTHING

In an earlier article I described how citizen spies are increasingly being used by the state to report on the possible wrongdoings of their neighbors. There is another type of spy which is increasingly being used by authorities in the U.S., Canada the UK and Australia. These spies are usually professionals like medical doctors and nurses and they are compelled to report certain types of wrongdoing.

Historically a person in the Anglo jurisdictions did not commit an offence by not reporting a crime. The exception was misprision of felony which was an offence under the common law of England and was classified as a misdemeanour. It consisted of failing to report knowledge of a felony to the appropriate authorities. It has been abolished in England and Wales, in Northern Ireland, in the Republic of Ireland, and in New South Wales. 

The United States still has "misprision of felony" as a federal offence. It provides that "whoever, having knowledge of the actual commission of a felony cognizable by a court of the United States, conceals and does not as soon as possible make known the same to some judge or other person in civil or military authority under the United States, shall be fined under this title or imprisoned not more than three years, or both". This offence, however, requires active concealment of a known felony rather than merely failing to report it.
 
Like many legal rights, the right not to report an offence has been eroded since the 1980's. Compulsory reporting is now part of the law in a hodgepodge of ways and in a hodgepodge of jurisdictions, state, provincial and national. Compulsory reporting like all these things started out with the most laudable of intentions. The first area of concern was bringing child abuse to the attention of social workers and police. As usual the U.S. was the source of the movement to expose child abuse. Legislation was passed in most of the American states requiring various persons to report child abuse.
 
Forty-eight American States have legislation designating professions whose members are mandated by law to report child maltreatment. Individuals designated as mandatory reporters typically have frequent contact with children. Compulsory reporting was initially limited to professionals who have frequent conduct with children such as social workers, teachers, principals, and other school personnel and physicians, nurses, and other health-care workers. The list of mandated ‘child abuse’ reporters, however, has gradually expanded. Seven States and the District of Columbia even include animal control or humane officers. Court-appointed special advocates are mandatory reporters in ten States; clergy are mandatory reporters in 27 States and Guam. Eighteen States have made it all really simple; any person who suspects child abuse or neglect is required to report regardless of profession. Upon conviction in Florida a mandated reporter who fails to report can face jail terms ranging from 30 days to 5 years, fines ranging from $300 to $10,000, or both jail terms and fines. 

New Hampshire’s law makes the following long list of people mandatory reporters: "any physician, surgeon, county medical examiner, psychiatrist, resident, intern, dentist, osteopath, optometrist, chiropractor, psychologist, therapist, registered nurse, hospital personnel (engaged in admission, examination, care and treatment of persons), Christian Science practitioner, teacher, school official, school nurse, school counselor, social worker, day care worker, any other child or foster care worker, law enforcement official, priest, minister, or rabbi". It then adds "or any other person having reason to suspect that a child has been abused or neglected".
 
The General Medical Council in the U,K, advise all doctors seeing adults to always be suspicious of child abuse and neglect even if they may never have met the children of those adults. Mr Dickson of the General Medical Council said: "It is important that doctors treating adults are child protection aware. Their responsibility extends to patients they may not have seen. Doctors need to be aware of the environment and individuals who may increase the risk of harm." All doctors have a responsibility to be aware of child protection issues and should report concerns even if they simply have a 'hunch or feel uneasy', says Sir Peter Rubin, chairman of the GMC.

Compulsory reporting is not, however, confined to child abuse. In North Carolina every citizen has a legal duty to report cases where there is suspected child abuse and/or neglect by a parent, guardian, custodian or caretaker; they are also required to report abuse, neglect or exploitation of a disabled or elder adult by their caretaker. Physicians and hospitals in North Carolina must report to law enforcement certain kinds of wounds, injuries or illnesses. School principals must report immediately to law enforcement when he or she has personal or actual knowledge that an act has occurred on school property involving certain offenses. Photo processors or computer technicians are also mandated to report, if within the scope of their employment, they come across images of a minor (or one who reasonably appears to be a minor) engaging in sexual activity.
 
Seniors are a rapidly expanding object of compulsory reporting. S. 7(1) of Alberta’s Protection for Persons in Care Act requires every person who has reasonable ground to believe there is or has been abuse involving an adult who receives care or support services from a hospital or lives in a care facility" to report abuse to a complaints officer, the police, or other authorized person, body or committee authorized to investigate abuse. In Manitoba the Protection for Persons in Care Act (s. 3(1)) requires every person with a reasonable belief that an adult resident, in-patient or person receiving respite care in a health facility is, or is likely to be, abused to promptly report the belief to Protection of Persons in Care Office at Manitoba Health. It is therefore mandatory for all health professionals to report abuse covered by this act.

Ontario’s Long-Term Care Homes Act applies to abuse and neglect of the residents of senior’s facilities. The Act (s. 24(1)) imposes a duty on the general population to report abuse and risk of abuse. Any person must report to the Director (who has been appointed by the Minister of Health) the following; improper or incompetent treatment or care resulting in harm or risk of harm, abuse of a resident by anyone, neglect by the licensee or staff that has resulted in harm or a risk of harm to the resident, unlawful conduct that has resulted in harm or a risk of harm to a resident and misuse or misappropriation of a resident's money. Abuse includes verbal abuse which in turn means "any form of verbal communication of a threatening or intimidating nature or any form of verbal communication of a belittling or degrading nature which diminishes a resident’s sense of well-being, dignity or self-worth".
 
Nova Scotia has taken it all one step further. It has made all of its citizens mandatory reporters of ALL adult abuse and neglect. Section 5(1) of Nova Scotia’s Adult Protection Act (s. 5(1)) requires every person to report abuse and neglect of vulnerable adults. The law states: "Every person who has information, whether or not it is confidential or privileged, indicating that an adult is in need of protection shall report that information to the Minister of Community Services. "Adult in need of protection" means an adult who, in the premises where he resides, (i) is a victim of physical abuse, sexual abuse, mental cruelty or a combination thereof, is incapable of protecting himself therefrom by reason of physical disability or mental infirmity, and refuses, delays or is unable to make provision for his protection therefrom, or (ii) is not receiving adequate care and attention, is incapable of caring adequately for himself by reason of physical disability or mental infirmity, and refuses, delays or is unable to make provision for his adequate care and attention" Individuals who fail to report the information are guilty of an offence and may be fined up to $1,000 or imprisoned for up to one year, or both (ss. 16(1) and 17). The wise, law abiding citizen wishing to avoid a one year jail sentence should be sending daily reports about his neighbors to the Minister of Community Services since they could be victims of mental cruelty (the citizen hears the neighbor’s wife delivering a nasty insult to him) or refuses or delays in making provisions for his protection therefrom (the husband does not report this mental cruelty to authorities) or refuses or delays to make adequate provision for his adequate care and attention (the neighbor is giving himself lung cancer by smoking or heading towards diabetes by over eating).

There is a also panoply of elder abuse legislation and mandatory reporting requirements in the U.S. Under Connecticut law elder abuse includes, but is not limited to, the willful infliction of physical pain, injury or mental anguish, or the willful deprivation by a caretaker of services which are necessary to maintain physical and mental health. Elder abuse also includes neglect, exploitation, and/or abandonment of an elderly (ages 60+) person. The list of mandated reporters is very similar to that for child abuse and neglect including licensed physicians and surgeons and licensed or unlicensed residents and interns, registered and licensed practical nurses, nursing home administrators, nurse’s aides, orderlies, and anyone else paid for providing care in a nursing home, patient advocates, medical examiners, dentists, osteopaths, optometrists, chiropractors, and podiatrists, psychologists and social workers, clergy, police officers, pharmacists and physical therapists. Maryland requires financial institutions to report suspected financial abuse of an elder adult.
 
Bullying is another new and expanding area of mandatory reporting. The Alberta Education Act was revised in 2012 to requires students to "refrain from, report and not tolerate bullying or bullying behaviour directed toward others in the school, whether or not it occurs within the school building, during the school day or by electronic means," In other words students are required to report all alleged bullying by other students whenever and where ever it occurs. Bullying as is usual is defined very broadly to include "demeaning behaviour by an individual where the behaviour is intended to cause harm, fear or distress to one or more other individuals in the school community, including psychological harm or harm to an individual’s reputation."

The Alberta law is particularly notable because it requires students to report cyberbullying if they witness it, with penalties including suspension and expulsion possible for those who do not. It has been pointed out that the Alberta legislation is asking kids to do more than the law requires of Canadian citizens when they witness a crime on the street. The observer (of crime) is not asked to step in and stop it; if anything, police discourage it and recommend that they be called instead. While there might be a civic duty to report crime, there is no legal threat if a person doesn’t do so (subject to being an accessory).  
 
There are numerous "compulsory reporting provisions in the U.S., the U.K. and Canada related to funding of organizations deemed to be "terrorist". A typical provision is a requirement under the Canadian Criminal Code for anyone in Canada and any Canadian outside Canada to disclose to the Royal Canadian Mounted Police and the Canadian Security Intelligence Service the existence of property in their possession or control that they know is owned or controlled by or on behalf of a terrorist or a terrorist group. In the U.K. a mandatory duty has been applied since 2002 on professionals who suspect that money or assets are the proceeds of any crime. The purpose was to combat the phenomenon of ‘money laundering’. Since 2000 a mandatory duty has applied to all citizens to report on the preparations and activities of terrorists. Mandatory reporting is required if a person merely believes or suspects that another person has committed an offence under any of sections 15 to 18, and bases his belief or suspicion on information which comes to his attention in the course of a trade, profession, business or employment.

The Proceeds of Crime Act 2002 has increased the scope of mandatory reporting. It has introduced duties to pass on information about criminal proceeds with the result that professionals may have to report the criminal activities of their clients or third parties. Unlike existing duties to report, the obligations in the Proceeds of Crime Act apply to all criminal offences and therefore represent a significant change in the approach of English criminal law towards mandatory reporting.
 
Terrorism on the road is also a mandatory reporting requirement in the U.K. According to sections 70 and 172 of its Road Traffic Act 1988, a driver or a vehicle owner may commit an offence by not reporting an accident or road traffic offence.

Physicians have a long list of mandatory reporting duties. In Ontario there are eighteen different categories of compulsory reporting that extend far beyond child abuse situations. For example the Highway Traffic Act of Ontario requires that physicians report every individual 16 years of age or over attending upon the physician for medical services, who, in the opinion of the physician is suffering from a condition that may make it dangerous to operate a motor vehicle. Reports must be sent to the Registrar of Motor Vehicles, and include the name and address of the individual, as well as the medical condition that affects their ability to drive.
 
Ontario physicians involved in the care of mentally ill patients who are following community treatment plans, have specific reporting duties under the Mental Health Act, and its regulations. These obligations include providing the police with information pertinent to the community treatment plan. Where a physician issues an order for examination, the physician must ensure that the police have complete and up-to-date contact information of the physician responsible for completing the examination (including name, address and telephone number), and are informed immediately if the patient attends the examination or if the order is revoked for any other reason before it expires.

Every Ontario facility that treats a person for a gunshot wound must disclose to local police services the following: the fact that a person is being treated for a gunshot wound, the person's name, if known, and the name and location of the facility. Ontario’s legislation (which was copying U.S. initiatives) was quickly followed by the Canadian provinces of Saskatchewan, Manitoba, Qu├ębec and Nova Scotia.
 
Ontario physicians are required to tattletale on their patients and fellow doctors if they suspect cheating on the medicare system. When, in the course of professional duties, a physician has reason to believe that a person (either another physician or an individual) or entity has paid or conferred a benefit, or charged or accepted payment of a benefit in exchange for improved access to an insured health service, the physician must report the matter to the General Manager of the Ontario Health Insurance Plan. Under the Health Insurance Act, physicians are required to report instances of health card fraud.

Nova Scotia has a similar long list of mandatory reporting requirements imposed upon its doctors. They go one better with The Personal Health Information Act imposes a duty to report on physicians where there has been a privacy breach. An individual who has custody or control of personal health information about a patient (such as a physician) must notify the patient as soon as possible if the custodian believes that the information is stolen, lost or subject to unauthorized access, use, disclosure, copying or modification; and as a result, there is potential for harm or embarrassment to the individual. Creates a kind of damned if you do, damned if you don’t situation.
 
Mandatory reporting just keeps getting bigger and bigger. There is a problem; let’s pass a law to compel someone to report it. If a doctor already has to deal with 18 different mandatory reporting situations, one more won’t make much difference. So what if the doctor’s major stress point with a patient is no longer diagnosing an illness and developing a successful treatment program but rather is figuring out whether there is a mandatory reporting requirement. The patient on the other hand has to wonder if it is a relationship with a medical caregiver or a deputized cop.

One well meaning law by one well meaning law we are creating a society where everybody is a spy on everybody else. Totalitarian regimes in other times and other places have created spy-on-spy systems in one big swoop; we are doing it with a "thousand cuts".
 


3 comments:

  1. Don't be late and take the facility of medical services.

    Elderly Protection Services

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  3. Professionals have a duty to protect society. You may not care about protecting your community, but that is why we have these laws and regulations. People like YOU need to be FORCED to do the right thing.

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