What are my rights as a user?
Users have rights and recourses under the ARPP.
The user does not have the right to:
- leave the institution when under a measure for institutional confinement.
The user has the right to:
- obtain from the health centre all relevant information on the statute, the different types of confinement, his rights and his recourses.
If the user is unable to understand due to his mental state, the information will be sent to a close relative or an interested third party. Once he is able to understand, the information must be provided for him;
- refuse any examination, care or treatment, with the exception of those ordered by the court (in the case of provisional confinement, for example) or in the case of emergency care (section 13 of the Civil Code of Québec);
- communicate, orally or in writing and with full confidentiality, with the persons of his choosing, barring a restriction from the physician. In that case, he must be so informed in writing. He may not be limited in his communications with his legal representative, his attorney and the Administrative Tribunal of Québec;
- testify at a hearing before the court. He has the right to be assisted by an attorney. A close relative who is informed may also be present. As exception, if the physician has serious reasons to believe that the user’s presence at his hearing may affect his state of health, an exemption order may be requested from the court;
- contest his court-authorized confinement before another court, i.e., the Administrative Tribunal of Québec;
- obtain support in the exercise of his rights.
The user must:
- submit to the court’s decisions.
The health centres must:
- inform a close relative or interested third party of the user’s confinement. The latter may express his preference, but the final decision shall be up to the physician and the health centre’s attorney. The goal is to ensure that the user’s family knows where he is and that it can provide assistance as needed and with the user’s consent;
- provide the user with all the information necessary to understanding the situation and the confinement without requiring him to seek such information;
- inform the user if, for health reasons, one of his rights is temporarily limited (for example, the right to communicate);
- inform the user of the resources available to assist him in the exercise of his rights.
What about confidentiality and the professional secret?
In Québec, the principle of confidentiality is based on the individual’s rights to inviolability and on respect for his private life [section 3 of the Civil Code]. Thus, without the individual’s authorization, the health centre may not share any confidential information on that individual. As for the professional secret, all professionals belonging to a professional association are obliged not to share any personal information on a user without said user’s consent.
Given that application of the ARPP is aimed at protecting life, certain general rules of confidentiality may be lifted:
- the police, social services and nurses have the right to exchange information on the crisis situation in view of informing the physician who will make the decision;
- a close relative or interested third party shall be informed of the legal procedures;
- if the individual is a minor, his legal representative shall also be informed of the confinement and of other subsequent procedures.
Concurrently and at all times, the following situations shall not be considered as breaches of confidentiality:
- the health centre’s employees may provide general information for close relatives (concerning mental disorders, the institution’s services, how to deal with symptoms, etc.);
- the health centre’s employees may offer support services to close relatives without providing confidential information;
- the user’s close relatives always have the right to share information with the health centre’s employees if they have preoccupations;
- the user’s close relatives and the health centre’s employees may work with the user to facilitate his cooperation toward inclusion of his close relatives in the provision of care in accordance with the ARPP.
What are my recourses and how do I obtain assistance?
If the user wishes to be represented by an attorney, it is possible to contact the attorney of his choice. In case the user does not have an attorney, the legal-aid office serving Nunavik can assign him one: 1-866-624-9189.
If the user disagrees with the reason for maintaining his confinement or with a decision concerning him under the ARPP, he can submit a request for contestation or revision to the Administrative Tribunal of Québec. The office located in Québec City serves Nunavimmiut: 1 800 567-0278.
Each health centre has a complaints commissioner among the members of its team. That person can also provide assistance for a user who requires support.
Inuulitsivik Health Centre (Puvirnituq): 1-888-988-2669
Ungava Tulattavik Health Centre: 1-883-964-2905 (509)
As second recourse, it is also possible to contact the ombudsman: 1 800 463-5070.
The user can also file a complaint against a particular intervener with that intervener’s organization or professional association, if that resource is registered with one. For example, for a social-services intervener, contact the Ordre des travailleurs sociaux et des thérapeutes conjugaux et familiaux du Québec (OTSTCFQ) [Québec order of social workers and conjugal and family therapists]: 1 888-731-9420, extension 242.