Similarly, physicians are unlikely to be able to refuse to work because of the risks associated with their work.14 When physicians enter the health profession, they implicitly accept a risk associated with the profession. To determine whether a particular practice is inherent in the work, physicians might ask, «If I take away what is supposed to be inherent, will my job still exist?» 19 The answer depends on the body and the individual. There is no evidence that this limit is applied in provinces whose health and safety legislation does not include it. The incident raises questions about the responsibilities of health care providers with respect to patient privacy, consent and law. Patient privacy has a long history in medicine. A translation of the Hippocratic Oath reads: «What I am allowed to see or hear during treatment or even outside treatment in relation to people`s lives, which must in no case be spread abroad, I will keep to myself.» Since then, patient information privacy has been a cornerstone of medical practice, and trust between a patient and a healthcare provider is one of medicine`s most enduring traditions. During a pandemic, physicians may experience tensions between their ethical responsibilities and their legal rights and obligations. For example, the Code of Ethics states that physicians have a fundamental ethical responsibility to «consider the patient`s well-being first,» but also to «promote and maintain the patient`s own health and well-being.» 24 Some universities have described the ethical dilemmas that can arise during a pandemic and developed policy statements specifically tailored to physicians` ethical obligations.27–29 The issues become more complicated when considering physicians` legal duty of care and their legal right to refuse to work in unsafe conditions. Physicians should be aware that the existence of this separate regulatory system does not deny their right to refuse to work in unsafe conditions, nor does it protect them from negligent liability for breach of their legal duty of care. Use engineering controls to protect medical staff, patients and visitors from suspected or confirmed COVID-19 individuals. These include physical barriers or partitions in triage areas to guide patients, curtains that separate patients in semi-private areas, and airborne infection isolation rooms (AIIRs) with adequate ventilation.

AIIRs are single rooms with negative pressure that provide at least 6 air changes (existing structures) or 12 air changes (new construction or renovation) per hour. Physicians in Canada have a legal duty of care to their current patients and, in certain circumstances, to those who are not their patients. Until more is known about how COVID-19 is spreading, OSHA recommends using a combination of standard precautions, contact precautions, air precautions, and eye protection (e.g., goggles, face shields) to protect medical personnel exposed to the virus. Would it not be nice if rights and obligations were balanced? We have health worker responsibilities and patients` rights, so why not health workers` rights and patients` responsibilities? It is the responsibility of everyone who works in health care, not just nurses, to know and follow their state`s legal guidelines regarding the disclosure of medical information and the policies and rules of their respective institution. It should also be noted that these rules are neither arbitrary nor frivolous. Violating patient trust, even in small ways, can undermine the goodwill health care providers need to be honest with their patients. At the same time, it is also the responsibility of health care providers to comply with requests for information from public servants when all policy and legal requirements have been met. The cases in which this limit applies depend on the person`s situation.

For example, physicians who work in large health care facilities where someone else can easily assume their responsibilities could not be considered a danger to a patient or another physician if they refused to work.23 However, a physician who works in a remote community and is the only person capable of performing certain essential tasks could be considered a danger to others. If he refuses to work. Hospitals and health facilities in Canada are subject to the health and safety laws of each province. The provisions relating to the right to refuse to work because of unsafe conditions differ slightly from province to province. In Manitoba, for example, a worker may refuse to work or perform a particular job if they have reasonable grounds to believe that doing so poses a risk to their safety or health, or to the safety or health of another worker or person.8 There is extensive literature on physicians` ethical obligations to treat during pandemics. But much less has been written about their legal obligations.