While rejecting the claim of fiduciary relation between doctor and relatives of patient, the CIC said the information sought by the patient herself can be provided. This is the 177th in a series of important judgements given by former Central Information Commissioner Shailesh Gandhi that can be used or quoted in an RTI application

The Central Information Commission (CIC), while allowing an appeal, directed the Public Information Officer (PIO) of Institute Of Human Behaviour and Allied Sciences (IHBAS), Delhi to provide complete information regarding psychiatric treatment and records to the patient, who had filed the application under the Right to Information (RTI) Act.

While giving the judgement on 27 December 2011, Shailesh Gandhi, the then Central Information Commissioner said, "In the instant case, the respondents, at no point have claimed that if the information is provided to the appellant, she would not be able to understand it or it would harm her. Therefore, the Bench finds no reason to accept the claim of a fiduciary relationship between the doctors and the husband of the patient."

Neemach (Madhya Pradesh) resident Rashmi Dixit Matiman, on 26 April 2011, sought from the PIO information regarding her psychiatric treatment and records relating to the same. Here is the information she sought and the reply provided by the PIO under the RTI Act...

1. The Appellant was kept in the Short Observation Facility (SOF) of IHBAS from 1 April 2011 to 4 April 2011. The Appellant has sought the reasons for the same along with attested photocopies of the relevant documents?  

PIO's Reply—The information sought was provided by the Appellant and her husband and was sensitive/confidential in nature. It was exempt under Section 8(1)(e) of the RTI Act.

2. Names, address, academic qualifications and experience of all the doctors who examined the Appellant during the mentioned period along with attested photocopies of the relevant documents.

PIO's Reply—Requisite information provided by way of enclosures. 

3. Attested photocopies of the observation reports, examination report, opinions of the doctors.

PIO's Reply—Same as reply to query 1.          

4. Attested photocopies of the questionnaire filled by the Appellant during observation pertaining to psychological examination including the remarks of the doctors on the same.        

PIO's Reply—Same as reply to query 1.          

5. Name, address and attested photocopies of appointment letters of the working staff, doctors, counsellors, staff nurses, attendants and drivers of the Mobile Mental Health Unit of IHBAS.

PIO's Reply—Requisite information provided by way of enclosures. 

6. Action taken by the management of IHBAS on the emails sent by the Appellant's mother to the Joint Director, Director on 5 April 2011-attested photocopies of the same.

PIO's Reply—The action taken was in the nature of clinical evaluation and the Appellant was discharged on 6 April 2011. 

7. The Appellant was kept in the Women's Ward from the afternoon of 4 April 2011. Her registration no. was 2011-4 13628. She was discharged from there on 6 April 2011. The Appellant's income, in the discharge letter, was shown as Rs50,000. What was the basis of this and attested photocopies of relevant documents.          

PIO's Reply—The information was given by the appellant's husband. 

8. Reasons given by Dr Arshad Hussain and Dr Shewta Sharma of the Mobile Mental Health Unit and that of the driver along with attested photocopies of relevant documents on the basis of which the Appellant was admitted in IHBAS on 1 April 2011.          

PIO's Reply- Same as reply to query 1.          

9. Attested photocopies of all the information, documents/records, emails, etc given by the appellant's husband to IHBAS pertaining to the Appellant.         

PIO's Reply- Same as reply to query 1.         

Citing incomplete and unsatisfactory information provided by the PIO, the appellant filed her first appeal.  

In his order, the First Appellate Authority (FAA), said he was satisfied that the record of the appellant contained inputs and information provided by herself, her husband and relatives, which are individualistic information shared by each person with the hospital team member. "Information in psychiatry case records is collection of information given by all persons.  The views expressed by the deemed PIOs (as mentioned in the order) were well accepted that in a psychiatry case-the medical records were not only physical clinical examination but included various information shared by the relatives particularly spouse, children, parents, etc. The fiduciary relationship in psychiatry cases extends not only to the patient but also to the information shared by others. Information provided by each of the informants to any of the team members of a mental health team, should be considered as having been provided in a fiduciary relationship. Therefore, Section 8(1)(e) of the RTI Act is applicable. Moreover, in cases wherein reasonable possibility of disputed marital or divorce proceedings existed, divulgence of information under the provisions of RTI Act provided by either of the spouses or partners or any other family member or even a friend  to a professional is neither appropriate nor desirable," the FAA said in the order.

Not satisfied with the FAA's order, Dixit Matiman, the appellant, approached the CIC with her second appeal.

During the hearing on 23 November 2011, the Bench of Mr Gandhi, the then CIC, heard both the parties. Dixit Matiman stated that she was forcibly admitted to IHBAS by her husband. She also claimed that she had not been informed about her ailments and alleged that she was hospitalized only to be terrorized and certified as mentally ill.

Dr NG Desai, the FAA claimed that information regarding the appellant's condition was obtained from different sources which included her husband and therefore the information was held in a fiduciary capacity by the doctors. The PIO argued that in psychiatry matters, it would not be correct to consider that a fiduciary relationship exists only between the doctor and the patient concerned and therefore it is exempted under Section 8(1)(e) of the RTI Act.

The FAA also stated that the appellant had been informed that she required further treatment and that she could be treated by a proper psychiatric specialist anywhere she chose. Dixit Matiman stated that this was not true and that the doctors were not willing to release her.

The FAA and PIO also cited certain decisions of the Commission in support of their contentions- Itwari Lal vs IHBAS (CIC/WB/A/2006/00787 dated 26/07/2007), Dipchand Chavanriya vs IHBAS (CIC/SG/A/2009/001554 dated 06/08/2009) and Shravan Kumar vs IHBAS (CIC/AD/A/2009/000233 dated 09/12/2009).

Mr Gandhi, then reserved his order at the hearing.

During the hearing on 27 December 2011, Mr Gandhi noted that the FAA and PIO, in their written submissions, have relied on certain decisions of the Commission.

He said, "It is legally well-established that information under the RTI Act can be denied only on the basis of Sections 8 and 9 of the RTI Act and no other exemptions can be claimed while rejecting a demand for disclosure. Given the same, the issue before this Bench is whether the denial of information on queries 1, 3, 4, 8 and 9 on the basis of Section 8(1)(e) of the RTI Act is justified. The PIO had claimed Section 8(1)(e) of the RTI Act in denying the information."

Section 8(1)(e) of the RTI Act exempts from disclosure-"information available to a person in his fiduciary relationship, unless the competent authority is satisfied that the larger public interest warrants the disclosure of such information".

Mr Gandhi said, "All relationships usually have an element of trust, but all of them cannot be classified as fiduciary. Information provided in discharge of a statutory requirement, or to obtain a job, or to get a license, cannot be considered to have been given in a fiduciary relationship."

The FAA and PIO have primarily argued that in psychiatry cases, the fiduciary relationship not only exists between the doctor and the patient, but also extends to all other persons such as the husband and relatives from whom information is obtained about the patients; all such information is held by the doctors in fiduciary capacity.

"In the instant case," Mr Gandhi said, "the FAA and PIO, at no point have claimed that if the information is provided to the appellant, she would not be able to understand it or it would harm her. Therefore, the Bench finds no reason to accept the claim of a fiduciary relationship between the doctors and the husband of the patient. The information is being sought by the appellant who was the patient herself. Hence, the fiduciary relationship exists between her and the doctors."

The Bench said, in Itwari Lal vs IHBAS (CIC/WB/A/2006/00787), the applicant had sought the medical history records of one Roshan Lal. The Commission had dismissed the appeal and held that since the information sought was a question of treatment of a patient which must always be held in confidence by his physician and was at the heart of the definition of a fiduciary relationship, the information must be denied not only under Section 8(1)(j), but also under Section 8(1)(e) of the RTI Act. In Dipchand Chavanriya vs IHBAS (CIC/SG/A/2009/001554), the applicant had sought information about medical records of one Jyoti. The appeal was dismissed by this Bench as the information was protected under Section 8(1)(e) of the RTI Act. Moreover, in Shravan Kumar vs IHBAS (CIC/AD/A/2009/000233), the applicant had sought information about the medical treatment/records of his wife. The Commission had held inter alia that information about a patient receiving psychiatric treatment was personal information and held in a fiduciary relationship by the doctors and also in light of the fact that there was an ongoing marital dispute between the applicant and his wife, the denial of information under Section 8(1)(e) of the RTI Act was justified. In the Shravan Kumar case, the husband had sought information about his wife's psychiatric treatment and hence, it was denied under Section 8(1)(e) of the RTI Act.

Mr Gandhi said, "In the cases cited by the FAA and PIO, the information was being sought by a person other than the patient. In the instant case, the information is being sought by the patient herself and these precedents are not relevant in deciding the present matter."

While allowing the appeal, he directed the PIO to provide complete information as per records on queries 1, 3, 4, 8 and 9 to Dixit Matiman before 20 January 2012.

CENTRAL INFORMATION COMMISSION

Decision No. CIC/SG/A/2011/002238/16606

http://ciconline.nic.in/cic_decisions/CIC_SG_A_2011_002238_16606_M_72950.pdf

Appeal No. CIC/SG/A/2011/002238

Appellant                                            : Rashmi Dixit Matiman,

                                                               Neemach, Madhya Pradesh

Respondent                                         : Birbal Singh,

                                                            Public Information Officer & Joint Director (Admin.),

                                                            Institute of Human Behaviour and Allied Sciences                                                                     Dilshad Garden, Delhi-110095