Page - 498 - in VULNERABLE - The Law, Policy and Ethics of COVID-19

VULNERABLE498 for PSWs and the need to develop disclosure standards that could guide them. As is well known, a culture of open disclosure and a clear framework for whistleblowers will have a positive impact on some aspects of patient safety.46 Finally, health care institutions must intro- duce processes for whistleblowing and should also create and foster a culture of disclosure. The framework should include several features, many of which have been recommended by previous scholars and review bodies. First, a statute must apply to all health care workers, from physicians to cleaning staff, regardless of their employment status. Past inqui- ries have noted that concerns raised by nurses, as opposed to doc- tors, are not always treated with the “same respect or seriousness as those raised by doctors.”47 Second, these instruments must extend to all forms of reprisal, including threats of reprisal.48 Third, these instru- ments should support disclosure by a health care worker in good faith. Fourth, the anonymity of a whistleblower must be protected where it is requested.49 Fifth, there must be robust penalties where these provi- sions are breached.50 Conclusion Health care workers have played two critical roles during the pan- demic: as providers of patient care and as whistleblowers. The over- whelming majority of health care workers have discharged their duty to provide patients with care during the COVID-19 crisis. However, 46. Minsu Ock et al, “Frequency, Expected Effects, Obstacles, and Facilitators of Disclosure of Patient Safety Incidents: A Systematic Review” (2017) 50 J Prev Med Public Health 68. 47. Sinclair, supra note 325 chapter 10 at 1. 48. For example: under Manitoba’s Public  Interest  Disclosure  (Whistleblower  Protection)  Act, supra note 38, s 2: “reprisal” means any of the following measures taken against an employee because the employee has, in good faith, sought advice about making a disclosure, made a disclosure, or co-operated in an investigation under this Act: (a) a disciplinary measure; (b) a demotion; (c) termination of employment; (d) any measure that adversely affects his or her employment or working conditions; (e) a threat to take any of the measures referred to in clauses (a) to (d).” 49. See for example: CDHO  Whistleblower  Policy,  supra note 39 at 2; Public Interest Disclosure  (Whistleblower  Protection)  Act,  supra  note 38, s 32.1(1). 50. Public  Interest  Disclosure  (Whistleblower  Protection)  Act,  supra  note 38, s 33(4).