Patient consent for AI scribes in Ontario

An appointment may require several different permissions. Consent to an examination or treatment does not automatically authorize audio capture or a third-party documentation service to process personal health information. Browser microphone permission only authorizes the device; it does not answer the legal or ethical question.

Under PHIPA, valid consent must be the individual's, knowledgeable, related to the information, and not obtained through deception or coercion. The exact authority and form may depend on the context. Practices should confirm profession-specific and organizational requirements.

Avoid describing the tool as merely “taking notes” if it records, transcribes, summarizes, stores, or sends information to a vendor. The explanation should reflect the actual configured data flow.

• That an AI-assisted documentation tool will capture or process the encounter.
• The purpose: for example, producing a draft note for clinician review.
• What information is involved and which external service providers receive it.
• Material benefits and limitations, including errors, omissions, bias, and privacy risk.
• That the clinician reviews and remains accountable for the final documentation.
• How long relevant information is kept under the practice's approved setup.
• That the patient may ask questions, refuse, or withdraw consent and use an alternative.

The practice should decide what its record needs to show: who consented, the method, date or encounter, the purpose explained, any limits, and whether a substitute decision-maker was involved. A product checkbox can support this process but cannot replace the underlying conversation.

Use an approved script or patient notice to improve consistency, then allow questions. When the use changes, such as a new purpose, vendor, participant, or data practice, assess whether new notice or consent is needed.

A person who withholds consent should continue to receive the same or a similar level of care through an alternative documentation method. Staff should know that path before the visit starts so refusal does not create pressure or delay.

If consent is withdrawn after capture begins, stop further collection through the AI scribe. Follow the approved process for information already collected and explain the next steps. The response may depend on PHIPA, the practice's obligations, the technical state, and the record context.

• Capacity and substitute decision-makers.
• Minors and profession-specific consent rules.
• Interpreters, family members, learners, or multiple participants.
• Virtual visits and people joining after capture begins.
• Sensitive services or settings where the risk profile is different.
• A participant who consents initially but later objects.