The last few months of 2018 saw a major battle over privacy, autonomy and use of health information in Australia as the basis for the national electronic health record changed from an opt-in system to one where every person had such a record unless they specifically requested to opt-out of the system. The debate was messy, involving both ethical and wider political concerns, with the ethical concerns partly heightened because of the political context. Canadian health leaders can learn from the mistakes and successes of this situation.
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