Health law in Canada最新文献

Since its enactment in 1984, the iconic Canada Health Act (CHA) has been at the centre of a polarized debate on whether universal coverage should be expanded or restricted in Canada. This discussion on the future direction of Canadian medicare has been vexed by prevailing myths about the CHA. These myths are unhelpful in that they perpetuate misleading notions about the ambit and impact of the CHA. This article deconstructs 10 of the more common myths to get at the realities of the CHA and the extent to which it sets national standards and constrains - or does not constrain - provincial health reform and innovation. Understanding the realities of the CHA is becoming a critical litmus test for the courts as they interpret the CHA and the provincial laws and regulations, which were established in conformity with five criteria - public administration, comprehensiveness, universality, portability, and accessibility). Separating myths from realities also allows practitioners and scholars to better understand the limits of the CHA.

Despite the creation of Ontario's Trillium Gift of Life Network Act in 1990, Ontario's prospect in organ supply remains low. Since 1990, medical findings have informed and changed approaches to organ donation; however, these approaches have not been implemented consistently across hospitals nor have they been integrated firmly into the law. This lack of consistency and integration, as research suggests, prevents organ donation rates from fulfilling their potential. In response to such downfalls, this article suggests areas in the Trillium Gift of Life Network Act that should be updated as a first step to improving organ donation rates.

On March 31, 2016, the government of Prince Edward Island committed to provide medical and surgical abortions in a public health facility in the Province by the end of the year, for the first time since 1982. The Province's announcement was a direct response to threatened Charter litigation initiated by a group of local veteran activists called Abortion Access Now PEI Inc., which challenged the government's policy not to provide abortion services in the Province. In this commentary, legal counsel for Abortion Access Now PEI Inc. situate the recent litigation efforts within the history of abortion access and advocacy in PEI. They attribute the reversal of the government's position to the successful refraining of the Province's abortion policy in the threatened litigation and the sustained and creative approaches employed by abortion access activists.

The following is Part II of a three-part paper presenting holistic models of determining impairment and occupational disability with respect to common "own occupation" and "any occupation" definitions, especially in the motor vehicle accident (MVA) context. This segment of the paper is for the purpose of educating readers regarding pertinent case law and related evolving judicial/arbitral interpretations surrounding the Post 104-week income replacement entitlement within the Ontario MVA insurance system. Best practices in disa- bility assessment methodology and analysis are supported in the context of holistic occupational disability assessment models in relation to the relevant case law. Comparative analysis was also utilized to inform the reader of the emphasis upon the quality of activity engagement across pre- and post- 104 week spheres. Beyond the MVA sphere, medically-legally, the reviewed case law and related clinical best practices are fully germane to the long term disability and WSIB (workers' compensation) sectors. A specific area emphasized by authors is that the assessment of pain is more complex than is generally acknowledged in many disability assessments. Research on the impact of pain on individuals with disabilities and impairments arising from injuries sustained, clearly demonstrates that traditional pain measurements are often inadequate to fully determine the disability arising from pain. Finally, particularly in the context of In- surance Examinations (lEs and Independent Medical Assessments for LTD), the principle of competitive employability is often not considered as it should be in accordance with the existing case law.

This three-part paper presents practical holistic models of determining impairment and occupational disability with respect to common "own occupation" and "any occupation" definitions. The models consider physical, emotional and cognitive impairments in unison, and draw upon case law support for empirically based functional assessment of secondary cognitive symptoms arising from psychological conditions, including chronic pain disorders. Case law is presented, primarily in the context of Ontario motor vehicle accident legislation, to demonstrate how triers of fact have addressed occupational disability in the context of chronic pain; and interpreted the "own occupation" and "any occupation" definitions. In interpreting the definitions of "own occupation" and "any occupation", courts have considered various concepts, such as: work as an integrated whole, competitive productivity, demonstrated job performance vs. employment, work adaptation relative to impairment stability, suitable work, retraining considerations, self-employment, and remuneration/socio-economic status. The first segment of the paper reviews the above concepts largely in the context of pre-104 Income Replacement Benefit (IRB) entitlement, while the second segment focuses on post-104 IRB entitlement. In the final segment, the paper presents a critical evaluation of computerized transferable skills analysis (TSAs) in the occupational disability context. By contrast, support is offered for the notion that (neuro) psychovocational assessments and situational work assessments should play a key role in "own occupation" disability determination, even where specific vocational rehabilitation/retraining recommendations are not requested by the referral source (e.g., insurer disability examination).

A physician-patient relationship is essential for the well-being of the patient, for without a strong and trusting relationship between both individuals, the patient may not receive the best care that they deserve. There are many legal policies and ethical principles a physician must follow when caring for a patient. It is both the legal and moral duty of the physician to act in the best interests of their patients, while making sure to respect them regardless of background and personal behaviours. The relationship is secured with both trust and respect, for without trust, the patient may hold back from stating their conditions which will result in the physician not providing them with all the care they require. Sometimes, lack of some of these key characteristics of the physician-patient relationship and other circumstances, may cause either the patient or the physician to terminate the relationship. Termination of a relationship creates a difficult situation for the patient, and therefore there are only specific situations where a physician may have permission to follow through and terminate their relationship. Both the law and ethical principles play a role in the decisions made by the physician in regards to their relationship with the patient, but regardless, the physician has the obligation to make sure their patient is receiving care by one means or another.

The mobile revolution is a watershed event across many fields, including health care. Now, electronic data storage, digital photography, smart phones and tablet devices present new opportunities for educators, researchers, and health care providers. Mobile technologies allow for new possibilities for physician collaboration as well as patient diagnosis, treatment and study. However, while it presents new opportunities, the mobile technological revolution in health care has brought about new risks to patient privacy. These risks to patients, in turn, translate into exposure to liability on the part of health care providers including physicians, allied health care professionals and institutions. This paper reviews recent developments in the legal landscape providing new forms of civil liability for breaches of privacy and discusses how risks of liability under those developing civil causes of action can be managed by health care providers, while they at the same time harness the potential of the mobile technological tide.