
Medical Law in Canada
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Inhalt
- Intro
- Title Page
- Copyright Page
- The Authors
- Table of Contents
- List of Abbreviations
- General Introduction
- Chapter 1. The General Background of the Country
- §1. Geography and Climate
- §2. Cultural Composition
- §3. Political System
- §4. Population and Vital Statistics
- §5. Social and Cultural Values Affecting Canadian Health Law and Policy
- Chapter 2. General Description of the Health-Care System
- §1. General Review of the Health-Care System
- §2. Regulation of the Health-Care System
- §3. Financing of the Health-Care System
- §4. Health-Care Insurance
- §5. Pharmacare
- §6. The Opioid Crisis
- I. Opioid Addiction and the Health-Care System
- II. The Response: Efforts to Curtail the Opioid Crisis
- A. Regulating Prescriptions and Pharmaceutical Manufacturers
- B. Harm Reduction Strategies
- III. Legal Proceedings
- IV. The Ongoing Crisis
- Chapter 3. Medical Law
- §1. Definition and Function
- §2. Sources of Medical Law
- Part I. The Medical Profession
- Chapter 1. Access to the Medical Profession
- §1. Training of Physicians
- §2. Health Human Resource Planning
- §3. Licensing of Physicians
- Chapter 2. Illegal Practice of Medicine
- §1. Legal Definition of the Offense
- I. Statutory Definition
- II. Judicial Interpretation
- §2. Regulating Alternative and Complementary Approaches to Health Care
- Chapter 3. Control over the Practice of Medicine
- §1. Disciplinary Organizations and Professional Codes
- I. Government Licensing Agencies
- II. Procedural Requirements
- III. Substantive Grounds for Discipline in the Medical Profession
- A. General
- B. Burden of Proof of Professional Misconduct
- C. Discipline for Non-registration as a Medical Practitioner
- D. Discipline for Incompetency
- E. Discipline for Incapacity
- F. Discipline for Sexual Misconduct with Patient
- G. Appeals
- IV. Judicial Review of Grounds for Disciplinary Action
- A. Judicial Review of Disciplinary Action
- V. Challenges to the Professions Regulatory System: Ontario Developments as an Example
- §2. Professional Liability
- I. Civil Liability
- A. General
- B. Battery
- C. Burden of Proof
- D. Negligence
- 1. Duty of Care
- 2. Standard of Care and Breach of Duty of Care
- a. General
- b. Specialists
- 3. Defenses Applicable to the Standard of Care
- a. Locality
- b. Approved Practice
- c. Error of Judgment
- d. Cost Containment and the Availability of Resources
- 4. Resulting Injury
- 5. Causation
- 6. Other Defenses to Medical Negligence Actions
- a. Contributory Negligence of Patient
- b. Expiration of Limitation Period
- §3. Indigenous Peoples' Health
- I. Background: The Sociological Realities of Indigenous Health
- II. Legal Framework
- III. Aboriginal Healers: Recognition and Regulation
- A. Acceptance of Indigenous Healing Practices
- B. Regulation of Indigenous Health Practices
- Part II. The Physician-Patient Relationship
- Chapter 1. General Description
- §1. Rights and Duties of Physicians and Patients
- I. Contract Law as a Source of Rights
- A. Implied Contract
- B. Express Contract, Specific Promises and Warranties of Cure
- II. Fiduciary Duty as a Source of Rights and Duties
- §2. Consent
- I. General
- A. Valid Consent to Treatment Is Required
- B. Consent May Be Implied or Express
- II. Specific Exceptions
- A. Emergencies
- B. Blanket Authorizations
- C. Therapeutic Privilege
- D. Statutory
- §3. Informed Consent
- I. Introduction
- II. Standards of Disclosure
- A. Prior to 1980: Physician-Based Standard
- B. Patient Standard
- III. Factors to Be Disclosed
- A. Diagnosis
- B. Nature and Purpose of Treatment
- C. Risks and Outcomes
- D. Alternatives
- E. Prognosis if Treatment or Test Is Declined
- F. Prognosis with Treatment
- G. Disclosure of Conflicts of Interest
- IV. Causation of Damage Complexities
- §4. Privacy
- I. Medical Information and Records: Confidentiality and Disclosure
- A. Introduction
- B. Standards of Medical Record Keeping
- C. Electronic Health Records
- §5. Secrecy
- I. Provider Duty to Maintain Confidentiality
- A. Sources of the Duty
- B. Statutory Immunities
- C. Privilege
- D. Liability for Breaches of Confidentiality
- 1. Statutory
- 2. Common Law Remedies
- E. Provider Duties to Disclose Patient Information to Third Parties
- 1. Patient Consent
- 2. Statutory Disclosures
- 3. Duty to Warn Third Parties
- 4. AIDS Confidentiality and Reporting
- 5. Quality of Care and Outcome Data
- §6. Complaints
- §7. Access to Medical Records
- I. Ownership of Records
- A. Patient Access
- B. Third-Party Access
- II. Retention of Medical Records
- III. Discovery of Records
- IV. Medical Records as Evidence
- V. Alteration or Spoliation of Records
- §8. Medical Fees
- Chapter 2. The Physician-Patient Relationship in Specific Terms
- §1. The Minor Patient
- I. Parental Authority to Make Health-Care Decisions
- II. Limitations on Parental Authority to Make Health-Care Decisions for Their Children
- III. A Minor's Right to Forgo Life-Sustaining Treatment for Religious Reasons
- A. The General Rule
- B. Statutory Exemptions for Spiritual Healing
- IV. Special Rules for Infants with Life-Threatening Conditions
- §2. Patients with Mental Health Issues
- I. Decisional Capacity
- A. Competency, Decisional Capacity and the Notion of Variable Capacity
- B. The Presumption of Capacity
- C. Judicial Considerations of Questions of Capacity
- D. Legal Tests of Capacity
- II. Informed Consent and the Right to Refuse Treatment
- Chapter 3. Specific Activities
- §1. Abortion
- I. The Constitutional Framework
- II. Particular Limitations and Restrictions on Abortions
- A. Limitations on Government Funding
- 1. Restrictions on Funding of Abortions outside Hospitals
- B. Regulation of Medical Techniques and Facilities for Use in Performing Abortion
- 1. Techniques
- a. RU-486
- b. Methotrexate and Misoprostol
- 2. Facilities
- C. Record Keeping Requirements
- D. Consent or Notification Requirements
- 1. Parental Consent or Notification
- 2. Spousal or Partner Consent or Notification
- §2. Sterilization
- I. Introduction
- A. Competent Adults
- B. Incompetent Adults
- 1. Therapeutic Sterilization of the Mentally Incompetent
- 2. Non-therapeutic Sterilization of the Mentally Incompetent
- 3. Non-therapeutic Sterilization Before Eve
- II. Legal Limitations on Sterilization of the Mentally Incompetent
- A. Constitutional Limitations
- B. Parens Patriae Jurisdiction
- C. Provincial Limitations
- III. Other Forms of Contraception
- A. Introduction to Other Forms of Contraception
- B. Federal Regulatory Requirements
- 1. Authority of the Health Protection Branch
- 2. Penalties
- 3. Process for Approval
- 4. Emergency Contraceptive Pill
- §3. Reproductive Technologies
- I. Fertility Drugs
- II. Artificial Insemination
- III. In Vitro Fertilization (IVF) and Related Procedures
- IV. The Status of Frozen Pre-embryos
- V. Surrogacy
- §4. Organ Transplants
- §5. Safety of the Blood Supply
- I. Krever Inquiry
- II. Criminal Liability
- III. Civil Liability
- IV. Problems of Supply
- §6. Research Involving Human Beings
- I. The Governance of Research Involving Human Research Subjects in Canada
- A. Dual Sources of Governance
- 1. Canadian Research Agencies and the Tri-Council Policy Statement (TCPS 2)
- 2. Health Canada: Clinical Trials for Drugs and Medical Devices
- 3. Common Law and Civil Law Requirements for Research Involving Human Subjects
- a. Halushka v. University of Saskatchewan
- b. Weiss v. Solomon
- c. Brock (Litigation Guardian of) v. Hsu
- d. Stirrett v. Cheema
- e. Barker v. Barker
- 4. Other Sources of Regulation
- II. The Creation, Authority and Membership of REBs
- A. Creation of REBs
- B. Authority of REBs
- C. Membership of REBs
- III. Criteria for REB Approval of Research
- IV. Informed Consent to Participate in Research as a Human Subject
- A. Generally
- B. Elements of Informed Consent
- C. Waivers and Alteration of Informed Consent Requirements
- 1. Non-consensual Research
- 2. Deception
- V. Access to REB Records
- A. Generally
- B. Applicability of Access to Information Act (Canada) and Privacy Act
- C. Rules of Discovery
- VI. Regulation of Research Performed upon Special Groups of Subjects
- A. Children
- 1. Generally
- 2. Categories of Risk or Benefit
- 3. Consent
- a. Consent of Parties Other Than the Child
- b. Consent of the Child
- B. Fetuses and Embryos
- 1. Fetuses in Utero
- 2. Fetuses ex Utero
- 3. Embryos
- C. Research Involving Adults Lacking Legal Decisional Capacity
- VII. Research Involving First Nations, Inuit and Métis Peoples
- VIII. Liability of REBs
- IX. Transparency and Access to Data
- §7. Law at the End of Life
- I. Recent Developments: The Decriminalization of Medical Assistance in Dying
- II. The Right to Forgo Life-Sustaining Treatment
- A. Competent Adults
- B. Formerly Competent Patients: Anticipatory Decision-Making and Advance Directives
- 1. Advance Directives or Living Wills
- 2. Powers of Attorney for Health Care
- 3. Court-Appointed Guardians of the Person
- 4. Family Consent Laws
- C. Patients Who Have Never Been Competent
- III. Requests for Continuation of Futile Treatment
- IV. Medical Assistance in Dying (Euthanasia, Physician-Assisted Suicide)
- A. Terminology
- B. Background: Partial Legalization of MAiD in Canada
- C. The Current Legal Status
- 1. Permissible Acts: MAiD Eligibility
- 2. Exclusions from MAiD Eligibility
- a. MAiD for Mature Minors
- b. Advance Requests
- c. Mental Disorder Is the Sole Underlying Medical Condition
- D. The Ongoing Development of MAiD Laws in Canada
- 1. Conscientious Objections to MAiD
- 2. MAiD for Persons Not at the End of Life and for Persons Who Have Lost Capacity
- 3. MAiD for the Sole Reason of Mental Disorder
- Part III. The Physician and the Health-Care System
- Chapter 1. Relations with Health-Care Institutions
- §1. Hospitals
- I. History
- II. Ownership, Funding and Administration
- III. Licensing and Evaluation
- §2. Relations Between Physicians and Hospitals
- I. Staff Privileges
- Selected Bibliography
- Index
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