Chapters 1-5 Flashcards
What are the 7 factors that explain the expanding role of law in treatment?
1) rise in concern about the legal rights of patients and clients (shift to less paternalistic)
2) recognition that all competent patients (i.e. young, old, mentally ill etc) can make their own treatment decisions regardless of their next-of-kin
3) increases in public concern about specific issues i.e. child abuse, violence, privacy etc (cycle of apathy, crisis, panic)
4) lots of legislation that is piecemeal and overlapping
5) expansion of what is included in health i.e. naturopaths, traditional Chinese medicine etc
6) politicizing health care i.e. wait times, doctor fees etc
7) increasing fiscal restraint
How is the conduct of health professionals in Canada assessed?
did they act reasonably in the circumstances
did they act in good faith
Describe the Canada Health Act (CHA)
DOES NOT provide Canadians with any legal right to publicly-funded health care
sets out the conditions for full federal cash contribution to the provinces
is the legislative basis for the Federal-Provincial Health Accord (which expired in 2014)
is not comprehensive, it only covers the “insured health services” and “insured persons”
provincial insurance plan cannot provide payment for extra-billing or user fees
federal contribution must be acknowledged
does not address provincial policies on fees that physicians may charge for uninsured services
What are the 5 pillars of medicare?
1) public administration- must be administered on a non-profit basis by a public authority appointed or designated by the province
2) comprehensiveness- must cover all insured services (sets out ones that are mandatory)
3) universality- insured persons must be entitled to all insured health services on a uniform basis (not insured include Canadian Forces, RCMP, federal prisoners, visitors and transients)
4) portability- no minimum waiting period longer than 3 months before residents are eligible for insured services, also must provide coverage to insured persons who are travelling
5) accessibility- health care must be provided on uniform basis that does not directly or indirectly impede reasonable access to insured services
What are the levels of assault under the Criminal Code?
assault
assault with a weapon or causing bodily harm
aggravated assault (i.e. maiming, wounding etc)
there are a parallel set of sexual assault offences
sexual assault
sexual assault with a weapon, while threatening a third party or causing bodily harm
aggravated sexual assault
Define assault under the Criminal Code
intentionally applying force to another person, directly or indirectly, without that person’s consent
also includes attempting or threatening to apply force to another person if one has, or causes another person to reasonably believe that one has, the present ability to carry out the threat
does NOT include all future threats of force, only those which are framed in terms of immediate harm
Note: consent is not a defence if the victim submits because of a threat of force, fraud or exercise of authority
Define sexual assault under the Criminal Code
intentional application of force to another of a sexual nature, without consent, or attempting or threatening such conduct
Note: consent of a person under 16 years of age provides no defence to any sexual assault charges unless the complainant is 12 or 13 and the accused is less than 2 years older, or 14 or 15 and less than 5 years older (cannot be in a relationship of trust, power or authority)
What is sexual exploitation?
Criminal Code
a person who is in a position of trust or authority with a young person (16 or 17) or on whom the young person is dependent engaging in any sexual conduct with that young person
Note: it is also an offence to invite or encourage a young person to engage in such sexual conduct
What is criminal harassment?
Criminal Code
stalking
any person who knows, or is reckless as to whether another person is harassed, from engaging in specified conduct that causes that person to reasonably fear for his or her own safety or that of anyone known to them
(only an offence if the accused engaged in the specified conduct without lawful authority)
i.e. repeatedly following or communicating with the person, watching his or her home or workplace or engaging in threatening conduct
What is cyberbullying?
Criminal Code
publishing an intimate image without consent
transmitting, distributing or making available an intimate image of others knowing that they did not consent or being reckless in this regard
only an offence if there was a reasonable expectation of privacy when the recording was made and when they offence was committed
Describe providing the necessities of life
Criminal Code
parents, foster parents, guardians and heads of a family have a legal duty to provide the necessities of life to their children who are under 16 years of age
is a criminal offence if:
-the children are in “destitute or necessitous circumstances”
-the failure endangers their lives, or has or is likely to permanently endanger their health
also a similar one to provide necessities of life to those under your charge i.e. elderly parents but only if:
they are unable to withdraw from your charge and provide the necessities of life for themselves and the failure endangers their lives, or has or is likely to permanently endanger their health
Describe suicide and the Criminal Code
everyone who counsels, aids or abets a person to commit suicide is guilty of an indictable offence regardless of whether the suicide occurs (s. 241)
also section 14 says that no one can consent to having death inflicted upon him or herself, and that such consent does not affect the criminal liability of any person who acts upon it
Explain the civil law process
pleadings- plaintiff files a statement of claim or writ of summons which sets out their claim against the defendant and the compensation they’re seeking, court clerk issues the claim but affixing the seal of the court and signing on the court’s behalf, plaintiff must arrange for a copy to be served on the defendant, defendant can provide a statement of defence (if not they are held liable), the statement of claim, statement of defence and all other documents filed with the court are called pleadings
discovery- pre-trial meeting at which the parties can clarify the issues and examine the witnesses, evidence and documents that the other party intends to use at trial, can settle
trial- plaintiff’s case is presented first, plaintiff must prove that the defendant committed a tort and that the tort was a cause of his/her losses (must establish that they are recognized as being recoverable in law), then the defendant makes his/her case, lawyers can cross-examine each other’s witnesses, both parties summarize their cases for the judge or jury and judge or jury decides if the defendant is liable and assesses damages
When a judge or jury assesses damages what are they doing?
attempt to put the plaintiff in the position, to the extent that money can do so, that he or she would’ve been in had the tort not been committed
usually pay legal costs as well
Note: a damage award provides no guarantee of recovering compensation, just permits the plaintiff to pursue various credit remedies against the defendant
In Carter v Canada what did the Supreme Court decide?
that ss. 241 (b) and 14 of the Criminal Code violated the Charter in regard to physician-assisted dying in the case of competent adults with grievous and irremediable medical conditions that cause enduring and intolerable suffering
Describe the tort of battery (civil law)
the intentional bringing about of any harmful or socially offensive physical contact with the person of another
don’t need to be harmed or away of the contact at the time
once the contact is proven, the defendant will be held liable unless he or she can establish defence i.e. consent
Note: mistaken belief that the plaintiff consented is not a valid defence
Describe assault in tort law
defined more narrowly than in criminal
the intentional creation in the mind of another of a reasonable apprehension of imminent physical contact
if the defendant had the apparent intent and ability, it doesn’t matter whether he/she actually intended or had the ability to do so
includes a threat of any immediate harmful or socially offensive physical contact
What is vicarious liability based on?
based on their relationship with the wrongdoer and not personal fault on their part
Can managers, supervisors and administrators be held vicariously liable for wrongful acts committed by their subordinate staff?
no but they may be held directly liable in negligence for failing to adequately screen, hire, train, place, monitor or discipline their staff
Note: employer would be held vicariously liable for the wrongful act of the frontline staff and the responsible manager, supervisor or administrator
Can board members be held vicariously liable for torts committed by an organization or its employees?
no
What is the 2-step approach to figuring out if someone can be held vicariously liable?
if pre-existing cases establish that it applies in the circumstances
if they were in a sufficiently close relationship with the wrongdoer and there was a significant connection between the wrongful act and the wrongdoer’s assigned task or authorized conduct
Child and Family Services Act
includes section that have statutory ages of consent for stipulated services and the mandatory reporting obligation regarding children in need of protection
Note: the CFSA’s definition of capacity, informed consent, age requirements, record keeping rules, and confidentiality provisions differ from those in the common law and the HCCA
Coroner’s Act
coroners are responsible for investigating and recording unexplained and suspicious deaths and deaths that occur in specified institutions, such as jails and other custodial institutions
also contains several mandatory reporting obligations
i.e. everyone who reasonably believes that a person may have died as a result of negligence, suicide, homicide, misadventure or other suspicious circumstance needs to report it to a coroner or police officer
Health Protection and Promotion Act
purpose is to protect the health of the public
creates boards of health to oversee the provision of programs and services i.e. sanitation, immunization, monitoring communicable diseases, preventative dentistry for school children, family planning, home care for the chronic and actually ill and public health education
also provides for the inspection and regulation of restaurants etc
also outlines the situations in which various health agencies and professionals just report communicable diseases or dangerous conditions to a medical officer of health
Trillium Gift of Life Act
governs inter-vivo and post-mortem donations of organs and tissue
ie must be 16 and competent to donate inter-vivo donation of non-regenerative tissue
also regulates substitute consent for these procedures
Mental Health Act
governs administration of psychiatric hospitals, and the criteria and procedures for voluntary, informal and involuntary admission, and community treatment orders
ie prohibits substitute consent to psychosurgery
also requires that every person admitted to a psychiatric facility be examined by a physician to determine their capacity to manage his/her own property
Public Hospitals Act
governs the administration of public hospitals
including medical records, admission of patients, funding and appointment of medical staff and the provision of training facilities for students
also provides for provincial grants and loans to hospitals
Limitations Act
stipulates the maximum amount of time that can pass between a wrongful act and a civil suit
standard limitation period is 2 years
limitation period doesn’t begin until the plaintiff knew or ought to have known the facts upon which the action is based, understood the harms that resulted from the wrongful act and was physically, mentally and psychologically able to commence an action
Unless a statute states otherwise what governs the relationship between health professionals and their patients?
common law principles of consent
At common law is a practitioner’s mistaken belief that the patient consented a defence?
no
What are some exceptions to the common law principles of consent?
unforeseen medical emergency where it is impossible to obtain a patient’s consent
consent to surgery, an overall course of treatment or a treatment plan provides consent to subordinate or technical procedures that are an inherent part of the surgery, course of treatment or treatment plan
therapeutic privilege to withhold information (not so much anymore)
When does the HCCA replace the common law?
only in regard to specified treatment and services provided by stipulated categories of professionals
What does Part II of the HCCA apply to?
applies to “treatment” which is broadly defined as anything that is done for a therapeutic, preventative, palliative, diagnostic, cosmetic or other health-related purpose and includes a course of treatment or plan of treatment
however this EXCLUDES:
capacity assessments, any treatment that poses little or no risk, examinations to determine the patient’s general condition, taking a history, admission to a hospital, psychiatric, care or other facility and personal assistance services
unless you proceed as though an excluded treatment was treatment then it does (LOL WTF)
applies to regulated health practitioners, but not social workers, addiction counsellors, employment assistance workers and youth workers
also governs substitute consent to general and emergency admission to hospitals and psychiatric facilities
What does Part III of the HCCA apply to?
governs substitute consent to admission and crisis admission to a care facility
What does Part IV of the HCCA apply to?
governs substitute consent to personal assistance services i.e. feeding, washing etc
What does Part V of the HCCA apply to?
governs the CCB (Consent and Capacity Board)
What does the HCCA not apply to?
various orders of a medical officer of health relating to communicable or virulent diseases
regulations governing communicable diseases in the eyes of newborns
substitute consent to research, non-medical sterilizations, and organ and tissue transplantation
the common law duty of caregivers to confine and restrain a person to prevent serious bodily harm
What is the general principle of consent under the HCCA?
Regulated health practitioners cannot provide treatment unless they are of the opinion that the patient was capable and consented or of the opinion that the patient was incapable and his/her SDM consented
What are the elements of a valid consent under the HCCA?
consent must be related to the proposed treatment
patient must be adequately informed prior to consenting
questions need to be answered honestly
must be voluntary
may be given expressly or implicitly
must not be obtained by misrepresentation or fraud
What kind of claim does failure to obtain a valid consent give rise to?
traditionally was battery
however now is only battery if the patient did not consent at all, the consent was exceeded or obtained fraudulently
in all other cases a negligence claim must now be brought
What is the 2-part test for capacity under the HCCA?
a patient is capable if they are able to understand the information related to the specific decision AND is able to appreciate the reasonable foreseeable consequences of consenting or refusing consent
Note: this applies whether the patient is an adult, minor, developmentally disabled, intoxicated, high, involuntarily detained in a mental hospital, vulnerable, frail, rash, or immature
also note: there is not diminished capacity, either capable or not
What happens when a CCB decision is challenged to the court?
until the case is resolved no treatment can be provided, except in an emergency
When are binding prior expressed wishes made?
when the patient is 16 and capable
When is a person capable of making property decisions? What act does this fall under?
if he/she is able to understand the information relevant to making the financial decision in question and is able to appreciate its reasonably foreseeable financial consequences
substitute decisions act
What is the age of consent to treatment at common law? HCCA?
there is no age for consent for either common law or the HCCA
however some courts have reframed the test of capacity to ensure that they are “mature” minors
What are the statutory ages of consent under the HCCA?
16 and older can consent to any services
under 16 require parental or guardian consent for residential care or psychotropic drugs
12 and older may consent to counselling without parental knowledge, however under 16 they must be informed of the desirability of involving their parents
Note: the CFSA does not address whether a competent child under the age of 12 can consent to counselling without parental consent
What does the Education Act say in terms of consent?
parental consent is required for IQ or personality testing for a student under 18
parents have a right to the pupil’s Ontario Student Record if the pupil is under 18
Note: the Education Act does not prevent schools from offering treatment, referral, assessment or counselling services to competent students under 18
Under the HCCA, if there are no prior expressed binding wishes, what must an SDM take into account when determining the patient’s best interests?
values and beliefs
previously expressed wishes when 16 or under or incapable
whether their condition or well-being is likely to improve
whether the treatment’s benefits outweigh the risks
whether a less intrusive treatment would be just as beneficial
Can an SDM consent to ancillary treatments and to admission to a hospital, psychiatric or other health facility?
yes
unless an incapable patient 16 or older objects to admission to a psychiatric facility, then an SDM can’t admit them voluntarily
When can an SDM apply to the CCB to challenge a patient’s prior expressed wish?
if its applicability in the circumstances or the patient’s capacity when the wish was expressed is unclear or if the patient was now capable they would probably consent because the outcome is significantly better than he or she would’ve anticipated
Name the 5 ways in which someone can obtain legal authority to make person care decisions on behalf of an incapable person in descending order
Court-appointed guardian of the person POA for personal care personal representative family members and other named under the HCCA section 20 Public Guardian and Trustee
What is the hierarchy of SDMs under the HCCA?
1) court-appointed guardian of the person
2) POA for personal care
3) personal representative appointed by the CCB
4) spouse or partner
5) child, parent or guardian
6) parent with only a right of access
7) siblings
8) other relatives related by blood, marriage, adoption
9) PGT
What is considered a spouse under the HCCA?
married, living together for at least a year, are the parents of a child together or have a cohabitation agreement under section 53 of the Family Law Act
lived together for at least a year and have a close personal relationship that is of primary importance in both of their lives
Note: are not a spouse if they are living separate as a result of a breakdown in their relationship
What happens if 2 or more people at the same level disagree when making a substitute decision?
the PGT makes the decision
What are the 5 ways to obtain authority to exercise substitute consent on behalf of an incapable person?
1) court-appointed guardian of property
2) POA for property under the Powers of Attorney Act
3) POA for property under the Substitute Decisions Act
4) statutory guardian pursuant to the Mental Health Act
5) statutory guardian pursuant to a certificate of incapacity
What are the obligations of guardians and powers of attorney for property?
must make decision in good faith for the incapable person’s benefit
must explain their powers and duties and encourage the incapable person to participate to the extent possible
encourage regular contact with supportive family and friends
must keep proper accounts for all transactions
if compensated must do a job equal to ppl who are compensated
are liable for damages resulting from a breach in their duties
in expenditures, priority must be given to the incapable person’s care and support
gifts, loans and charitable donations are limited
PGT must keep an updated list of guardians and give it to anyone who requests it
What does the legal concept of custody refer to?
a bundle of decision making rights and responsibilities regarding a child including where they live, religious upbringing, education, day-to-day parenting decisions, authority to make treatment, counselling and care decisions
but only if a child is incapable of making these decisions for themselves or if a a statute authorizes the parent to make the decisions on behalf of the child
What does an access parent have authority to?
rights to visit and be visited by the child
the same rights as the custodial parent to information about the child’s health, education and well-being
Who has legal custody of a child?
both parents unless a separation agreement or court order provides otherwise
if the parents don’t live together the custodial parent is deemed to be the one the child lives with
What 4 factors do the courts recognize that can negate consent?
mistake - mistaken belief that a health professional was responsible for creating
fraud - fraudulent belief that either the health professional made or was aware of, however only if it went to the NATURE of the act and not a collateral matter (except in HIV cases etc then it is to the harmful consequences of the act)
duress - compulsion/coercion, narrowly defined as a threat of immediate physical force
public policy - consent may be negated if it would be unfair or unconscionable to allow the defendant to raise the defence or if the consent was obtained by exploiting a relationship of trust
When does the Criminal Code permit treatment without consent? (federal)
- taking blood samples from unconscious impaired driving suspects in cases involving death or bodily injury
- judges can issue warrant fir taking blood, hair or saliva samples for DNA testing from individuals who are reasonably believed to have committed a specified sexual or other designated offence
When does the Quarantine Act allow treatment without consent? (federal)
travellers can be detained, medically examined and treated without consent in order to prevent introduction or spread of a communicable disease
Note: travellers are those arriving in or leaving Canada
When does the Ontario Health Protection and Promotion Act allow treatment without consent?
- a MOH can order someone to submit to an examination and/or treatment for a communicable disease or order them to refrain from specific conduct
- if they fail to comply the MOH can apply for a court order for a virulent disease
- the court can order the, to be detained and treated for up to 6 months
When does the Immunization of School Pupils Act allow treatment without consent?
it doesn’t really
students need to be immunized or exempted (religious, conscientious or medical grounds) or else an MOH can require a school to suspend them
What does the Child and Family Services Act do?
authorizes Children’s Aid Societies to apprehend and detain children in need in specified situations
does NOT give them the right to consent or refuse on the child’s behalf, it merely transfers the decision making authority the parents had to them
What are the common law rights with respect to life-prolonging treatment?
there is a common law right to refuse and withdraw from life-prolonging treatment and to demand that a third party withdraw life prolonging treatment (regardless of consequences)
there is NO common law right to demand life-prolonging treatment be initiated or demanding that it be continued
Note: that the SCC interpreted the HCCA as requiring consent to withdraw life prolonging treatment though (Cuthbertson v Rasouli)
What can physicians do regarding DNRs?
may issue a DNR if resuscitation is medically inappropriate, but may need consent of the patient, the SDM, CCB or a court
How is assisted suicide differentiated from euthanasia?
usually euthanasia if the doctor were to play a direct physical role i.e. inject the substance etc
What is euthanasia considered?
both voluntary and involuntary euthanasia are considered to be first-degree murder under sections 229 and 231(2) of the Criminal Code
may have a defence in certain circumstances given Carter v Canada
What is Bill 52?
a bill enacted in Quebec requiring that all institutions provide end-of-life care, which includes terminal palliative sedation and medical aid in dying
must be 18 or older, capable, insured and have an incurable serious illness, be in an advanced state of irreversible decline in capability and suffer constant and unbearable physical or psychological pain that cannot be relieved
When is an accused found unfit to stand trial?
if they are unable, because of a mental disorder, to understand the nature or possible consequences of the proceedings or to communicate with counsel
What happens if an accused is found to be unfit?
they are detained and treated without their consent for up to 60 days
after that if they are still unfit the trial is stayed
trial can continue if/when their condition improves and they become fit
When can someone be NCR?
if they were suffering from a mental disorder that made them incapable of appreciating the nature and quality of the act or of knowing that it was wrong both legally AND morally (R v Chaulk)
party raising the issue must prove it
What happens if the accused is NCR?
absolute discharge, conditional discharge or detention in a hospital
must do the least restrictive one
cannot be treated against their will even if its in their best interests
Criminal Review Boards maintain authority over them until they are absolutely discharged
What are high-risk accuseds?
designation for ppl found to be NCR for a serious personal injury offence
are not eligible for absolute or conditional discharge
must be detained in hospital until a court removes the designation based on a Criminal Review Board’s recommendation
What are general factors associated with mental health and sentencing?
psychiatric and psychological issues
willingness to address these issues
ongoing risk
What are aggravating factors associated with mental health and sentencing?
history of violence
refusal to seek responsibility
failure to seek or accept assistance for an underlying psychiatric, psychological or other problem
What are mitigating factors associated with mental health and sentencing?
having a physical or mental disability
acceptance of responsibility
commitment to address psychiatric, psychological or other problem
Can participation in treatment be a condition of probation, parole or conditional discharge?
yes
they can refuse consent however they will probably not get parole etc then
What are dangerous offenders?
must be convicted of sexual, violent or other serious offence whose persistent aggressive conduct or brutality indicates that they pose an ongoing threat to the life and safety of others
are subject to indeterminate imprisonment and restricted parole eligibility (if/when paroled are put on lifetime supervision)
What are long-term offenders?
must be convicted of sexual, violent or other serious offence that warrants at least 2 years imprisonment and the accused poses a substantial risk of reoffending that may eventually be controlled in the community
are subject to a long-term supervision order of up to 10 years after release and parole has ended
What are voluntary patients?
capable individuals who are admitted to a psychiatric facility on their own behalf
cannot be detained, however their status can be changed if they meet the criteria
What are informal patients?
incapable individuals who are admitted under their SDM’s authority and consent
16 and older cannot be admitted against their will by their SDM except in limited circumstances
What are involuntary patients?
individuals detained in a psychiatric facility under a certificate of involuntary admission or renewal
admission is based on statutory authority and not their SDM
When does section 15 of the MHA allow a physician to apply for psychiatric assessment of a person? (and similar circumstances for police, justices of the peace and judges)
physician needs to have REASONABLE cause to believe that one of the criteria was met:
(a) threatened or attempted to cause bodily harm to him/her self
(b) has behaved violently towards another person or has caused another person to fear bodily harm from him or her
(c) has shown a lack of competence to care for him/her self
also needs to be of the opinion that the person’s mental disorder would LIKELY result in one of the following:
(d) serious bodily harm to the person
(e) serious bodily harm to another person
(f) serious physical impairment of the person
physician then must fill out a Form 1 and sign within 7 days
this completed form allows them to be detained and assessed in a psychiatric facility for up to 72 hours (does not let you treat)
after assessment physician must decide if they are to be released, admitted as voluntary, informal or involuntary
What section of the MHA sets out the criteria for involuntary admission? What are they? Then what?
section 20(5)
physician must be of the opinion after assessing that he/she is both:
(a) suffering from a mental disorder of a nature or quality that likely will result in
serious bodily harm to the patient, another person or serious physical impairment of the patient
and
(b) that the patient is not suitable for admission or continuation as a informal or voluntary patient
then fill out a Form 3
can then detain, restrain, observe and examine the patient for up to 2 weeks
then for 1 month, then 2, then 3, then 3 thereafter
When can a CTO be issued?
need to meet the criteria for involuntary admission
must within the past 3 years have been admitted to a psychiatric facility 2 or more times or for a cumulative period of at least 30 days or have been the subject of a previous CTO
physician must have examined them in the last 72 hours and believe that they have a mental disorder, such that the patient needs continuing treatment, supervision or care while living in the community
also need consent of the patient or SDM, consult broadly in developing the community treatment plan and inform their patient of their legal rights
When does a CTO expire?
after 6 months if not renewed or terminated
can be terminated at the patients request or if they withdraw (or SDM withdraws) consent to the treatment plan
What happens if the treatment plan of a CTO is breached?
physician can issue an order which authorizes police to apprehend them
once returned to the facility physician must examine them and see if they should be released, held for an assessment or subject to another CTO
When must a rights adviser be notified?
when a certificate of involuntary admission is issued or renewed or when (with some exceptions) a patient between the ages of 12 and 16 is admitted as an informal patient
What governs consent to psychiatric treatment?
the HCCA not the MHA
When does the MHA allow patients to be restrained?
only involuntary patients
however you have a common law power to restrain any patient to prevent them from seriously injuring themselves or others
What is not included in psychosurgery?
electroconvulsive therapy and specified neurological procedures
Neto vs Klukach
Neto bipolar, doesn’t like Li
3 criterion for determining if they have the ability to evaluate the relevant information
1) need to acknowledge that they have what others may call a mental illness
2) need to understand how treatment and alternatives can affect their quality of life
3) decision must not be based substantially on delusional thinking
court granted her appeal because she was okay on all 3 of these
Park v Park
husband POA for care, daughter for property
husband wanted to be both, tried to have her declared incapable
capacity assessor indicated that Mrs. Park had shown a clear understanding of her financial decisions and an appreciation of why her decisions were correct
her appeal was granted
Scardoni v Hawryluck
on ventilator doctors wanted to take her off, daughters did not, said it was because she was a devout Roman Catholic
Court set aside the CCBs decision and wouldn’t let the doctors terminate her treatment because:
-it is based on values and beliefs not church doctrine
-statements about life should be considered general expressed wishes even though they weren’t precise enough to be binding
-may have misapprehended evidence thinking she was suffering more than she was
Hamilton Health Sciences v D. H.
11 yo with leukaemia, mother withdrew from chemo
Court did not allow the the order bc she was a loving parent and protected by aboriginal beliefs
except it doesn’t matter that she was a caring parent and the mother’s cultural beliefs are not relevant to making treatment decisions for a child
eventually had an addendum in which she got chemo and the traditional therapy
R vs Mabior
HIV and consent based on a fraudulent belief
needed to use a condom and have a low viral load
6 charges, acquitted on 4, then 3 were reinstated
Norberg v Wynrib
doctor having sex with addicted patient in exchange for drugs majority said battery 1 said negligence 2 said breach in fiduciary duty (supreme court)
Nancy B v Hotel dieu
capable 25 yo, couldn’t move, wanted to be taken off the ventilator
court granted her injunction
judge ignored another case the criminal code
Rotaru v Vancouver General Hospital
wanted to resume treatment of terminally ill mother even though doctors were against it
court didn’t allow it because it would be an abuse of its power to require doctors to act contrary to their fundamental duty to their patients
medical records were released for a second opinion
IHV Estate v
S. C. wanted to become court-appointed guardian of her mother and sought an injunction preventing her ventilator from being removed
became guardian, injunction not given
didn’t want to require doctors to treat contrary to their view
medical records were released and SC had to be notified 72 hours before ventilator was removed
Cuthbertson v Rasouli
in PVS his wife didn’t want to consent to withdrawal of life support and giving only palliative care
majority Supreme Court upheld that this was considered treatment under the HCCA and thus consent was required and the doctors couldn’t do it
2 dissenting justices said that HCCA didn’t have anything to do with this
Carter v Canada
ss. 14 and 241(b) and physician-assisted suicide
R vs Chaulk
15 and 16 year old broke into house and killed owner
found NCR because they understood it was legally wrong but not that it was morally wrong
Re W.J.K.
42 yo women with schizophrenia and history of violence and non-compliance with meds
involuntary patient, appealed certificate of renewal
which was granted
had been charged with assault but there wasn’t evidence that she actually caused bodily harm
also no evidence she hurt anyone in the hospital
said if she found her imaginary children she would call a lawyer
evidence fell short that it was “likely” that she would cause serious bodily harm to another
Re N.O.
16 yo, schizophrenia
challenged involuntary admission
certificate was granted
even though he hadn’t hurt anyone yet, he had a history of violence, wouldn’t take medication would probably hurt someone
