Midterm Flashcards
CMPA
Canadian Medical Protection Association
Canada Health Act
Criteria for provincial health insurance plans to receive a federal contribution
5 pillars of medicare
Public Administration Comprehensiveness Universality Portability Accessibility
CC Assault
Intentionally applying force without consent. Could be attempting or threatening. Must be capable of causing immediate harm
Sexual Assault
Threatening, attempting or applying force of sexual nature without consent
2 occasions when people under 16 can consent to sex
12-13 and the partner is less than 2 years older
14-15 and the partner is less than 5 years older
Sexual Exploitation
Sexual contact of a 16-17 year old by a person of authority or trust
Providing necessities of life
Without lawful excuse, for children under 16. If children/dependents are destitute or health is endangered.
3 stages of civil law proceedings
Pleadings
Examination for discovery
Trial
Pleadings
Statement of claim by plaintiff and statement of defense by defendant. Defendants’ failure to respond is a win for the plantiff
Discovery
Pre-trial meeting to review evidence and examine witnesses. Minimize surprise of trial and try to settle
Trial
Prove defendant committed tort resulting in recoverable losses for the plaintiff. Could be given a damage reward, allowing to them to seek recovery
Common law. Battery
Intentional, harmful or socially offensive physical touch. Any non-consensual contact besides socially accepted practice. Plaintiff does not need to be harmed or even be aware at the time. No touch, no battery.
Common law. Assault
Intentional creation of mind in another of reasonably imminent physical contact. Need apparent intent and ability, but not actual physical contact. No need to be harmed
How can an administrator be found liable
Negligence–> personally liable through screening, hiring, monitoring of employees
Vicarious Liability
Based on relationship with wrong-doer, not personal fault. Does not apply to independent contractors
When can an employer be held liable for an employees intentional criminal act?
Physical/sex crimes in which the assigned task put the accused in a position that would increase the likliehood of act
Vicarious liability test
Party is sufficiently close to tort feasor
Significant connection between wrongful act and assigned task
Child and Family Services Act
Provincial legislation governing services provided to children including age of consent and mandatory reporting of abused children
Coroners Act
Duty of HCPs and institutions to report unexpected or suspicious deaths to police.
HPPA
Health promotion and protection act. Governs public health and boards of health, monitoring disease, health eductaion and food safety
HCP duty under HPPA
Must report communicable and virulent diseases to minister of health
Trillium Gift of life
Governs inter-vivos and post-mortem organ/tissue donation
Age for organ donation
Must be 16 and capable to donate non-regenerative tissue
MHA
Administration for criteria of voluntary/involuntary admission to psychiatric facilities, and CTOs. Does not govern treatment
What is the period of limitations for almost all civil actions
2 years. Begins when plaintiff should have known of events, and was able to bring the charges
What crimes are not subject to limitation act
Assault involving minors with a person in a position of trust or dependency
4 exceptions to HCCA consenting
Medical emergency where obtaining consent is impossible, life saving measures can be taken immediately
Medical officer and disease spread measures
Chemicals in the eyes of newborns
SDM consent to research, sterilization, transplant
HCCA
Consent and Capacity provisions. Criminal code and common law still apply
HCCA Part 2
Treatment–> admission to facility, exams, low risk treatment, assistance with ADLs. SDM consent to admission to facilities
HCCA Part 3
SDM consent to admission to a care facility–> long term care home
HCCA Part 4
SDM consent to personal assistant services
HCCA Part 5
Consent and capacity board
Treatment without consent is..
Negligence for not obtaining consent
“Capable” under HCCA
Able to understand information related to decision and foreseeable consequences. Threshold is low to protect patient autonomy
Neto vs. Klukach
Girl with bipolar is now refusing to take lithium based on past bad experiences. CCB agreed with doctor she was incapable. Court decided she was based on 3 principles
3 principles of determining capacity in court
Patient does not need to admit they are mentally ill
Must be able to assess information and consequences
Decision must not be based on delusional thinking
Incapable person right to appeal
Able to appeal to CCB or court but no treatment can be provided until the matter is reolved
Prior expressed wish
Capable person older than 16 can express a binding wish for future care. Unsubstantiated claims are accepted
HCCA age of consent for tretament
There is none. Anyone that is capable can consent or refuse treatment or to have information shared with parents
3 ages of consent under Child and family Services Act
16 and older can consent to anything
Under 16 need parental consent for admission to residential facilities and taking psychotropic drugs
12 years old can consent to counselling without parents
Ages for SDA
16 and older can be POA for personal care
18 and older can be POA for property
Education Act
Parental consent needed for personality and IQ testing of students under 18. And their right to access and seek correction of their Ontario student record
Priorities of decision making for SDM
Prior expressed wish
Values, beliefs
Wish made while under 16 or incapable
When can an incapable person over 16 be admitted to a psychiatric facility involuntarily
If SDM is a court appointed POA or statutory guardian
5 ways to become SDM for personal care of an incapable person
Court appointed guardian POA for personal care Personal representative Family members and others under s.20 Public guardian and trustee
Duty of PGT in personal, property care
Must investigate any allegation that the person is suffering, or their assets are at risk. Must apply to become temporary guardian
Hierarchy of SDMs under HCCA s.20
9
Court appointed guardian POA for personal care Personal representative appointed by CCB Spouse or partner cohab. 1 yr or have a kid Child, parent, guardian Parent with right of access Siblings Blood relatives, marriage, adoption PGT
Janzen vs Janzen
EJ was a vegetable. Sister did not want to pull the plug but the wife did.
Both applied to court but sided with the wife saying it was in his best interest
5 ways to obtain authority to be SDM of property
Court appointed guardian of property POA under POA act POA under SDA Guardian under MHA Guardian from certificate of incapacity
PGT is guardian of property when
Patient is in a psych facility, or for certificate of incapacity
Non-custodial parents
Can not consent, even if they have right to access. They are entitled to info on the child’s health and well-being
CMG vs DWS
Mom and dad battle over vaccinations for kid. Dad wins
4 factors negating consent
Mistake
Fraud
Duress/ Compulsion
Public policy
Fraud
Knowingly making a false statement or misleading the patient by ommitting information. Must directly lead to risk of serious bodily harm
Dures/Compulsion
Threat of immediate physical harm.
Public policy
Consent is negated if defense is unconcionable or consent was obtained through expolitation of a position of trust
CC treating without consent
Permits drawing blood from an unconcious person suspected of impaired driving causing serious bodily harm. DNA testing for people accused of serious crimes
Quarantine Act
Travellers arriving or departing from Canada can be detained and treated for communicable disease without consent
HPPA laws for MOH
MOH is permitted to order exam/treatment for communicable/virulent diseases. Can apply to court for failure to comply with orders
Immunization of pupils
Allows MOH to suspend unimmunized children who have not been exempted based on religion or medical reason. Unimmunized children can be excluded during an outbreak
CC s.14
Homicide provisions. Struck down by Carter
Life prolonging tretament
No right to demand that life prolonging treatment be initated. But you do need to consent to withdraw it
Cuthbertson vs Rasouli
Rasoulis doctors wanted to take him off life support because he was in a vegetative state. Court granted wife injunction so they couldnt do it without consent. Turning off respirator and beginning palliative care was a treatment that they must consent to
DNR
Patient, SDM or doctor can order one
Carter vs. Canada
Struck down sections 14 and 241 of criminal code, allowing doctors to assist suicide for patients who are capabale and suffeirng
Bill C-14
Replaced sections 14 and 241. New provisions for medical aid in dying
Euthanaisa
Inducing gentle death. Now allowed if they meet criteria under C-14
Bill 52
`Quebec ill requires all institutions to provide end of life care. Must notify the minister if the doctor refuses.
Unfit to stand trial
Suspected of havign a mental disorder preventign them from undertsnading the proceedings or to communicate with counsel. Can be detained and treated without consent for 60 days
R. vs Dobson
Tried to use NCR due to schizophrenia as a defense for stabbing two women. Court said he understood that it was wrong
NCR options
Absolute discharge
Conditional Discharge
Detain in hospital
Dangerous offender
Serious crime and persistent agression that poses a threat–> lifetime supervision, limited parole
Long-term offender
Serious crime and high risk of reoffending–> long term supervision and community tretament
Voluntary patient
Capable, admitted on their own behalf, cant be dteained
Informal patient
Patient 12-15 admitted under SDM consent
Involuntary patient
Detained in facility under certificate of stautory authority. Age 16 up can rarely get admitted against their will
S. 51 MHA
Authorizes police, justice of the peace and judges to apprehend and detain people suspected of having a mental illness if they threaten bodily harm or show lack of self-care
Process of s.51 apprehension
Doctor does form 1 within 7 days, given power to detain and assess person ina faiclity for 72 hours. No authority to treat
S. 20 MHA
Criteria for involuntary admission. Form 3 allows doc to detain and examine for 2 weeks. Certificate of renewal lasting 3 months
When must the doctor notify the rights officer?
When an informal patient is admitted ot a CTO is initiated or renewed.
Community Treatment Order
Involuntary criteria are met, person has been in a facility for 30 cumulative days in the last 2 years . Expires in 6 months
