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1
Schmeiser, Douglas A. "Living Wills and Medical Treatment of the Terminally Ill." Healthcare Management Forum 2, no. 3 (October 1989): 32–37. http://dx.doi.org/10.1016/s0840-4704(10)61226-4.
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A terminally ill individual may sign a living will, which is a document requesting to be allowed to die a natural death, have it witnessed and address this wish to a relative, physician, lawyer or medical facility. No legislation, however, exists in Canada concerning living wills. Consequently, establishing the legal situation is based on both legislative and non-legislative sources. This article explores implications of the Criminal Code, the application of rules of criminal and civil law, provisions of the Charter, living will legislation in the United States and the power of attorney approach regarding this controversial issue.
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Villeneuve, Michael J. "Medical Assistance in Dying: A Review of Canadian Regulatory Documents." Policy, Politics, & Nursing Practice 21, no. 2 (May 2020): 56–59. http://dx.doi.org/10.1177/1527154420923733.
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After years of heated debate about the issue, medical assistance in dying (MAiD) was legalized in Canada in 2016. Canada became the first jurisdiction where MAiD may be delivered by nurse practitioners as well as physicians. Experience has revealed significant public demand for the service, and Canadians expect nurses to advocate for safe, high-quality, ethical practice in this new area of care. Pesut et al. offer a superb analysis of the related Canadian nursing regulatory documents and the challenges in creating a harmonized approach that arise in a federation where the Criminal Code is a federal entity and the regulation of health care providers and delivery of care fall under provincial and territorial legislation. Organizations like the Canadian Nurses Association contribute to the development of good legislation by working with partners to present evidence to help legislators consider impacts on public health, health care, and providers. Nursing regulators across Canada responded quickly to the unfolding policy landscape as the federal legislation evolved and will face that task again: In February 2020, the federal government tabled legislation to relax conditions related to MAiD requests that will force regulators and professional associations back to public advocacy and legislative tables. The success of the cautious approach exercised by nursing bodies throughout this journey should continue to reassure Canadians that their high trust in the profession is well placed.
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Kiang, Milton. "Medical Mask Resellers Punished in Canada." Studia Humana 9, no. 2 (July 1, 2020): 69–74. http://dx.doi.org/10.2478/sh-2020-0014.
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AbstractIn times of pandemics or natural catastrophes, prices of commodities, such as water, food and medicines, tend to shoot up, in response to a surge in demand and depleting supplies. The government, in its misguided efforts to maintain “price affordability”, imposes price controls and anti-price-gouging legislation and bans the reselling of food and medical supplies. These interventions in the free market are the exact opposite of what the government should do, if it wants to ensure that enough commodities go to people who need them, that people do not hoard all available goods on grocery shelves, and most importantly, that suppliers have the incentive to produce more goods to meet current and future demand at market prices.
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Singh, Harprit Kaur, Mary Ellen Macdonald, and Franco A. Carnevale. "Considering medical assistance in dying for minors: the complexities of children’s voices." Journal of Medical Ethics 46, no. 6 (April 24, 2020): 399–404. http://dx.doi.org/10.1136/medethics-2019-105762.
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Medical assistance in dying (MAID) legislation in Canada followed much deliberation after the Supreme Court of Canada’s ruling in Carter v. Canada. Included in this deliberation was the Special Joint Committee on Physician Assisted Dying’s recommendation to extend MAID legislation beyond the inclusion of adults to mature minors. Children's agency is a construct advanced within childhood studies literature which entails eliciting children’s voices in order to recognise children as active participants in constructing their own childhoods. Using this framework, we consider the possible extension of MAID legislation to most minors. We highlight important questions regarding how insights from children’s voices could be mobilised in the life or death context of MAID. We conclude that children’s voices have the potential to help determine their eligibility for MAID; however, incorporating children's voices in the context of MAID requires careful consideration due to the complexity of voice.
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BROWNE, ALISTER, and J. S. RUSSELL. "Physician-Assisted Death in Canada." Cambridge Quarterly of Healthcare Ethics 25, no. 3 (June 27, 2016): 377–83. http://dx.doi.org/10.1017/s0963180116000025.
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Abstract:The Criminal Code of Canada prohibits persons from aiding or abetting suicide and consenting to have death inflicted on them. Together, these provisions have prohibited physicians from assisting patients to die. On February 6, 2015, the Supreme Court of Canada declared void these provisions insofar as they “prohibit physician-assisted death for a competent adult person who (1) clearly consents to the termination of life and (2) has a grievous and irremediable medical condition (including an illness, disease or disability) that causes enduring suffering that is intolerable to the individual in the circumstances of his or her condition.” This declaration of invalidity was scheduled to take effect one year (later extended by six months) after the ruling, to give the government time to put legislation in place. We trace the history of this decision, discuss how it has forever changed the debate on physician-assisted dying, and identify the issues that must be resolved to write the legislation. Of special importance here are the topics of access, safeguards, and conscientious objection.
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Wiebe, Sarah. "Producing Bodies and Borders: A review of immigrant medical examinations in Canada." Surveillance & Society 6, no. 2 (February 27, 2009): 128–41. http://dx.doi.org/10.24908/ss.v6i2.3253.
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Anxiety about our borders is not a new phenomenon. Distrust of immigrants, external threats, fraud and efforts to secure borders to deflect risky outsiders features prominently in political paranoia today and has since the fortification of state boundaries. This article is concerned with such anxiety and paranoia as it shapes Canadian political discourse, policy and practice in efforts to secure our borders and keep out potential risks. These risks – the poor, the unhealthy, the fraudulent – operate as real concerns for our political elite. Despite liberalized changes to border technologies, specifically citizenship and immigration legislation and practice, I argue that the assumptions about these ‘risks’ remain.
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Gaind, K. "Medical assistance in dying: The Canadian experience." European Psychiatry 41, S1 (April 2017): S336—S337. http://dx.doi.org/10.1016/j.eurpsy.2017.02.289.
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Canada is in the midst of implementing new and rapidly evolving policies on medical assistance in dying (MAID). Following the landmark Canadian Supreme Court Carter v. Canada ruling in February 2015, the former prohibition against physician-assisted death was deemed to violate the Canadian Charter of Rights and Freedoms. The Court provided until 2016 for development of national legislation and policies that allowed for physician-assisted dying in cases of “grievous and irremediable” illness and “intolerable suffering”. This session will review shifting public, societal and medical concepts regarding assisted dying and the Canadian experience to date, including evolving local and national policies that have been developed to allow medical assistance in dying in certain circumstances. We will also review work of the Canadian psychiatric association task force on medical assistance in dying (presented by the Task Force Chair), with a focus on challenges and issues relevant to mental health and mental illness.Disclosure of interestThe author has not supplied his declaration of competing interest.
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BROWNE, ALISTER, and J. S. RUSSELL. "How to Legalize Medically Assisted Death in a Free and Democratic Society." Cambridge Quarterly of Healthcare Ethics 29, no. 3 (June 2, 2020): 361–68. http://dx.doi.org/10.1017/s0963180120000080.
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AbstractIn 2015, the Supreme Court of Canada struck down the criminal law prohibiting physician assisted death in Canada. In 2016, Parliament passed legislation to allow what it called ‘medical assistance in dying (MAID).’ The authors first describe the arguments the Court used to strike down the law, and then argue that MAID as legalized in Bill C-14 is based on principles that are incompatible with a free and democratic society, prohibits assistance in dying that should be permitted, and makes access to medically-assisted death unnecessarily difficult. They then propose a version of MAID legislation (‘Ideal MAID’) that gives proponents and opponents of MAID everything they can legitimately want, contend that it is the only way to legalize MAID that is compatible with a free and democratic society, and conclude that it is the way to legalize MAID in Canada and other similarly free and democratic societies.
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Simpson, Alexander I. F. "Medical Assistance in Dying and Mental Health: A Legal, Ethical, and Clinical Analysis." Canadian Journal of Psychiatry 63, no. 2 (December 7, 2017): 80–84. http://dx.doi.org/10.1177/0706743717746662.
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Medical assistance in dying (MAiD) legislation is now over a year old in Canada, and consideration is turning to whether MAiD should be extended to include serious mental illness as the sole qualifying condition for being eligible for MAiD. This article considers this question from ethical and clinical perspectives. It argues that extending the eligibility for MAiD to include those with a serious mental illness as the sole eligibility criterion is not ethical, necessary, or supported current psychiatric practice or opinion.
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Oliphant, Allyson, and Andrea Nadine Frolic. "Becoming a medical assistance in dying (MAiD) provider: an exploration of the conditions that produce conscientious participation." Journal of Medical Ethics 47, no. 1 (May 5, 2020): 51–58. http://dx.doi.org/10.1136/medethics-2019-105758.
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The availability of willing providers of medical assistance in dying (MAiD) in Canada has been an issue since a Canadian Supreme Court decision and the subsequent passing of federal legislation, Bill C14, decriminalised MAiD in 2016. Following this legislation, Hamilton Health Sciences (HHS) in Ontario, Canada, created a team to support access to MAiD for patients. This research used a qualitative, mixed methods approach to data collection, obtaining the narratives of providers and supporters of MAiD practice at HHS. This study occurred at the outset of MAiD practice in 2016, and 1 year later, once MAiD practice was established. Our study reveals that professional identity and values, personal identity and values, experience with death and dying, and organisation context are the most significant contributors to conscientious participation for MAiD providers and supporters. The stories of study participants were used to create a model that provides a framework for values clarification around MAiD practice, and can be used to explore beliefs and reasoning around participation in MAiD across the moral spectrum. This research addresses a significant gap in the literature by advancing our understanding of factors that influence participation in taboo clinical practices. It may be applied practically to help promote reflective practice regarding complex and controversial areas of medicine, to improve interprofessional engagement in MAiD practice and promote the conditions necessary to support moral diversity in our institutions.
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Shevchuk, Oleksandr, Volodymyr Maryniv, Yuliia Mekh, Oleksandra Shovkoplias, and Oksana Saichuk. "Aspects of legal regulation of the provision of medical services." Revista Amazonia Investiga 9, no. 27 (March 21, 2020): 357–66. http://dx.doi.org/10.34069/ai/2020.27.03.39.
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The article focuses on the need to respect human rights in the provision of medical services in Ukraine. It is strictly unacceptable to restrict citizens of Ukraine in receiving free medical services, since such a right is provided for by Art. 49 of the Constitution of Ukraine. It is proposed to consider that a medical service includes all types of medical care and is a special activity in relation to human health. The concept and main signs of medical services are revealed, it is established that the state, local governments, legal entities and individuals, including the patient, can be the customer of medical services. Ukrainian legislation governing the provision of medical services does not meet international standards. The positive experience of the EU countries (France, Denmark, Slovakia) and the world (Australia, Canada) shows that access to medical services is provided within the framework of medical insurance, in most cases free of charge, and is controlled by authorized state organizations. The purpose of the article is to determine the content, signs of medical services, classification criteria for their subjects, disclose the features of their legal regulation, clarify the problems of legalization of medical services and improve legislation taking into account foreign experience. The research methodology is based on a systematic approach, which is determined by the specifics of the topic of the article, and is also associated with the use of general and special research methods. The comparative legal method and the method of legal analysis were used in the study of legislative rules governing the provision of medical services. Using the method of legal analysis, groups of subjects of medical legal relations in the field of medical services are determined and their powers are analyzed. The formal logical method was used to differentiate the criteria for distinguishing between the legal structures “medical care” and “medical service”. The results of the study contributed to the identification of certain legal problems that arise when citizens receive medical services and require immediate resolution. It is also advisable to introduce compulsory state health insurance.
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Rohr, Rachel. "Taxing Disability: A Critical Look into the Medical Cannabis Regime under the New Cannabis Act, 2018." Journal of Canadian Studies 55, no. 2 (July 1, 2021): 436–57. http://dx.doi.org/10.3138/jcs-2020-0027.
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Medical marijuana users represent many people with disabilities in Canada. Recent legislative attempts have allowed people with disabilities to access cannabis as medicine, however the landscape is ever changing. The Cannabis Act was recently introduced, legalizing marijuana for all; however, people with disabilities have not been accounted for when it comes to the issue of access to medicine. Those who rely on cannabis as medicine and those who enjoy it recreationally are now part of the same system, for better or worse. The new medical marijuana regime, under the new Cannabis Act, boasts a “two-stream” process, and it claims that it will be maintaining and improving the old medical regime alongside the new recreational regime. The applicable taxes tell a different story. Medical marijuana has always been subject to sales tax despite being effectively prescribed by doctors to manage and treat many disabilities and illnesses. Now, with the enactment of the Cannabis Act, medical marijuana is subject to an excise tax too—colloquially known as the “sin tax.” Recreational and medical marijuana are subject to the same taxation scheme, making any notion of a “two-stream” process nonsensical and blatantly unfair. The purpose of this article is to provide insight into the varying faults concerning the medical marijuana regime in Canada, with specific emphasis on the issue of taxation. In the simplest terms, taxing medical marijuana is taxing medicine and effectively taxing people with disabilities. Broken down into five parts, this article discusses the underlying reasons for the taxes surrounding medical marijuana, provides a case study of the most important tax case for medical marijuana users, scrutinizes the lack of recognition of medical marijuana as a proper prescription, outlines the ways to improve legislation, and, finally, explores a potential Charter challenge that can be effectively brought against this taxation.
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Lalancette, Mireille, Stéphanie Yates, and Carol‐Ann Rouillard. "#Participating #Contesting: Studying Counterpublics’ Discourses on Twitter About the Social Acceptability of Medical Assistance in Dying Legislation in Canada." Canadian Review of Sociology/Revue canadienne de sociologie 57, no. 4 (November 2020): 604–31. http://dx.doi.org/10.1111/cars.12303.
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Paterson, Stephanie. "Midwives, Women and the State: (De)Constructing Midwives and Pregnant Women in Ontario, Canada." Canadian Journal of Political Science 44, no. 3 (September 2011): 483–505. http://dx.doi.org/10.1017/s000842391100045x.
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Abstract.Ontario'sMidwifery Actcame into effect on January 1, 1994, at a time of radical health care restructuring, marked by hospital closures and staffing cuts. In addition, feminist backlash was rampant in the popular media. Given these conditions, some have suggested that midwifery legislation was implemented because it aligned with the government's cost-cutting initiatives, while others have suggested that the government was responding to the dissatisfaction with obstetric practice outlined by a well-organized lobby. While these factors were no doubt important in the passing of the legislation, I offer a more critical reading of the policy texts, suggesting that the legislation and its enabling regulations problematize not only costs or client satisfaction but also the knowledge of midwives and the women they serve. In framing the issue as one of public safety, the policy ensemble introduced a new form of birthing expert—the expert midwife—reimposing a hierarchical relationship in the birthing process, serving to reify medical science and to objectify birthing women. In so doing, the legislation potentially silences claims for both professional and reproductive autonomy.Résumé.LaLoi sur les sages-femmesde l'Ontario est entrée en vigueur le premier janvier 1994 au cours d'une période houleuse dans le domaine de la santé qui fut marquée par des fermetures d'hôpitaux et des réductions de la main-d'œuvre. De plus, à cette époque, les médias populaires avaient clairement adopté une position antiféministe. Étant donné cette conjoncture, on proposa dans quelques articles que cette loi fut adoptée parce qu'elle cadrait bien avec les priorités gouvernementales de coupures budgétaires, tandis que d'autres insistèrent que le gouvernement ne faisait que réagir au mécontentement à l'endroit de la pratique obstétricale exprimé par un groupe d'intérêts puissant. Ces facteurs ont sans doute joué un rôle important dans l'adoption de la loi, mais je propose, en contrepartie, une interprétation plus critique des textes de politiques publiques. J'avance que la loi et sa réglementation soulignent une problématique qui va au delà des coûts et de la satisfaction de la clientèle, englobant aussi le savoir des sages-femmes et celui de leurs clientes. En formulant le débat en termes de sécurité publique, la législation a instauré une nouvelle forme d'expertise – l'experte sage-femme – qui réimpose une hiérarchie professionnelle dans le domaine de l'accouchement, ce qui a pour effet de solidifier la position de la médecine traditionnelle et d'objectiver les femmes. Ce faisant, la loi risque de négliger les revendications d'autonomie des professionnelles et des partisanes de l'accouchement naturel.
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Santi, Nicolas. "From Courtroom to Bedside - A Discussion with Dr. Jeff Blackmer on the Implications of Carter v. Canada and Physician-Assisted Death." University of Ottawa Journal of Medicine 5, no. 1 (May 22, 2015): 13–15. http://dx.doi.org/10.18192/uojm.v5i1.1276.
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Introduction:On February 6th, 2015, the Supreme Court of Canada (SCC) concluded that “the prohibition on physician-assisted dying is void insofar as it deprives a competent adult of such assistance where (1) the person affected clearly consents to the termination of life; and (2) the person has a grievous and irremediable medical condition (including an illness, disease or disability) that causes enduring suffering that is intolerable to the individual in the circumstances of his or her condition.”[1]. The Court added, “The declaration of invalidity is suspended for 12 months,”[1] to allow the government to respond with appropriate legislation to guide and regulate the practice of Physician-Assisted Death (PAD).Dr. Jeff Blackmer is the Vice President of Medical Professionalism at the Canadian Medical Association (CMA). He holds a Masters in Medical Ethics from the University of Toronto. He served as the Executive Director of the CMA’s Office of Ethics, Professionalism and International Affairs and has been the interim Director of Ethics for the World Medical Association in Geneva. In an interview on February 11th, Dr. Blackmer kindly agreed to help us navigate through an array of ethical and practical ramifications stemming from the decision on Carter v. Canada.
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Crumley, Ellen T., Caroline Sheppard, Chantelle Bowden, and Gregg Nelson. "Canadian French and English newspapers’ portrayals of physicians’ role and medical assistance in dying (MAiD) from 1972 to 2016: a qualitative textual analysis." BMJ Open 9, no. 4 (April 2019): e020369. http://dx.doi.org/10.1136/bmjopen-2017-020369.
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ObjectiveTo examine how Canadian newspapers portrayed physicians’ role and medical assistance in dying (MAiD).DesignQualitative textual analysis.SettingOnline and print articles from Canadian French and English newspapers.Participants813 newspaper articles published from 1972 to 2016.ResultsKey Canadian events defined five eras. From 1972 to 1990, newspapers portrayed physician’s MAiD role as a social issue by reporting supportive public opinion polls and revealing it was already occurring in secret. From 1991 to 1995, newspapers discussed legal aspects of physicians’ MAiD role including Rodriguez’ Supreme Court of Canada appeal and Federal government Bills. From 1996 to 2004, journalists discussed professional aspects of physicians’ MAiD role and the growing split between palliative care and physicians who supported MAiD. They also reported on court cases against Canadian physicians, Dr Kevorkian and suffering patients who could not receive MAiD. From 2005 to 2013, newspapers described political aspects including the tabling of MAiD legislation to change physicians’ role. Lastly, from 2014 to 2016, newspapers again portrayed legal aspects of physicians’ role as the Supreme Court of Canada was anticipated to legalise MAiD and the Québec government passed its own legislation. Remarkably, newspapers kept attention to MAiD over 44 years before it became legal. Articles generally reflected Canadians’ acceptance of MAiD and physicians were typically portrayed as opposing it, but not all did.ConclusionsNewspaper portrayals of physicians’ MAiD role discussed public opinion, politicians’ activities and professional and legal aspects. Portrayals followed the issue-attention cycle through three of five stages: 1) preproblem, 2) alarmed discovery and euphoric enthusiasm and 3) realising the cost of significant progress.
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Keyserlingk, Edward W. "The Eve Decision — A Common Law Perspective." L’affaire Eve et la stérilisation des déficients mentaux 18, no. 3 (April 17, 2019): 657–75. http://dx.doi.org/10.7202/1058698ar.
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By its decision in the Eve case, the Supreme Court of Canada clarified and settled the law in at least two important respects. From now on, provincial statutes can only be used to authorize guardians to permit involuntary contraceptive sterilizations if their wording clearly and explicitly so provides. The Prince Edward Island statute in question did not do so. Secondly, though the Court's parens patriae jurisdiction is of unlimited scope and does extend to cases involving medical procedures, it cannot serve as the basis for authorizing non-therapeutic sterilizations. By ruling out the applicability of parens patriae, and by insisting that judges are not able to deal adequately with such cases, the Supreme Court may have strengthened the case for new legislation in this area. The writer argues that such legislation should provide for access to contraceptive sterilization for the mentally disabled, and the needed safeguards to protect those unable to consent or refuse from the imposition of sterilization in the interests of parties other than themselves.
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Downie, Jocelyn, Adelina Iftene, and Megan Steeves. "Assisted dying for prison populations: Lessons from and for abroad." Medical Law International 19, no. 2-3 (June 2019): 207–25. http://dx.doi.org/10.1177/0968533219866235.
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Canadian federal legislation setting out the framework for medical assistance in dying (MAiD) in Canada came into effect in June 2016. Because of section 86(1) of the Corrections and Conditional Release Act, as soon as MAiD became available in the community, it also needed to be made available to federal prisoners. There are some good reasons to be concerned about MAiD in the Canadian corrections system based on logistical, legal, and moral considerations. Fortunately, Canada is not the first country to decriminalize assisted dying and so Canadian policies and practices can be compared to others and take some lessons from their experiences. Thus, by reviewing the legal status of assisted dying in prisons internationally, the regulation of assisted dying, demand for assisted dying from prisoners, and the process for prisoners accessing assisted dying, this article offers a comparative overview of assisted dying for prisoners around the world in an effort to inform Canadian and other jurisdictions’ law, policy, and practice.
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Braun, Kerstin. "The Right to Assisted Dying: Constitutional Jurisprudence and Its Impact in Canada, Germany and Austria." ICL Journal 15, no. 3 (July 27, 2021): 291–318. http://dx.doi.org/10.1515/icl-2021-0008.
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Abstract Many states are grappling with the regulation of assistance in suicide and ending the life of another upon their request. Initially punishable in most countries, a growing number of jurisdictions have now introduced permissive frameworks decriminalising, to varying degrees, rendering assistance in dying. Other countries, however, have proceeded with the criminal prohibition and several courts have upheld the lawfulness of the respective criminal laws during human rights and constitutional challenges. Yet, the Supreme Court of Canada in 2015, the German Federal Constitutional Court in February 2020 and the Austrian Constitutional Court in December 2020 have respectively declared unconstitutional and void national criminal laws prohibiting rendering assistance in dying. This article first outlines the criminal law framework relating to assisted dying in Canada, Germany and Austria. It subsequently analyses the judgments before pondering their impact on the legal landscape in the three countries. The article concludes that while the Canadian Supreme Court decision appears to have had a significant impact on the introduction of subsequent legislation in Canada, the effects of the Constitutional Courts’ judgments seem much more subdued in Germany and are yet to unfold in Austria.
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Adams, Eric M. "Human rights at work: Physical standards for employment and human rights law." Applied Physiology, Nutrition, and Metabolism 41, no. 6 (Suppl. 2) (June 2016): S63—S73. http://dx.doi.org/10.1139/apnm-2015-0552.
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This review focuses on the human rights dimensions of creating and implementing physical standards for employment for prospective and incumbent employees. The review argues that physical standards for employment engage two fundamental legal concepts of employment law: freedom of contract and workplace human rights. While the former promotes an employer’s right to set workplace standards and make decisions of whom to hire and terminate, the latter prevents employers from discriminating against individuals contrary to human rights legislation. With reference to applicable human rights legislative regimes and their judicial interpretation in Canada, the United States, the United Kingdom, and Australia, this review demonstrates the judicial preference for criterion validation in testing mechanisms in the finding of bona fide occupational requirements. With particular attention to the Supreme Court of Canada decision in Meiorin, this review argues that an effective balance between workplace safety and human rights concerns can be found, not in applying different standards to different groups of individuals, but in an approach that holds employers to demonstrating a sufficient connection between a uniform physical standard of employment and the actual minimum requirements to perform the job safety and efficiently. Combined with an employer’s duty to accommodate, such an approach to lawful physical standards for employment conceives of worker and public safety and workplace diversity as emanating from a shared concern for human rights.
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Murray, Glenn F. "Cocaine Use in the Era of Social Reform: The Natural History of a Social Problem in Canada, 1880–1911." Canadian journal of law and society 2 (1987): 29–43. http://dx.doi.org/10.1017/s0829320100001149.
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Current interest in the non-medical use of cocaine in Canada can be gauged by the attention this drug is getting in the various media. Not surprisingly, researchers have now entered the arena in the hope of answering some of the questions posed by this phenomenon. A similar trend occurred in regard to marijuana more than a decade ago when popular concern led to a federal commission that eventually recommended the repeal of the offence of cannabis possession. The wave of concern created considerable scholarly interest in Canada's approach to the control of narcotic drugs, including cannabis, which had been defined as narcotic for legal purposes. Much research followed on various fronts, from studies on the effects of cannabis on health to the social consequences of punishment.Several studies have examined the origins of Canada's legislative response to narcotic drug use. A principal conclusion from these studies is that legislation became possible because of hostility toward minority groups associated with drug use, specifically, the Chinese who were known for their use of opium. In the present paper, however, we see that drug control grew as much out of a “cocaine scare” as out of concern with opium use. Moreover, cocaine attracted attention in part precisely because its use was not confined to despised minorities, but permeated society as a whole, affecting “young people as well as seniors,” “men and women,” those from “poorer classes,” those from “respectable families” and those “who should and do know better.”
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Lord, Phil. "Access to Inclusive Education for Students with Autism: An Analysis of Canada’s Compliance with the United Nations Convention on the Rights of Persons with Disabilities." Canadian Journal of Disability Studies 9, no. 5 (December 20, 2020): 328–46. http://dx.doi.org/10.15353/cjds.v9i5.700.
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This article argues that Canada fails to meet its obligation under article 24 of the United Nations Convention on the Rights of Persons with Disabilities to provide students with autism with access to inclusive education. Moving beyond Canadian legislation, under which every province and territory recognises the right of all students to an inclusive education, it analyses Canada’s education system and the implementation of the goal of inclusive education. It points out the effect of five interrelated factors on the inclusiveness of the Canadian education system and its accessibility for students with autism: reductions in funding for education; the inadequacy of individual support measures and parent participation; the lack of education and training for teachers; the use of language indicative of the medical model of disability by governments; and "voluntary segregation" – the voluntary removal of children from the public education system by their parents. It concludes that Canada likely does not meet its obligations under the United Nations Convention on the Rights of Persons with Disabilities.
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Bergeron, Glen L. "Incidence, Awareness, and Reporting of Sport-Related Concussions in Manitoba High Schools." Canadian Journal of Neurological Sciences / Journal Canadien des Sciences Neurologiques 46, no. 04 (July 2019): 443–50. http://dx.doi.org/10.1017/cjn.2019.58.
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ABSTRACT:Background and Objectives: Federal and provincial governments in Canada are promoting provincial legislation to prevent and manage sport-related concussions (SRCs). The objective of this research was to determine the incidence of concussions in high school sport, the knowledge of the signs, symptoms, and consequences of SRC, and how likely student athletes are to report a concussion. Methods: A cross-sectional survey of athletes (N = 225) from multiple sports in five high schools in one Manitoba school division was conducted. Results: Participants in this study were well aware of the signs, symptoms, and consequences of SRC. Cognitive and emotional symptoms were the least recognized consequences. SRC is prevalent in high schools in both males and females across all sports. Of the 225 respondents, 35.3% reported having sustained an SRC. Less than half (45.5%) reported their concussion. Athletes purposely chose not to report a concussion in games (38.4%) and practices (33.8%). Two major barriers to reporting were feeling embarrassed (3.4/7) and finding it difficult (3.5/7) to report. There was, however, strong agreement (Mean 5.91/7, SD 0.09) when asked if they intend to report a concussion should they experience one in the future. Conclusions: The results suggest that high school athletes would benefit from more SRC education. Coaches and team medical staff must be trained to be vigilant for the mechanism, signs, and symptoms of injury in both game and practice situations. This study will also inform the implementation of pending legislation in Manitoba and perhaps other provinces in Canada.
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Rosso, Alexandra E., Dirk Huyer, and Alfredo Walker. "Analysis of the Medical Assistance in Dying Cases in Ontario: Understanding the Patient Demographics of Case Uptake in Ontario since the Royal Assent and Amendments of Bill C-14 in Canada." Academic Forensic Pathology 7, no. 2 (June 2017): 263–87. http://dx.doi.org/10.23907/2017.025.
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On June 17, 2016, the Canadian government legalized medical assistance in dying (MAID) across the country by giving Royal Assent to Bill C-14. This Act made amendments to the Criminal Code and other Acts relating to MAID, allowing physicians and nurse practitioners to offer clinician-administered and self-administered MAID in conjunction with pharmacists being able to dispense the necessary medications. The eligibility criteria for MAID indicates that the individual 1) must be a recipient of publicly funded health services in Canada, 2) be at least 18 years of age, 3) be capable of health-related decision-making, and 4) has a grievous and irremediable medical condition. Because this is a new practice in Canadian health care, there are no published Canadian statistics on MAID cases to date, and this paper constitutes the first analysis of MAID cases in both the province of Ontario and Canada. Internationally, there are only a few jurisdictions with similar legislation already in place (US, the Netherlands, Belgium, Luxembourg, Switzerland, Columbia, Japan, and the United Kingdom). The published statistics on MAID cases from these jurisdictions were reviewed and used to establish the current global practices and demographics of MAID and will provide useful comparisons for Canada. This analysis will 1) outline the Canadian legislative approach to MAID, 2) provide an understanding of which patient populations in Ontario are using MAID and under what circumstances, and 3) determine if patterns exist between the internationally published MAID patient demographics and the Canadian MAID data. Selected patient demographics of the first 100 MAID cases in Ontario were reviewed and analyzed using anonymized data obtained from the Office of the Chief Coroner for Ontario so that an insight into the provision of MAID in Ontario could be obtained. Demographic factors such as age, sex, the primary medical diagnosis that prompted the request for MAID, the patient rationale for making a MAID request, the place where MAID was administered, the nature of MAID drug regimen used, and the status/specialty of medical personnel who administered the MAID drug regimen were analyzed. The analysis revealed that the majority of the first 100 MAID recipients were older adults (only 5.2% of patients were aged 35-54 years, with no younger adults between ages 18-34 years) who were afflicted with cancer (64%) and had opted for clinician-administered MAID (99%) that had been delivered in either a hospital (38.8%) or private residence (44.9%). Although the cohort was small, these Ontario MAID demographics reflect similar observations as those published internationally, but further analysis of both larger and annual case uptake in both Ontario and Canada will be conducted as the number of cases increases.
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Murdoch, Blake. "The legal and policy considerations of transplanting pediatric thymus regulatory T cells as an immunotherapy in Canada." Medical Law International 20, no. 3 (September 2020): 201–10. http://dx.doi.org/10.1177/0968533220963157.
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Regulatory T cells (Tregs) hold promise for cell-based therapies for autoimmunity and transplant rejection. In Canada, the potential collection, short-term banking, and transplantation of pediatric Tregs left over from surgery raise legal and policy concerns. Tregs likely fall under the definitions of “tissue” found in most provincial donation and transplantation statutes. With the exception of Alberta’s Human Tissue and Organ Donation Act, the fundamental distinction between donation of tissue primarily for transplantation and secondary donation of by-products of a medical intervention undertaken for the benefit of the donor is inadequately addressed in Canadian law. Most statutes prohibit transplantation except in accordance with their provisions and do not contemplate living donation by minors under a specific age. Provinces could amend their legislation in order to properly enable the transplantation of by-products like Tregs from infant donors. This process is relatively ethically uncontroversial, so if common research ethics and privacy concerns can be addressed, it should likely be permitted.
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Haag, Andrew M., Katelyn Wonsiak, and David Tyler Dunford. "Alberta not criminally responsible project: Rates of persons found NCRMD and absolute discharges in Alberta following the Not Criminally Responsible Reform Act." Journal of Community Safety and Well-Being 6, no. 3 (August 24, 2021): 121–26. http://dx.doi.org/10.35502/jcswb.207.
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In 2014, then-Canadian Prime Minister Stephen Harper passed the Not Criminally Responsible Reform Act into law, which gave Canadian courts and Review Boards new powers to protect the public from particularly dangerous mentally ill offenders. The most controversial change to the law included the designation of the High-Risk Accused. Once designated by the courts as a High-Risk Accused, that individual is barred from leaving a forensic hospital except for urgent medical reasons. In this article, the authors assess the impact of the Not Criminally Responsible Reform Act on the forensic mental health system in Alberta, Canada. The findings indicate that the legislation did not lead to any meaningful changes in the Alberta forensic mental health system in terms of absolute discharges and incoming persons found not criminally responsible.
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van Draanen, Jenna, HaoDong Tao, Saksham Gupta, and Sam Liu. "Geographic Differences in Cannabis Conversations on Twitter: Infodemiology Study." JMIR Public Health and Surveillance 6, no. 4 (October 5, 2020): e18540. http://dx.doi.org/10.2196/18540.
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Background Infodemiology is an emerging field of research that utilizes user-generated health-related content, such as that found in social media, to help improve public health. Twitter has become an important venue for studying emerging patterns in health issues such as substance use because it can reflect trends in real-time and display messages generated directly by users, giving a uniquely personal voice to analyses. Over the past year, several states in the United States have passed legislation to legalize adult recreational use of cannabis and the federal government in Canada has done the same. There are few studies that examine the sentiment and content of tweets about cannabis since the recent legislative changes regarding cannabis have occurred in North America. Objective To examine differences in the sentiment and content of cannabis-related tweets by state cannabis laws, and to examine differences in sentiment between the United States and Canada between 2017 and 2019. Methods In total, 1,200,127 cannabis-related tweets were collected from January 1, 2017, to June 17, 2019, using the Twitter application programming interface. Tweets then were grouped geographically based on cannabis legal status (legal for adult recreational use, legal for medical use, and no legal use) in the locations from which the tweets came. Sentiment scoring for the tweets was done with VADER (Valence Aware Dictionary and sEntiment Reasoner), and differences in sentiment for states with different cannabis laws were tested using Tukey adjusted two-sided pairwise comparisons. Topic analysis to determine the content of tweets was done using latent Dirichlet allocation in Python, using a Java implementation, LdaMallet, with Gensim wrapper. Results Significant differences were seen in tweet sentiment between US states with different cannabis laws (P=.001 for negative sentiment tweets in fully illegal compared to legal for adult recreational use states), as well as between the United States and Canada (P=.003 for positive sentiment and P=.001 for negative sentiment). In both cases, restrictive state policy environments (eg, those where cannabis use is fully illegal, or legal for medical use only) were associated with more negative tweet sentiment than less restrictive policy environments (eg, where cannabis is legal for adult recreational use). Six key topics were found in recent US tweet contents: fun and recreation (keywords, eg, love, life, high); daily life (today, start, live); transactions (buy, sell, money); places of use (room, car, house); medical use and cannabis industry (business, industry, company); and legalization (legalize, police, tax). The keywords representing content of tweets also differed between the United States and Canada. Conclusions Knowledge about how cannabis is being discussed online, and geographic differences that exist in these conversations may help to inform public health planning and prevention efforts. Public health education about how to use cannabis in ways that promote safety and minimize harms may be especially important in places where cannabis is legal for adult recreational and medical use.
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Pesut, Barbara, Sally Thorne, Megan L. Stager, Catharine J. Schiller, Christine Penney, Carolyn Hoffman, Madeleine Greig, and Josette Roussel. "Medical Assistance in Dying: A Review of Canadian Nursing Regulatory Documents." Policy, Politics, & Nursing Practice 20, no. 3 (May 6, 2019): 113–30. http://dx.doi.org/10.1177/1527154419845407.
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Canada's legalization of Medical Assistance in Dying (MAiD) in 2016 has had important implications for nursing regulators. Evidence indicates that registered nurses perform key roles in ensuring high-quality care for patients receiving MAiD. Further, Canada is the first country to recognize nurse practitioners as MAiD assessors and providers. The purpose of this article is to analyze the documents created by Canadian nursing regulatory bodies to support registered nurse and nurse practitioner practice in the political context of MAiD. A search of Canadian provincial and territorial websites retrieved 17 documents that provided regulatory guidance for registered nurses and nurse practitioners related to MAiD. Responsibilities of registered nurses varied across all documents reviewed but included assisting in assessment of patient competency, providing information about MAiD to patients and families, coordinating the MAiD process, preparing equipment and intravenous access for medication delivery, coordinating and informing health care personnel related to the MAiD procedure, documenting nursing care provided, supporting patients and significant others, and providing post death care. Responsibilities of nurse practitioners were identified in relation to existing legislation. Safety concerns cited in these documents related to ensuring that nurses understood their boundaries in relation to counseling versus informing, administering versus aiding, ensuring safeguards were met, obtaining informed consent, and documenting. Guidance related to conscientious objection figured prominently across documents. These findings have important implications for system level support for the nursing role in MAiD including ongoing education and support for nurses' moral decision making.
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Latchmore, Tessa, C. J. Schuster-Wallace, Dan Roronhiakewen Longboat, Sarah E. Dickson-Anderson, and Anna Majury. "Critical elements for local Indigenous water security in Canada: a narrative review." Journal of Water and Health 16, no. 6 (October 15, 2018): 893–903. http://dx.doi.org/10.2166/wh.2018.107.
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AbstractIndigenous communities in Canada are over-represented with respect to poor water quality and water advisories. To date, approaches to solve this water crisis have been founded in the Western Science (WS) context with little to no consultation or dialogue with those communities most impacted, and without regard for culture. A literature review was undertaken to: (i) document Indigenous Knowledge (IK), and perspectives regarding water and (ii) to identify current local water security tools utilized by Indigenous communities. The aim is to provide sound evidence regarding the value of ownership and leadership by Indigenous communities in the context of current and appropriate resources available to (re)claim these roles. Solutions must remain consistent with, and founded upon, traditional Indigenous worldviews and cultural values to ensure sustainable water security. Literature reviewed from the past ten years revealed one overarching creation theme with three water-specific themes in Indigenous communities; namely, water from natural sources, water as a life-giving entity, and water and gender. Ultimately, there needs to be a new framing of local water security with the development of tools which engage IK and WS in order to assess local water security and appropriately inform interventions, policies, regulations and legislation.
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Vilcu, Alexandra. "Tendencies of High-Skilled Migration coming from Romania. Favourable Legislation and Social Policies." European Journal of Social Sciences Education and Research 1, no. 1 (May 1, 2014): 65. http://dx.doi.org/10.26417/ejser.v1i1.p65-69.
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The external migration of a significant part of Romania's high-skilled population is a social phenomenon which became increasingly frequent starting from the 1990s, right after the fall of the communist regime. The basis for this phenomenon consists of several causes: globalization, the strengthening of international economic relations, and later on, Romania's adhesion to the European Union. Research has shown that of all high-skilled population, the professionals who emigrate more frequently consist of engineers, teachers, medical staff, scientific researchers, economists and architects. Besides, the chosen destinations have been variable throughout time. The first phase in time took place in the 1990s, when a large part of the high-skilled population chose to emigrate for professional purposes in countries such as The United States of America, Canada, Germany or Israel. The second important phase occurred after year 2000, when the focus was placed on EU countries, especially after Romania's integration. Apart from temporary unqualified migration, the number of high-skilled migrants and those who leave the country to continue their studies also soared. The chosen countries generally include Great Britain, Germany, Belgium, France and Austria. Given these differences in the tendencies of high-skilled migration, this paper will offer an insight on how the phenomenon evolved, and the factors that caused these variations in space and time. Most likely, some of the countries that were preferred have been facilitating the integration of high-skilled immigrants in society, as opposed to unqualified ones, through a selective set of laws and social policies which are meant to favour this social category. Therefore, we will discover and analyze various examples and benefits of legislation and social policies which offered social protection to high-skilledimmigrants in various countries. This paper is made and published under the aegis of the Research Institute for Quality of Life, Romanian Academy, as part of the programme co-funded by the European Union within the Operational Sectorial Programme for Human Resources Development, through the Project for Pluri and Interdisciplinarity in doctoral and post-doctoral programmes. Project code: POSDRU/159/1.5/S/141086
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Birch, Stephen, and Amiram Gafni. "Achievements and Challenges of Medicare in Canada: Are We There Yet? Are We on Course?" International Journal of Health Services 35, no. 3 (July 2005): 443–63. http://dx.doi.org/10.2190/rwa1-c3pb-0ky4-hbut.
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Health care policy in Canada is based on providing public funding for medically necessary physician and hospital-based services free at the point of delivery (“first-dollar public funding”). Studies consistently show that the introduction of public funding to support the provision of health care services free at the point of delivery is associated with increases in the proportionate share of services used by the poor and in population distributions of services that are independent of income. Claims about the success of Canada's health care policy tend to be based on these findings, without reference to medical necessity. This article adopts a needs-based perspective to reviewing the distribution of health care services. Despite the removal of user prices, significant barriers remain to services being distributed in accordance with need—the objective of needs-based access to services remains elusive. The increased fiscal pressures imposed on health care in the 1990s, together with the failure of health care policy to encompass the changing nature of health care delivery, seem to represent further departures from policy objectives. In addition, there is evidence of increasing public dissatisfaction with the performance of the system. A return to modest increases in public funding in the new millennium has not been sufficient to arrest these trends. Widespread support for first-dollar public funding needs to be accompanied by greater attention to the scope of the legislation and the adoption of a needs-based focus among health care policymakers.
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Milne, Richard, Katherine I. Morley, Heidi Howard, Emilia Niemiec, Dianne Nicol, Christine Critchley, Barbara Prainsack, et al. "Trust in genomic data sharing among members of the general public in the UK, USA, Canada and Australia." Human Genetics 138, no. 11-12 (September 17, 2019): 1237–46. http://dx.doi.org/10.1007/s00439-019-02062-0.
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Abstract Trust may be important in shaping public attitudes to genetics and intentions to participate in genomics research and big data initiatives. As such, we examined trust in data sharing among the general public. A cross-sectional online survey collected responses from representative publics in the USA, Canada, UK and Australia (n = 8967). Participants were most likely to trust their medical doctor and less likely to trust other entities named. Company researchers were least likely to be trusted. Low, Variable and High Trust classes were defined using latent class analysis. Members of the High Trust class were more likely to be under 50 years, male, with children, hold religious beliefs, have personal experience of genetics and be from the USA. They were most likely to be willing to donate their genomic and health data for clinical and research uses. The Low Trust class were less reassured than other respondents by laws preventing exploitation of donated information. Variation in trust, its relation to areas of concern about the use of genomic data and potential of legislation are considered. These findings have relevance for efforts to expand genomic medicine and data sharing beyond those with personal experience of genetics or research participants.
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Roychoudhury, Priodarshi, Astha Koolwal Kapoor, Declan Walsh, Henry Cortes, and Hance Clarke. "State of the science: cannabis and cannabinoids in palliative medicine—the potential." BMJ Supportive & Palliative Care 11, no. 3 (April 26, 2021): 299–302. http://dx.doi.org/10.1136/bmjspcare-2021-002888.
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Cannabinoids are chemicals derived naturally from the cannabis plant or are synthetically manufactured. They interact directly with cannabinoid receptors or share chemical similarity with endocannabinoids (or both). Within palliative medicine, cannabinoid receptors (CB1 and CB2) may modulate some cancer symptoms: appetite, chemotherapy-induced nausea and vomiting, and mood, pain and sleep disorders. Opioid and cannabinoid receptors have overlapping neuroanatomical receptor distribution, particularly at the dorsal horn, dorsal striatum and locus coeruleus. They have a favourable safety profile compared with opioids, and cannabis-based medicines help chronic pain. While cannabidiol (CBD) has anti-inflammatory properties, tetrahydrocannabinol (THC) is the psychoactive substance for issues such as mood and sleep. Nabiximols (Sativex), a CBD:THC combination, is Food and Drug Administration approved for some multiple sclerosis symptoms and epilepsy. There has been a swift societal evolution in attitudes about use of cannabis and cannabinoid medicines for chronic pain. In the USA, 33 states have now legalised prescription-based medical cannabis for several medical conditions; Canada has had legislation since 2001 authorising medical use. The European Union (EU) recently declared all EU citizens must have access to medical cannabis over the next 4 years. The integration into medicine and routine clinical use of cannabis is fraught with information gaps, regulatory issues and scarcity of research. Each patient should have a comprehensive assessment and risk–benefit discussion before any cannabis-based intervention to avoid possible complications such as hallucinations, psychosis and potential cardiac harm.
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Lewis, Penney. "Rights Discourse and Assisted Suicide." American Journal of Law & Medicine 27, no. 1 (2001): 45–99. http://dx.doi.org/10.1017/s0098858800011163.
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The debate surrounding the legalization of assisted suicide has been galvanized in recent years by reports of specific cases of assisted suicide, primarily involving physicians such as Kevorkian and Quill, and by impassioned pleas for legalization and assistance in suicide from individuals suffering in the throes of terminal or agonizing diseases, such as Sue Rodriguez. Media attention on criminal trials of individuals accused of assisting in a suicide has heightened public awareness of the issue. The constitutionality of criminal prohibitions on assisted suicide has been tested in various jurisdictions, and has recently been considered by the Supreme Courts of both the United States and Canada. Following two narrowly unsuccessful attempts to enact dignified death provisions by referenda in Washington and California, Oregon voters passed the first of such proposed laws in November 1994, providing for physician-assisted suicide under certain specified conditions. Attempts to introduce legislation to legalize assisted suicide in other jurisdictions have been galvanized by the success in Oregon. A model statute has been drafted by a group of law professors, philosophers and medical professionals.
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Leck, E., S. Barry, and S. Christie. "P.117 The opinion of Canadian spine surgeons on medical assistance in dying (MAID); a cross-sectional survey of Canadian spine society (CSS) members." Canadian Journal of Neurological Sciences / Journal Canadien des Sciences Neurologiques 46, s1 (June 2019): S44. http://dx.doi.org/10.1017/cjn.2019.210.
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Background: On February 6, 2015, the Supreme Court of Canada struck down the Criminal Code absolute prohibition on assisted dying, and in June 2016 the new law, Bill C-14, came into effect allowing for medical assistance in dying. We sought to determine the attitudes and opinions of Canadian neurosurgeons and orthopedic spine surgeons regarding MAID. Methods: A cross-sectional survey was sent out to members of the Canadian Spine Society (CSS), which included 21 questions pertaining to opinions regarding MAID. Responses were collected between May-June 2016. Results: A total of 51 surgeons responded to the survey, comprised of a mix of spine surgeons from across the country. The majority of surgeons supported MAID (62.8%), and right of physicians to participate (82.4%). Most surgeons supported the right to conscientious objection (90.1%), but also mandatory duty to refer (49.0%). The conditions most frequently felt to be appropriate for MAID included metastatic spine tumour (76.5%), malignant intramedullary tumour (64.7%), primary malignant spine tumour (54.9%), cervical spinal cord injury with tetraplegia (49.0%) and multiple myeloma (33.3%). Conclusions: This study highlights the complex landscape that exists when discussing MAID, but also the overall support of physicians, and need for ongoing conversations, particularly with issues not addressed by the current legislation.
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Gartner, Coral, Marilyn Bromberg, Tanya Musgrove, and Kathy Luong. "Vape Club: Exploring Non-Profit Regulatory Models for the Supply of Vaporised Nicotine Products." International Journal of Environmental Research and Public Health 15, no. 8 (August 14, 2018): 1744. http://dx.doi.org/10.3390/ijerph15081744.
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Vaporised nicotine products (VNPs) that are not approved as therapeutic goods are banned in some countries, including Australia, Singapore, and Thailand. We reviewed two non-profit regulatory options, private clubs and the Australian Therapeutic Goods Administration Special Access Scheme (SAS) that have been applied to other controlled substances (such as cannabis) as a potential model for regulating VNPs as an alternative to prohibition. The legal status of private cannabis clubs varies between the United States, Canada, Belgium, Spain, and Uruguay. Legal frameworks exist for cannabis clubs in some countries, but most operate in a legal grey area. Kava social clubs existed in the Northern Territory, Australia, until the federal government banned importation of kava. Access to medical cannabis in Australia is allowed as an unapproved therapeutic good via the SAS. In Australia, the SAS Category C appears to be the most feasible option to widen access to VNPs, but it may have limited acceptability to vapers and smokers. The private club model would require new legislation but could be potentially more acceptable if clubs were permitted to operate outside a medical framework. Consumer and regulator support for these models is currently unknown. Without similar restrictions applied to smoked tobacco products, these models may have only a limited impact on smoking prevalence. Further research could explore whether these models could be options for regulating smoked tobacco products.
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Morton, Wendy J., and Michael Westwood. "Informed consent in children and adolescents." Paediatrics & Child Health 2, no. 5 (September 1, 1997): 329–33. http://dx.doi.org/10.1093/pch/2.5.329.
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Abstract Confusion persists about when a minor can give informed consent to medical treatment. Physicians may be hesitant to treat minors, even as adolescents, without first obtaining parental or guardian consent for fear of being sued for battery or negligence. However, the common law in Canada is clear that a minor can give informed consent to therapeutic medical treatment, provided heorshe can understand the information regarding the proposed treatment and can appreciate the attendant risks and possible consequences. Courts have accepted that there is no precise age at which a minor can be presumed to have the capacity to give informed consent. Each minor must be individually assessed to determine whether he or she possesses the requisite maturity and level of understanding to comprehend the nature, benefits and risks of the proposed treatment. The responsibility for determining a minor's capacity rests with the physician or another health care provider who is seeking to obtain the informed consent. In the event that legal action is taken against the physician on the grounds the minor lacked the capacity to give informed consent, the court must be satisfied that the minor did have sufficient capacity. Examples of cases where the physician was sued by either the minor or the minor's parents are included. In addition, an overview of existing provincial legislation dealing with minors and informed consent is provided.
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McLachlan, Richard S., and Michael W. Jones. "Epilepsy and Driving: A Survey of Canadian Neurologists." Canadian Journal of Neurological Sciences / Journal Canadien des Sciences Neurologiques 24, no. 04 (November 1997): 345–49. http://dx.doi.org/10.1017/s0317167100033047.
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ABSTRACT:Background:A seizure is the most common cause of loss of driving privileges for medical reasons but there is variability in how physicians and the authorities who regulate driving approach this issue.Methods:A questionnaire regarding epilepsy and driving was sent to all adult neurologists in Canada (n = 494).Results:Of 289 (59%) neurologists responding, 50% usually report patients with seizures to the department of motor vehicles compared to only 4% for stroke/TIA, 26% for dementia and 8% for other neurologic disorders (p < 0.0001). In the five provinces with mandatory reporting laws, seizures were reported most of the time by 84% compared to only 19% in the five provinces with discretionary reporting (p < 0.0001). Nationwide, 44% agreed with mandatory reporting but this also differed in provinces with and without mandatory reporting legislation (63% vs. 37%, p < 0.0001). Only 49% agreed with the current recommendation of at least one year seizure free interval before resuming driving.Conclusions:Seizures are disproportionately reported compared to other neurological conditions. Many neurologists disagree with the recommended Canadian standards for duration of driving restriction after seizures. Variability in the attitude and practice of neurologists in regard to reporting of seizures is confirmed.
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Saunders, L. Z. "Virchow's Contributions to Veterinary Medicine: Celebrated Then, Forgotten Now." Veterinary Pathology 37, no. 3 (May 2000): 199–207. http://dx.doi.org/10.1354/vp.37-3-199.
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In 1858, Rudolf Virchow, the professor of pathology in Berlin University, published the book “Cellular Pathology”. A compendium of his lectures to physicians and medical students, he introduced the use of microscopy for the study of human diseases. To an astonishing extent Rudolf Virchow was helpful to the disciplines of veterinary medicine (and veterinary pathology). Considered a scientific genius in several disciplines, this essay deals exclusively with the devotion of Virchow, a scholarly physician, to the profession of veterinary medicine. He respected veterinary research, supported governmental veterinary education, and provided a role model for the veterinarians who were drafting control legislation of contagious diseases in livestock. Repeatedly, he responded in help when seemingly irretrievable problems arose. Examples of Virchow's activities in the realms of veterinary medicine and pathology are marshalled here to shed light on this pioneer “veterinary pathologist”. In celebration of 50 years of the American College of Veterinary Pathologists in 1999, it is timely to remember that Rudolf Virchow, the father of cellular pathology, also fathered veterinary pathology, whose offsprings in Canada and the U.S.A. (Osler, Clement, Williams, Olafson, Jones 26 ) had enabled them to form and foster the A.C. V.P.
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Sim, K. Howe, Anton Marinov, and Gary A. Levy. "Xenotransplantation: A Potential Solution to the Critical Organ Donor Shortage." Canadian Journal of Gastroenterology 13, no. 4 (1999): 311–18. http://dx.doi.org/10.1155/1999/231798.
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The success of allotransplantation as a treatment for end-stage organ failure has resulted in the need for an increasing number of organ donors. Attempts to meet this need include the use of organs from living related and unrelated donors, financial or other incentives for the donor family, and even the reuse of transplanted organs. Despite these initiatives, the supply of organs for transplantation still falls far short of the demand, as evidenced by longer waiting times for transplantation and decreasing transplantation rates. Even if Canada were able to increase its organ donor rate to that of Spain (40 to 50/million), where organ donation is governed by ‘presumed consent’ legislation, this would not alleviate the problem of donor shortage. Interest in xenotransplantation stems from the need to overcome this increasingly severe shortage of human organs. Indeed, some argue that xenotransplantation is the only potential way of addressing this shortage. As immunological barriers to xenotransplantation are better understood, those hurdles are being addressed through genetic engineering of donor animals and the development of new drug therapies. However, before xenotransplantation can be fully implemented, both the scientific/medical communities and the general public must seriously consider and attempt to resolve the many complex ethical, social and economic issues that it presents.
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Stasiulis, Daiva. "Elimi(Nation): Canada’s “Post-Settler” Embrace of Disposable Migrant Labour." Studies in Social Justice 2020, no. 14 (March 26, 2020): 22–54. http://dx.doi.org/10.26522/ssj.v2020i14.2251.
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This article utilizes the lens of disposability to explore recent conditions of low-wage temporary migrant labour, whose numbers and economic sectors have expanded in the 21stcentury. A central argument is that disposability is a discursive and material relation of power that creates and reproduces invidious distinctions between the value of “legitimate” Canadian settler-citizens (and candidates for citizenship) and the lack of worth of undesirable migrant populations working in Canada, often for protracted periods of time. The analytical lens of migrant disposability draws upon theorizing within Marxian, critical modernity studies, and decolonizing settler colonial frameworks. This article explores the technologies of disposability that lay waste to low wage workers in sites such as immigration law and provincial/territorial employment legislation, the workplace, transport, living conditions, access to health care and the practice of medical repatriation of injured and ill migrant workers. The mounting evidence that disposability is immanent within low-wage migrant labour schemes in Canada has implications for migrant social justice. The failure to protect migrant workers from a vast array of harms reflects the historical foundations of Canada’s contemporary migrant worker schemes in an “inherited background field [of settler colonialism] within which market, racist, patriarchal and state relations converge” (Coulthard, 2014, p. 14). Incremental liberal reform has made little headway insofar as the administration and in some cases reversal of more progressive reforms such as guaranteed pathways to citizenship prioritize employers’ labour interests and the lives and health of primarily white, middle class Canadian citizens at the expense of a shunned and racialized but growing population of migrants from the global South. Transformational change and social justice for migrant workers can only occur by reversing the disposability and hyper-commodification intrinsic to low-wage migrant programs and granting full permanent legal status to migrant workers.
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Sinmez, Cagri Caglar, and Askin Yasar. "Experimental Animal Use in Turkey: A Comparison with Other Countries." Alternatives to Laboratory Animals 47, no. 2 (May 2019): 82–92. http://dx.doi.org/10.1177/0261192919861874.
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The legal structure that governs animal use in Turkey is in line with that of the European Union (EU). In 2004, legislation on the use of animals for experimental and other scientific purposes was established in Turkey for the first time. The present study aimed to compare the data on experimental animal use in Turkey (during the period 2008–2017) with similar reports from selected countries (the United States, Australia, Canada and the EU). In Turkey, a total of 2,104,828 animals were used for experimental and other scientific purposes during 2008–2017. Of the animals used, 758,887 were fish (36%), 433,417 rats (21%), 302,512 birds other than quail (14%) and 285,531 mice (13%). According to a breakdown by purpose for use, in Turkey during 2009–2017, out of a total number of 1,955,307 animals used, 56% were for fundamental biological studies, with a high proportion used for research on animal disease. Compared with the other countries, fewer animals were used in Turkey although the national trend seems to indicate that the number is fluctuating. Further studies are required to uncover the reasons behind this reduced animal use in Turkey, as compared to other countries.
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Katzmarzyk, Peter T., Louise A. Baur, Steven N. Blair, Estelle V. Lambert, Jean-Michel Oppert, and Chris Riddoch. "International conference on physical activity and obesity in children: summary statement and recommendationsThis summary statement and recommendations from the International Conference on Physical Activity and Obesity in Children is being published simultaneously in the International Journal of Pediatric Obesity and Applied Physiology, Nutrition, and Metabolism.For the International Association for the Study of Obesity Physical Activity Task Force and the Conference Speaker Panel (the conference speaker panel includes Tom Baranowski, Claude Bouchard, Kelly Brownell, Deborah Cohen, William H. Dietz, Rod Dishman, Mary Flynn, William Haskell, James O. Hill, W.P.T. (Philip) James, Russell Pate, John Peters, Michael Pratt, Harry Rutter, James Sallis, Jo Salmon, Chantal Simon, and Boyd Swinburn)." Applied Physiology, Nutrition, and Metabolism 33, no. 2 (April 2008): 371–88. http://dx.doi.org/10.1139/h07-176.
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The increasing prevalence of obesity among the world’s children and youth was the impetus for an international conference convened in Toronto, Canada, to examine issues related to physical activity and obesity in children (24–27 June 2007). The goal of the conference was to assimilate, interpret, and share scientific evidence with key stakeholders to develop recommendations concerning effective physical activity policies and programs to address obesity in children. The conference was attended by approximately 1000 delegates from 33 countries who gathered to listen to the invited speakers and to share information on promising practices related to the promotion of physical activity with the aim of reducing the burden of obesity in children. The major topics addressed at the conference included the biological and behavioural causes of obesity, current and past levels of physical activity and sedentarism in children, the role of the social, family, and built environments in addressing the physical activity deficit, and the role of legislation and industry in promoting physical activity. Promising physical activity interventions among children were presented, and important research, policy, and practice recommendations to address the issue of physical inactivity and obesity were provided.
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Dhadwal, Gurbir, and Mark G. Kirchhof. "The Risks and Benefits of Cannabis in the Dermatology Clinic." Journal of Cutaneous Medicine and Surgery 22, no. 2 (October 23, 2017): 194–99. http://dx.doi.org/10.1177/1203475417738971.
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Cannabis ( Cannabis sativa/indica), also known as marijuana, has been used for medicinal and recreational purposes for millennia. There has been a recent trend to legalize the use of cannabis, as illustrated by the recent legalization votes in numerous states in the United States and legislation in Canada to allow recreational cannabis use. With this increasing consumption of cannabis, dermatologists will see increased pressure to prescribe cannabis and will see the side effects of cannabis use with greater frequency. There are several approved medical indications for cannabis use, including psoriasis, lupus, nail-patella syndrome, and severe pain. In addition, very preliminary studies have suggested cannabis and its derivatives might have use in acne, dermatitis, pruritus, wound healing, and skin cancer. Further well-controlled studies are required to explore these potential uses. Conversely, the side effects of cannabis use are relatively well documented, and dermatologists should be aware of these presentations. Side effects of cannabis use include cannabis allergy manifesting as urticaria and pruritus, cannabis arteritis presenting with necrosis and ulcers, and oral cancers from cannabis smoke. In this review, we summarize some of the studies and reports regarding the medicinal uses of cannabis in the dermatology clinic and some of the side effects that might present more often to dermatologists as the use of cannabis increases.
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Heffernan, Eithne, Jenny Mc Sharry, Andrew Murphy, Tomás Barry, Conor Deasy, David Menzies, and Siobhan Masterson. "Community first response and out-of-hospital cardiac arrest: a qualitative study of the views and experiences of international experts." BMJ Open 11, no. 3 (March 2021): e042307. http://dx.doi.org/10.1136/bmjopen-2020-042307.
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ObjectivesThis research aimed to examine the perspectives, experiences and practices of international experts in community first response: an intervention that entails the mobilisation of volunteers by the emergency medical services to respond to prehospital medical emergencies, particularly cardiac arrests, in their locality.DesignThis was a qualitative study in which semistructured interviews were conducted via teleconferencing. The data were analysed in accordance with an established thematic analysis procedure.SettingThere were participants from 11 countries: UK, USA, Canada, Australia, New Zealand, Singapore, Ireland, Norway, Sweden, Denmark and the Netherlands.ParticipantsSixteen individuals who held academic, clinical or managerial roles in the field of community first response were recruited. Maximum variation sampling targeted individuals who varied in terms of gender, occupation and country of employment. There were eight men and eight women. They included ambulance service chief executives, community first response programme managers and cardiac arrest registry managers.ResultsThe findings provided insights on motivating and supporting community first response volunteers, as well as the impact of this intervention. First, volunteers can be motivated by ‘bottom-up factors’, particularly their characteristics or past experiences, as well as ‘top-down factors’, including culture and legislation. Second, providing ongoing support, especially feedback and psychological services, is considered important for maintaining volunteer well-being and engagement. Third, community first response can have a beneficial impact that extends not only to patients but also to their family, their community and to the volunteers themselves.ConclusionsThe findings can inform the future development of community first response programmes, especially in terms of volunteer recruitment, training and support. The results also have implications for future research by highlighting that this intervention has important outcomes, beyond response times and patient survival, which should be measured, including the benefits for families, communities and volunteers.
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Aliyeva, Zamina. "The Law Aspects in Health Management: A Bibliometric Analysis of Issues on the Injury, Damage and Harm in Criminal Law." Marketing and Management of Innovations, no. 3 (2020): 293–305. http://dx.doi.org/10.21272/mmi.2020.3-21.
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The paper presents the analysis of the approaches to define the areas of research on the injury, damage and harm to human health in criminal law. The obtained results proved that crimes, connected to drugs abuse, their legislation become an essential part of the issues. At the same, developing of government control, medical standards, improving quality of medical education balancing the «medical mistake – injury to human’s health – jurisprudence consequences» triangle in the tendency of the injury, damage and harm in criminal laware becoming very important to the healthcare system due to increasing requirements of regulators, customers and shareholders. The paper aimed to analyse the tendency in the literature on the injury, damage and harm in criminal law, which published in books, journals, conference proceedings etc. to identify future research directions. The methodological tools are VOSviewer, Scopus and Web of Science (WoS) software. This study covers 1072 papers from Scopus and WoS database. The time for analysis were 1970-2020. The Scopus and WoS analyse showed that in 2012-2019 the numbers of papers on the injury, damage and harm in criminal law issues began to increase. However, the topics changed from general issues to the problem of decriminalisation of drug trafficking, and the corresponding paradigm shift in the punishment of some crimes, increasing interest in punishing corporations for violating environmental regulations. In 2017 the number of documents dedicated to injury, damage and harm in criminal law was increased by 667% compared to 2012. The main subject areas of analyses of the injury, damage and harm in criminal law were the next: Law, Public environmental, occupational health, Criminology penology, Substance abuse, Psychiatry, Medicine. The biggest amount of investigations of the injury, damage and harm in criminal law was published by the scientists from the USA, United Kingdom, Australia and Canada. In 2019 such journals with high impact factor as International Journal of Drug Policy, International Journal of Law and Psychiatry, The Lancet etc. published the number of issues, which analysed of the injury, damage and harm to human health in criminal law. Such results proved that theme on the injury, damage and harm to human health in criminal law is actually in the ongoing trends of the modern jurisprudence and regulation. The findings from VOSviewer defined 6 clusters of the papers which analysed the injury, damage and harm to human health in criminal law from the different points of views. The first biggest cluster (with the biggest number of connections) merged the keywords as follows: criminal justice, law enforcement, public health, health care policy, harm reduction, drug legislation, drug and narcotic control, substance abuse, homelessness etc. The second significant cluster integrated the keywords as follows: criminal behaviour, crime victim, adolescent, violence, mental health, mental disease, prisoner, young people, rape, police etc. The third biggest cluster concentrated on criminal aspects of jurisprudence, criminal law, human right, legal liability, social control, government regulation etc. The obtained results allow concluding that balancing the triangles «medical mistakes – criminal – education» and «drugs – criminal – justice» and «abortion – criminal – women/children» form an important part of the injury, damage and harm in criminal law issues. Keywords injury, damage, harm, human health, criminal law, management, governance.
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Nolan, Brodie, Alun Ackery, and Bryan Au. "What to do when a patient wants to record a patient-physician interaction in the emergency department." CJEM 20, no. 3 (May 16, 2017): 471–75. http://dx.doi.org/10.1017/cem.2017.23.
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ABSTRACTRecent technological advances allow for instantaneous high quality video and audio recordings with the touch of a button. In Canada, patient privacy is highly regulated by provincial legislation, although patients themselves have little in the way of laws or regulations to observe. Patients taking video recordings of their own medical care does not currently fall under any of the provincial privacy laws. With no such governance for the general public, patients generally have greater freedom to record a patient-physician interaction. Unfortunately, there are no official policies from the provincial physician colleges regarding how best to proceed in these circumstances. Therefore, the onus is on individual hospitals and emergency departments (EDs) to develop their own policy on video recordings. A policy should ideally cover possible recording devices, locations, staff involved, and mandate that a written consent form be included with the patient’s chart. While every request should be considered individually, physicians should generally not feel compelled to agree to the patient recording the clinical encounter. Patients are legally allowed to record a patient-physician interaction without consent of their physician, because the patient can provide the “one-party consent” for the conversation to be recorded. Physicians should accept the possibility that they are being recorded at all times and should strive to communicate as clearly and effectively as possible. Physicians should strive to provide the same level of care that they would even if they were not being recorded, and not let it interfere with their clinical decision-making.
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Nolan, B., A. Ackery, and B. Au. "P096: Hospitalselfie: a review of implications and recommendations on patients making video recordings in hospital." CJEM 18, S1 (May 2016): S110. http://dx.doi.org/10.1017/cem.2016.272.
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Introduction: Smartphones are everywhere. Recent technological advances allow for instantaneous high quality video and audio recordings with the touch of a button. In Canada, physician smartphone use is highly regulated by provincial legislature and multiple policies have been published from provincial physician colleges and the Canadian Medical Protective Association (CMPA). Patients on the other hand have no such laws to observe. We set out to look at what legislation and policies exist to provide guidance to physicians in two potential scenarios: when a patient requests to record a patient-physician interaction and if a patient surreptitiously records a patient-physician interaction without consent of the physician. Methods: A literature review searching for articles on patient video recordings and patient smartphone use was completed on both Medline and PubMed. Further review of each provincial privacy act and communication with each provincial privacy office was performed. Consultation with each provincial physician college and the CMPA was also done to identify any policies or recommendations to guide physicians. Results: Patients making video recordings do not fall under any provincial privacy law and there are no existing policies from any provincial physician college or the CMPA to provide guidance. Therefore, physicians must rely on their own institution’s policy regarding patient video recording in the health care setting. Be familiar with your institution’s policy. If your institution does not have a policy, create one with the input of appropriate stakeholders. Patients may surreptitiously video record medical interactions without physician consent. Although this may not be permitted under an individual institution’s policy, it is not illegal under the Criminal Code. Thus, it is important to behave in a professional manner at all times and assume you may be recorded at any time. Conclusion: The majority of patients’ recordings will be done without litigious intentions, but rather with the goal of understanding more about their own health and medical care. Unfortunately there are those who will undermine the physician-patient relationship. Physicians cannot allow this to cause distrust in future relationships, nor should it force physicians to practice more defensive medicine. Physicians must continue to practice the art of medicine and accept that “performance” is a part of the job.
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Durant, Keri-Lyn, and Katherine Kortes-Miller. "Physician snapshot: the forming landscape of MAiD in northwestern Ontario." Palliative Care and Social Practice 14 (January 2020): 263235242093292. http://dx.doi.org/10.1177/2632352420932927.
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Background: Options available to Canadians at the end of life increased with the legalization of medical assistance in dying (MAiD). Bill C-14 modified the Canadian Criminal Code allowing individuals who meet very specific criteria to receive a medical intervention to hasten their death. June 2019 marked 3 years since the legislation has changed and while met with favour from most Canadians who believe it will provide enhanced options for quality of life at the end of life, there remains much debate over both its moral implications and practical components. Little is known regarding the Canadian healthcare provider experience with MAiD, in particular in rural and remote parts of the country such as northwestern Ontario. Objectives: The purpose of this study was to explore physicians’ experiences in Northwestern Ontario with MAiD. The geographic location of this study is of particular significance as physicians in rural and remote parts of Canada face unique challenges in the provision of high-quality palliative and end-of-life services. This qualitative research focused on developing a better understanding of physicians’ perceptions and practices with MAiD, in particular regarding access, decision-making, provision of service and role clarity. Methods: The researchers employed an exploratory qualitative research approach, using 1 semi-structured focus group and 18 semi-structured interviews comprising 9 set of questions. Data were collected through audio-taped semi-structured interviews, in person and by telephone. Findings: Four distinct but interconnected themes emerged from thematic analysis of the transcripts of the focus group and interviews: physician perception of patient awareness, appreciation and understanding of MAiD; challenges providing true choice at end of life; burgeoning relationships between palliative care and MAiD; and physician recommendations. Conclusion: The results of this study provide a snapshot of the Northwestern physician experiences with MAiD and contribute to the growing body of work exploring these issues on a national scale. MAiD is highlighted as both a rewarding and challenging experience for physicians in Northwestern Ontario in this study.
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Makukh-Fedorkova, Ivanna. "Canadian model of the system of health protection: basic approaches and mechanisms of realization." Mediaforum : Analytics, Forecasts, Information Management, no. 6 (December 17, 2018): 25–38. http://dx.doi.org/10.31861/mediaforum.2018.6.25-38.
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The features of forming and development the system of health protection Canada open up in this article; attention is concentrated on the personal touches and general principles of construction of sphere of medical service. An author marks that the Canadian system of health protection in obedience to international standards provides the high enough level of medical service and by a certificate there are high life-span and low level of child’s death rate it. Principles of social organization of society and system of health protection in Canada were formed in the second half of ХХ century. The system of health protection Canada has a reasonable legislative base; her forming took place in a few stages: on the first stage (beginning of 40th of XX of century) the grant of having special purpose subsidies is legislatively envisaged for the special programs of health protection and for building of hospital establishments. Such normatively-legal base assisted to development of network of hospital establishments in a country; on the second stage (in 1957) was passed an act that fastened federally-provincial allocation of financial resources on Medicare about medical insurance. Thus the quality indexes of grant of Medicare were determined by national requirements; on the third stage (1968-1979) legislative documents that formed the Canadian system of medical insurance of Medicare and set distribution of money on hospital. In 1984 in Canada was passed an act about a health protection that fastened basic principles of Medicare. This system provides free or practically free medical service and medical services to all citizens of Canada. Such structure was worked out because medical service is in the department of local, provincial authorities, but not federal government. It is well-proven that the Canadian system of health protection has certain defects also, in fact on the modern stage Canadian medicine tests a sharp requirement in experience doctors, and also one of basic problems there are large turns in medical establishments and protracted expectation of possibility to get medicare. In the same time, without regard to the outlined problems, the Canadian system of medicine under the name of Medicare is pride of country, as financed by the state and provides free medical service to all citizens practically.