Toronto Notes @)a Comprehensive Medical Reference & Review for MC CGEEthical, Legal and Organizational PACS yee Mom ete Celia) Carlo Hojilla and Winnie Siu, chapter editors Asem Bishnoi and Grace Yeung, associate editors Amy Shafey, EBM editor Dr. Philip Hébert, staff editor Logal Matters 2 ‘The Doctor-Patient Relationship under the Law Consent under the Law Power of Attorney (POA) Confidentiality and Reporting Requirements Privacy of Medical Records Negligence and Liability Physician Competence and Conduct lice eee eg) Principies of Ethics Code of Ethics Confidentiality Consent Assessing Capacity ‘Truth Telling Resource Allocation Research Ethics Physician-Industry Relations Doctor-Pationt Relationship Personal and Professional Conduct, Areas of Controversy Organization of Heal History. Key Principles of the Canada Health Act Health Care Expenditure and Delivery in Canada Role of the Provincial Licensing Authorities Distinction Between Licensure and Certification Role of Professional Associations Professional Associations in Canada and the US. can Canada... 18 ‘The US. Health Care System ........2..2..19 Health Care Expenditure and Delivery Access to Health Services The Uninsured Physician Responsibi Regarding Death a Role of the Coroner Palliative and End-of-Life Care References a Further information on these topics can be found in the Objectives ofthe Considerations. specs ofthe Practice of Medicine (CLEO) ~ which can be downloaded ‘website at www:mce.ca/ pa leo.paf 1 Lego, Ethical and of charge from the Toronto Notes 2010 ELOAMIELOAM2 Legal Matters “Toronto Notes 2010 Peter ME tac ie @-; The Doctor-Patient Relationship Under the Law + the laws which regulate the doctor-patient relationship function to protect patients 16; Comin tow | hse awe are derived rom thee sources 1 he common law (in Que, the Cel Coe af totpaccs veer iween |” Grete) 2) statutes and 3) the Constitation FE a + the common las the body of legal le a principles, derive from judges” decisions 2m salen teonae toon | that forma the basis ofthe Anglo anadon legal system. Areas comm ie nel aes eee * Yor a allows patients to recover damages for wrong at committed agaist Ss them. The most important ors in meal relationship ae: 1) melee (ce Se Neqligenr and Lishity, ELOAMG) and 2) hatey (he aplinton of force 0.8 ar eee eae person's body without thr consent) Sollee totter yiee + The doctor patent relationship constitutes a contract, which gives se to various Sree a ere onic gs andes that. f reached, may rs the award of damages + doctor alo has a fiucary duty to thei patient that an ligation to act nthe patient's est interests + statutes ar nws passed by provincial legislatures and the federal pariament for example: ‘in Ontario the Hoath ave Consent At roglates consent to treatment (se Const tinder the Le LOAM) the Personal Health information Protection Act regulates the collection, se and ‘isclosre of health records (se Pic of Mesa Recs, ELOAMS) the Crna Coe andthe Conrad Drage and Subst Act regulate the we of many medications + the Constitution is he supreme law of Canada’ al ther laws mat be consistent witht lrthey ae of mo force and eet * the Canaion Charter f Rights and Frets guarantees individuals the rights (among. thers) of life liberty security ofthe person and walt ander the lave + these rights resect only fo sch easonae its prescribe y lor a8 can be ‘domonstrably astied in fre and democratic society proess. Consent Under the Law + consent ofthe patient must be obtained before any medical intervention is provided Se amramy, ])1Saeea Eg ate ses tet a a gion iin Me wecmpmn fit | > Concent canbe ener expres or implied, an example Gf plied consent is patient =a folding out cir ar fo an eumunizaton SAA RIEIEESERIERIE| © consent xa ccgoing proces end can be ethdrwv ox changed after itis gir teatepra tees ree | > Fra car Cont et covers consent to eaten admission toa tacit and personal Seaectsembeir sean |” asstance services (eg home cae) feich intron ettetteshcrormavdaee | Exceptions to Consent el emergencies , , ee ee + Peatment canbe provided without consent where a patent i experiencing severe esrre Sacer oon a sffering, OR where a delay in treatment would lead to serious harm or death AND “Scam! bese he ae oth sie deco maker + Gmeigency metenent should pot volte par enpaok expressed ish of he patient (eg a signed Jehovah's Wines card) 2. Legislation Mental Health gislaton allows for The detention of patents without ther consent ee Consent, ELOAMS) + payee oupdens tobe compelled acese to acre plan in acordanoe ith Communty Testment Ones oe Bahia, PSE) + mia lw mi fice ein dtsin cae, an treat patents wihout ter consent (ga paint with TB seksi ake tmedlication) for the purpoee of preventing tranemission of communicable diseases (ee Population and Community Health PHO) 3. Special Stustons Dublc helt emergencies suchas an epidemic or communicable disease trestment + Rstrnt for toarrbton by police Majo Excoptions to Consort + Enupece 1 Comme spans Mantle gon Four Basic Requirements of Valid Consent 1. Voluntary * consent must be given free of coercion or pressure * the physician must not deliberately mislead the patient about the proposed treatment 2. Capable the patient must be able to understand the nature and effect of the proposed treatment 3. Specific the consent provided is specific to the particular procedure being propose and to the particular provider who wil cary out the procedure (Lethe patient must be informed if students will be involved in providing the treatment)