Authorized Confinement in Healthcare
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Questions and Answers

What does the parameter of 'Authorized Confinement (Institutional)' primarily refer to?

  • Confinement without oversight or regulation
  • Voluntary admission of patients to care facilities
  • Legal processes allowing confinement for treatment (correct)
  • Patient-initiated request for confinement

    • Which of the following is not a type of confinement mentioned in the outline?

  • Authorized Confinement
  • Temporary Confinement (correct)
  • Preventative Confinement
  • Provisional Confinement

    • In the context of privacy, which category is NOT included in the management of confidentiality?

  • Patient access to medical records
  • Confidential communications with family (correct)
  • Care issues regarding minors
  • Privacy of deceased patients

    • Which of the following best describes the 'Rights of the person under confinement'?

    <p>Rights are maintained except for safety protocols</p> Signup and view all the answers

    What aspect does 'Management of Limited Resources' relate to in healthcare?

    <p>Balancing patient rights with available resources</p> Signup and view all the answers

    What is a key requirement for authorized confinement in an institution?

    <p>A court order meeting specific criteria</p> Signup and view all the answers

    Which of the following describes preventative confinement?

    <p>Confinement for individuals who are deemed a future threat</p> Signup and view all the answers

    What does the term 'renewal' refer to in the context of authorized confinement?

    <p>Increasing the duration of confinement upon re-evaluation</p> Signup and view all the answers

    Which aspect of confinement pertains to patient rights?

    <p>The legal rights granted to individuals under confinement</p> Signup and view all the answers

    What is the primary focus of the section on 'potential issues in confinement'?

    <p>Identifying challenges related to patient care and rights</p> Signup and view all the answers

    What type of authorization is required for confinement in a health or social services institution after a psychiatric assessment determining confinement is necessary?

    <p>Court authorization</p> Signup and view all the answers

    What is the burden of proof regarding a person's confinement?

    <p>On the healthcare establishment</p> Signup and view all the answers

    Which of the following descriptions must be included when detailing grave or important danger for a patient?

    <p>Specific and precise descriptions of the danger</p> Signup and view all the answers

    Under what circumstances can a patient be confined without a court order?

    <p>When a physician orders it due to immediate danger</p> Signup and view all the answers

    Which of the following is NOT a requirement for a person's confinement?

    <p>The person must provide consent for confinement</p> Signup and view all the answers

    What is insufficient to constitute real danger in a patient regarding their mental health assessment?

    <p>A doubt as to their dangerousness</p> Signup and view all the answers

    Who may assist in the confinement process during preventive measures?

    <p>Peace officer</p> Signup and view all the answers

    What must happen upon a person's arrival at an institution?

    <p>The person must be examined by a physician.</p> Signup and view all the answers

    What occurs if an institution cannot provide the necessary psychiatric examination?

    <p>The institution must redirect the person to another equipped facility.</p> Signup and view all the answers

    Which statement reflects an important consideration regarding a patient's future danger after leaving confinement?

    <p>The fact that the patient may become dangerous again once released is not a valid reason for confinement.</p> Signup and view all the answers

    What is necessary for a person to remain hospitalized after the first examination?

    <p>The examination must conclude the necessity of confinement.</p> Signup and view all the answers

    What must be demonstrated for provisional confinement of a person?

    <p>The person must be a danger to themselves or others.</p> Signup and view all the answers

    What should happen if a patient refuses to be evaluated?

    <p>A court order may be requested for further evaluation.</p> Signup and view all the answers

    What time frame is specified for carrying out a psychiatric examination after a person is taken in charge?

    <p>Within 24 hours.</p> Signup and view all the answers

    What is one characteristic of serious danger for a person under assessment?

    <p>The risk must be high and foreseeable.</p> Signup and view all the answers

    What resource is specifically mentioned as necessary for institutions to provide psychiatric examinations?

    <p>A psychiatrist.</p> Signup and view all the answers

    What is required if a person under confinement has been confined for longer than 21 days?

    <p>They must be examined periodically.</p> Signup and view all the answers

    How often must psychiatric examination reports be produced after the initial 21 days of confinement?

    <p>Every three months.</p> Signup and view all the answers

    Which of the following rights is NOT granted to a person under confinement?

    <p>The right to refuse all medical treatment.</p> Signup and view all the answers

    In what situation is the service of application for confinement exempt?

    <p>In clinical situations.</p> Signup and view all the answers

    Who is responsible for informing a minor under confinement about their care program?

    <p>The minor's parents or authorized guardian.</p> Signup and view all the answers

    What must occur before a health establishment can treat a person confined against their will?

    <p>Consent approval from the Superior Court.</p> Signup and view all the answers

    Under what conditions may restraints be used on a confined individual?

    <p>When ordered or during an emergency.</p> Signup and view all the answers

    What type of court can a confined person appeal their confinement to?

    <p>Administrative Tribunal.</p> Signup and view all the answers

    What is required of a professional if they suspect a child's security or development is in danger?

    <p>Contact the Director of Youth Protection without delay.</p> Signup and view all the answers

    What constitutes a situation where a child's security and development IS in danger?

    <p>The child is experiencing psychological ill-treatment.</p> Signup and view all the answers

    Which of the following statements about minors under 14 years of age is true?

    <p>Parental authority or tutor must consent to their treatment.</p> Signup and view all the answers

    In which scenario is a court order necessary when involving a minor over 14 years of age?

    <p>When the minor requires care but refuses it.</p> Signup and view all the answers

    What constitutes a situation where a child's security and development MAY BE in danger?

    <p>The child has been absent from school without cause.</p> Signup and view all the answers

    What happens if a minor over 14 years refuses care that they require?

    <p>A court order is required for treatment if they refuse.</p> Signup and view all the answers

    Who must be informed if a minor over 14 remains in a health establishment for over 12 hours?

    <p>The parents or tutor.</p> Signup and view all the answers

    What action should be taken if a child leaves a care facility unauthorized?

    <p>Contact the Director of Youth Protection.</p> Signup and view all the answers

    Study Notes

    Law 2 - Confinement, Privacy & Confidentiality, and Resources

    • Course name: NUR1 - 424
    • Course semester: Fall 2024
    • Lecturer: Daria Kapnik

    Plan

    • 1. Authorization for Treatment:
      • 1.1 Recap of Court Orders under CCQ
      • 1.2 Treatment order
    • 2. Confinement Law:
      • 2.1 General Principles
      • 2.2 Parameters
      • 2.3 Types of Confinement
      • 2.4 Preventative Confinement
      • 2.5 Provisional Confinement
      • 2.6 Authorized Confinement (Institutional)
        • 2.6.1 Motion for Authorized Confinement – Process
        • 2.6.2 Motion for Authorized Confinement – Duration
        • 2.6.3 Motion for Authorized Confinement – PSY content
        • 2.6.4 Motion for Authorized Confinement – Court order criteria
        • 2.6.5 Motion for Authorized Confinement – Renewal
        • 2.6.6 Motion for Authorized Confinement – End of Confinement
        • 2.6.7 Motion for Authorized Confinement – Longer Confinement
      • 2.7 Rights of the person under confinement
      • 2.8 Potential issues in confinement
    • 3-4. Privacy, Confidentiality, and Resources:
        1. Privacy - Patient access and medical records
        • 3.1 General
        • 3.2 Deceased patients
        • 3.3 Privacy, confidentiality and care issues regarding minors
        1. Management of Limited Resources and Patient Rights
        • 4.1 Key Provisions
        • 4.2 Caselaw

    Outline

    • 1. Authorization for Treatment:

      • 1.1 Recap of Court Orders under CCQ
        • Art. 16 CCQ: person of full age incapable of giving consent categorically refuses care; no representative found for delegated consent or refuses without justification; minor over 14 refuses care (not emergencies or where life/integrity threatened)
        • Arts. 17/18 CCQ: care entails serious risk to minor's health and may cause grave and permanent effects
      • 1.2 Treatment order
        • WHO?: health establishment has burden of proof
        • WHAT?: patient lacks capacity to consent; patient categorically refuses treatment; proposed treatment is in patient's best interest
        • HOW?: expert reports, testimonial evidence (psychiatrist & residents)
          • Nova Scotia criteria: understanding of illness, nature & purpose of treatment (options), benefits & risks of treatment & non-treatment, is comprehension affected by illness?
        • WHY?: to introduce/enforce treatment

    • 2. Confinement in an Institution:

      • 2.1 General Principles

        • Confinement is exceptional measure, contrary to integrity and inviolability. Person must represent serious and immediate danger to self or others.
        • Legislation includes Quebec Civil Code + Code of Civil Procedure + Act respecting the Protection of persons

      • 2.3 Types of Confinement

          1. Voluntary Confinement (patient consents)
          1. Forced Confinement:
          • a. Preventive (in specialized institution)
          • b. Provisional
          • c. Authorized (requires motion)

      • 2.4 Preventative Confinement

        • Grave and immediate danger to self/others
        • Physician order, not court order; possible peace officer assistance.
        • 72-hour period, if danger persists, court order needed
        • Section 8 of Act P-38

      • 2.5 Provisional Confinement

        • Danger to self/others (grave or serious, not necessarily immediate)
        • Court order (motion) required if patient refuses evaluation
        • Police assistance may be authorized (or ordered)

      • 2.6 Authorized Confinement - Process

        • Physician must conclude confinement is not necessary—patient released.
        • Application for confinement must be presented to court within 48 hours.

      • 2.6 Authorized Confinement - Duration

        • Maximum of 30 days; if less is necessary specify timeframe; patient must be released once no longer considered a danger
        • Discretion for judges to adjust duration based on evidence

      • 2.6 Authorized Confinement - PSY content

        • Psychiatric examination report must deal with necessity of confinement if danger to self/others (due to mental state)
        • Must assess patient's ability to care for themselves and manage property, advisability of protective supervision.

      • 2.6 Authorized Confinement - Court order criteria

        • Court must conclude confinement is necessary.
        • Even necessary confinement may not be authorized by the court if there is no credible reason to believe the person is dangerous.

      • 2.6 Authorized Confinement - Renewal

        • At expiry of 30-day period, can extend to maximum 90 days.
        • Requires a new examination concluding confinement remains necessary.

      • 2.6.6 Motion for Confinement - End of Confinement

        • Confinement ends when justification is no longer present, or as the time limit specified expires, or upon court or administrative tribunal order

      • 2.6.7 Motion for Confinement - Longer Confinement

        • If confinement is for more than 21 days, periodic examinations to determine continued necessity
        • Examinations must be conducted every 21 days and every three months thereafter.

      • 2.7 Rights of the person under confinement -Comprehensive schedule of rights per P-38 -Right to receive application for confinement -Person's testimony is required unless unavailable or useless due to health reasons -Right to communicate. - Patients allowed to communicate with authorized outside persons. - Right to counsel

      • 2.8 Potential issues in confinement

        • Consent to care must still go through the Superior Court, they can keep the person, but can't treat them against their will.
        • Use restraints required per protocol only if ordered/emergency
        • AWOL: contact DPS office if requested.

    3. Caselaw

    • 3.1 Charles Le Moyne c. E.(F.) (CQ): 20-year-old male college student brought to hospital by police; family and friends said he wasn't a danger
    • 3.2 CSSS Côte-de-Gaspé c. P(C): Bipolar patient, seeking to renew confinement; doctors felt patient remained dangerous. Confinement eventually denied, dangerousness must be present in short-to-medium term.
    • 3.3 Hôpital Maisonneuve-Rosemont c. H.(M.): 33-year-old man refused medication; refusal was maintained by courts.
    • 3.4 J.M. c. Hôpital Jean-Talon du (CIUSSS) du Nord-de-l'Île-de-Montréal, 2018 QCCA 378: The appeal was granted because patient was wrongfully held in confinement after 72 hours.

    4. Privacy

    • 4.1 General: Right of access to own records. Must be accurate, complete, unambiguous info. Medical professional may deny access if there's a significant likelihood of adverse effect on patient or third party.

    • 4.2 Deceased patients: Heirs, legatees, and legal representatives of a deceased person are entitled to info in the record. Spouse, ascendants, or direct descendants can receive info, unless the deceased refused to grant access. People with parental authority have access for a minor (under 14) even if deceased.

    5. Privacy, Confidentiality, and Care Issues Regarding Minors

    • Parental access to a minor's health information is addressed.
    • Access by other bodies requires statutory duties of disclosure and is handled by other bodies
    • Details for when access can be refused by institution

    6. Management of Limited Resources and Patient Rights

    • 6.1 Key provisions(LSSSS): Addresses patient rights to continuity of care, service in English, and accompaniment, choice of physician in the context of available resources.
    • 6.2 Cases Law:
      • 6.2.1 Jasmin c Cité de la santé de Laval: Hospitals can't refuse treatment based on residence if the care is available.
      • 6.2.2 Noël-Voizard c. CSSS Lasalle: Plaintiff broke wrist, had to wait excessively long in emergency room. Was deemed the medical staff did the best to handle the situation, with the resources available.
      • 6.2.3 J.O vs Hôpital Royal Victoria: Dialysis patient was extremely verbally abusive. Hospital was subsequently able to transfer care to another facility.

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    Related Documents

    Law 2 - Confinement, Privacy & Confidentiality, and Resources NUR1 424 Fall 2024 PDF

    Description

    This quiz explores key concepts related to authorized confinement in institutional settings, focusing on patient rights, management of resources, and types of confinement. Test your knowledge on important aspects and requirements concerning confinement and confidentiality in healthcare.

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