Civil Law and Patient Rights in Canada
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Questions and Answers

Which level of government holds decision-making power in healthcare in Canada?

  • Federal government
  • Local government
  • Provincial government (correct)
  • Municipal government

What must nurses provide to ensure they respect patient rights according to the AHSSS?

  • Guarantee a successful treatment outcome
  • Obtain free and enlightened consent (correct)
  • Provide treatment without explanation
  • Obtain verbal consent

What is the primary obligation of medical professionals towards their patients?

  • Obligation of satisfaction
  • Obligation of means (correct)
  • Obligation of consensus
  • Obligation of result

Which article of the AHSSS guarantees patients the right to choose a medical professional?

<p>Article 6 (D)</p> Signup and view all the answers

What is the role of disciplinary boards in healthcare?

<p>To sanction deviations from standards of practice (A)</p> Signup and view all the answers

Which of the following is NOT a primary source of law mentioned?

<p>Doctrine (B)</p> Signup and view all the answers

What is a requirement for nurses in obtaining patient consent?

<p>They must provide explanations for patient comprehension (C)</p> Signup and view all the answers

Under what circumstance might confidentiality of a user's record be waived?

<p>In cases where mental state presents a danger (D)</p> Signup and view all the answers

What must occur before a heart can be removed from a deceased individual?

<p>Irreversible cessation of circulatory and respiratory function (C)</p> Signup and view all the answers

Which of the following accurately describes the definition of death as per the content?

<p>Irreversible cessation of brain function and consciousness (C)</p> Signup and view all the answers

In Canada, what type of organ donation legislation is currently in place?

<p>Explicit consent (opt-in) (D)</p> Signup and view all the answers

Which principle states that organs should be removed only if consent is obtained and no objections are evidenced?

<p>WHO Principle #1 (B)</p> Signup and view all the answers

What scenario is NOT one of the circumstances in which deceased organ donation can occur?

<p>Active rehabilitation of the patient (C)</p> Signup and view all the answers

Which aspect can create tension between palliative care and organ donation requirements?

<p>Use of advanced life support equipment (B)</p> Signup and view all the answers

Which of the following is prohibited in relation to organ donation?

<p>Financial compensation for organ donations (C)</p> Signup and view all the answers

What is a requirement for living organ donors according to WHO principles?

<p>Living donors should be connected emotionally or legally to the recipient (C)</p> Signup and view all the answers

What is the main legal responsibility of a hospital towards its patients?

<p>To provide care that adheres to current, generally accepted standards in similar situations (B)</p> Signup and view all the answers

How does professional fault differ from an error of judgment in medical practice?

<p>Professional fault involves a breach of established standards of care, whereas an error of judgment does not. (A)</p> Signup and view all the answers

In a medical malpractice lawsuit, who do patients typically sue?

<p>The hospital rather than individual healthcare professionals (B)</p> Signup and view all the answers

What principle describes a hospital's liability for the actions of its staff?

<p>Vicarious liability (A)</p> Signup and view all the answers

What is the main distinction between negligence and malpractice in a medical context?

<p>Negligence involves carelessness, whereas malpractice refers to unethical professional conduct. (D)</p> Signup and view all the answers

What duty do medical professionals have concerning patient consent?

<p>They must get free and enlightened consent before any intervention. (B)</p> Signup and view all the answers

In the case of Ciarlariella v. Schater, what was the outcome regarding patient consent?

<p>The consent provided by the patient was upheld despite her distress. (A)</p> Signup and view all the answers

According to the principles guiding medical professionals, how should their conduct be assessed?

<p>Against the conduct of a prudent and diligent professional in similar circumstances (D)</p> Signup and view all the answers

What does CCQ article 10 emphasize regarding personal integrity?

<p>No one may interfere with a person without free and enlightened consent. (C)</p> Signup and view all the answers

What is the typical administrative action for misconduct by nurses?

<p>Reporting to the professional board for disciplinary action (D)</p> Signup and view all the answers

What must be included in the information provided to the patient for informed consent?

<p>The proposed treatment, its benefits, and the risks of not undergoing it (D)</p> Signup and view all the answers

According to the legal framework, what does a healthcare provider's duty to inform include?

<p>All associated risks and consequences of treatment alternatives (B)</p> Signup and view all the answers

What is NOT a criterion for establishing a person's capacity to consent?

<p>Age of the individual (D)</p> Signup and view all the answers

What rights do patients have regarding their informed consent?

<p>To revoke their consent at any time (B)</p> Signup and view all the answers

What happens if a minor under the age of 14 refuses care?

<p>Parental authority must provide consent for care (C)</p> Signup and view all the answers

Which of the following statements about a judge's role in assessing treatment is accurate?

<p>The judge assesses if treatment is appropriate and its benefits outweigh the negatives (C)</p> Signup and view all the answers

Which of the following is a correct interpretation of 'capacity' in a medical context?

<p>Ability to understand the nature of illness and treatment options (D)</p> Signup and view all the answers

What should occur if a patient categorized as inapt to consent shows a categorical refusal for treatment?

<p>Obtain a motion from a hospital lawyer based on a psychiatric report (D)</p> Signup and view all the answers

What does article 4 of the Code of Ethics of Nurses specify about treatment options?

<p>Options must exclude potentially harmful treatments (D)</p> Signup and view all the answers

According to the criteria of informed consent, what must always be true about consent?

<p>It must be free and enlightened (B)</p> Signup and view all the answers

Which of the following best describes the situation referred to in Starson v Swayze regarding patient autonomy?

<p>Law can enforce treatment against the wishes of incompetent individuals (D)</p> Signup and view all the answers

What additional requirement is needed if care for a minor entails serious health risks?

<p>Parental authority and potential court authorization may be necessary (B)</p> Signup and view all the answers

When must a patient be informed as per LSSS 8 about their health?

<p>As soon as possible after any incident affecting their condition (A)</p> Signup and view all the answers

What is the focus of the Code of Ethics article 41 regarding consent?

<p>Consent must remain enlightened for the duration of care (A)</p> Signup and view all the answers

What must healthcare professionals obtain from patients prior to providing care?

<p>Informed consent with understanding of risks (A)</p> Signup and view all the answers

Under what condition is informed consent not required in healthcare?

<p>In emergency situations where consent cannot be obtained in time (D)</p> Signup and view all the answers

What is one reason that consent may be considered invalid?

<p>Consent was given based on a misrepresentation (C)</p> Signup and view all the answers

What does CCQ 1457 state regarding civil liability?

<p>Every individual must abide by rules of conduct to avoid causing harm (D)</p> Signup and view all the answers

Which of the following can be a component of damages in civil liability claims?

<p>Compensatory damages for lost wages (B)</p> Signup and view all the answers

What can indicate a failure in the duty to obtain informed consent?

<p>Providing inadequate information about risks (B)</p> Signup and view all the answers

What could happen if a healthcare professional fails to interpret a patient's symptoms correctly?

<p>The healthcare professional may face civil liability for negligence (B)</p> Signup and view all the answers

In the case of a person incapable of giving consent, who can provide consent on their behalf?

<p>A spouse or close relative of the person (A)</p> Signup and view all the answers

Which aspect is NOT considered during the assessment of consent validity?

<p>Presence of witnesses during the consent process (A)</p> Signup and view all the answers

What is a key element in establishing extracontractual liability?

<p>Conduct that is deemed careless or unreasonable (C)</p> Signup and view all the answers

What does the College de Médecins’ 3-tier test assess?

<p>The necessity and benefits of imposed treatment (D)</p> Signup and view all the answers

What should be done if a patient expresses fear during the consent process?

<p>Try to reassure the patient and clarify their fears (B)</p> Signup and view all the answers

What is not a valid reason for refusing treatment according to CCQ regulations?

<p>Patient's challenging behavior (A)</p> Signup and view all the answers

Which of the following is a criterion for valid consent under CCQ?

<p>Consent must be free and without coercion (A)</p> Signup and view all the answers

What type of liability protects patients when healthcare professionals cause harm?

<p>Extracontractual liability (B)</p> Signup and view all the answers

Flashcards

Patient's Rights in Healthcare

Legal entitlements of individuals receiving healthcare services, outlining their rights regarding service access, choices, information, accompaniment, and language.

Civil Law in Canada

A system of law focused on the rights and responsibilities of individuals toward each other, governed by legislation and court decisions.

Act Respecting Health Services and Social Services (AHSSS)

Quebec legislation that covers the rights and duties of health and social service users and providers in Quebec.

Standard of Care for Nurses

Professional expectations and skills expected of nurses while providing care; measured against the competence & diligence of other nurses in similar situations.

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Informed Consent

The right of patients to understand potential risks and benefits of a treatment or procedure before agreeing to it, a free and enlightened decision.

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Professional Obligations (Doctors/Nurses)

Duties and responsibilities of medical professionals, including providing accurate diagnoses, treatments, adhering to professional secrecy, and obtaining informed consent.

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Primary vs. Secondary Sources of Law

Primary sources are formal legal documents, like laws & case decisions; secondary sources are scholarly works about law, like articles or books.

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Duty of Means, Not Result

Medical professionals are responsible for their efforts and care, not guaranteeing a specific outcome for patients.

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Standard of Care (Nurses)

The recognized, accepted standards of practice a reasonable nurse in a specific specialty should follow.

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Breach of Standard of Care (Nurses)

A nurse's actions that don't meet the established standards of care, regardless of intent.

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Professional Fault (Nurses)

Violation of professional standards; not simply an error of judgment.

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Vicarious Liability

A hospital's legal responsibility for the actions of its staff, even if the staff are at fault.

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Free and Enlightened Consent

A patient's consent must be freely given and based on a proper understanding of the situation.

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Medical Malpractice

Improper or unethical conduct by a healthcare professional, often resulting in patient harm.

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Negligence

Failure to use reasonable care, which results in injury or harm.

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Capacity (Patient)

The patient's ability to understand and make decisions related to their care.

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Hospital Protocol

Official procedures and standards established by a hospital.

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Definition of death (medical)

Irreversible cessation of circulatory and/or respiratory function, or irreversible cessation of all brain functions, including the brainstem.

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Organ donation after death (criteria)

Can occur under certain conditions including neurological determination, or circulatory determination of death. Explicit consent is typically necessary.

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Explicit consent

A direct, positive agreement or authorization to receive or do something.

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Ethical issue in transplantation (consent)

Consent must be given freely without coercion or pressure, and donors must not be exploited by offering financial reward.

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Donation after cardiac death

Organ donation after irreversible cessation of circulatory and respiratory functions.

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Scarcity and Allocation

Ethical considerations of how to fairly distribute limited organs among those who need them.

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GIFT criteria

Guidelines used to determine the need for organ donation in specific patient cases (grave prognosis or GCS score).

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Donation from living donors

Organ donation by living persons is permitted under specific legal regulations, and is often related to genetic relatives.

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Duty to Inform

Healthcare providers' obligation to provide all necessary information for the patient's informed decision-making.

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Capacity to Consent

A person's legal ability to make decisions about their healthcare.

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Minor's Consent (<14 years)

Parents or guardians must consent to medical care for minors under 14, unless it's an emergency.

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Minor's Consent (>14 years)

Minors older than 14 can generally consent to treatment related to their health needs.

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Lack of Capacity (Tier 1)

A legal determination that a person isn't able to understand and decide about treatment, often due to a mental health concern.

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Lack of Capacity (Tier 2)

Court review of appropriateness and necessity of treatment when a person lacks the capacity to consent.

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Categorical Refusal

A person actively and clearly refuses treatment, even if the treating psychiatrist believes it's medically necessary.

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Personal Autonomy

The right of a person to make their own decisions, including healthcare choices.

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Effective Medical Treatment

Actions taken by healthcare providers that focus on safe and effective methods to improve a patient's health.

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Authorization granted

A period of time agreed upon for medical care under court order when a patient lacks capacity.

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Reasonable patient standard

A hypothetical measurement used to judge what a person in a similar situation may consent to based on risk vs reward.

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Emergency Care

Medical care given when immediate action is essential to prevent serious harm or death, usually without full consent.

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Prognosis

The predicted outcome of a medical condition or treatment.

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Emergency Exception

Consent not required if patient's life/integrity is in immediate danger and consent can't be obtained.

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Delegated Consent

Consent given by a legal representative when a person lacks capacity.

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Extracontractual Liability

Responsibility for harm caused by negligence, not related to a contract.

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Contractual Liability

Responsibility under a contract for failure to fulfil promises.

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Elements of Liability

Fault, damages, and causation needed for proving negligence.

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Adequate Causation

Direct relationship between the action and the injury stemming directly, not from background circumstances.

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Civil Liability in Healthcare

Legal recourse for patients whose rights are violated.

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Informed Consent and Risks

Patients must be informed about the risks and consequences when making decision about their treatment.

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Misleading Information

Providing incomplete or inaccurate information to a patient.

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Monocular Pain

Pain in only one eye.

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3-Tier Test

A framework used to evaluate the necessity of a treatment by examining its benefits, harm, and overall good.

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Invalid Consent

Consent that is not legally binding due to factors such as coercion or lack of understanding.

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Study Notes

Civil Law in Canada

  • Canada has three levels of government: federal, provincial, and municipal.
  • The Constitution Act of 1982 gives provinces power over healthcare.
  • Provinces determine the scope and standards of practice for medical professionals and the rights of health service users.
  • Provincial bodies (like OIIQ) often set ethical standards and best practices, and disciplinary boards enforce them.

Primary Sources of Law

  • Legislation:
    • Quebec Civil Code (CCQ)
    • Charter of Human Rights and Freedoms
    • Act respecting health services and social services (AHSSS)
    • Nurses Act regulations (e.g., Code of Ethics for Nurses)
    • Youth Protection Act
    • Act respecting the protection of persons whose mental state presents a danger to themselves or others

Secondary Sources of Law

  • Doctrine: Legal scholarship (textbooks, articles, government documents).

Patient's Rights

  • AHSSS (Articles 4-16): Covers rights and obligations of health/social service users and providers.
  • Basic Rights:
    • Continuity and safety of services
    • Choice of medical professional
    • Information about options, risks, and benefits
    • Accompaniment by a chosen person
    • Service in English
    • Service within the institution's available resources
  • These rights may be echoed in other legislation.
  • Details of patient rights often found in nursing codes of ethics (e.g., AHSSS Article 8 in Nurses Act Articles 40, 41).

Professional Obligations

  • Medical and nursing professionals have a duty to obtain informed consent, provide correct diagnoses and treatment, maintain confidentiality, and respect professional secrecy.
  • Obligations of Means (not Result): Professionals are responsible for acting with the skill and care of a reasonable professional, but not for guaranteed outcomes.
  • Standard of Care: Nurses must meet current, generally accepted professional standards.
  • Hospital Liability: Hospitals are vicariously liable for the actions of their staff (CCQ 1463).
  • Individual Responsibility: Professionals remain individually responsible for their actions, though patients often sue hospitals in malpractice cases.

Negligence vs. Malpractice

  • Negligence: Failure to meet the standard of care of a reasonably prudent person.
  • Malpractice: Improper professional conduct. In practice, malpractice generally means professional negligence.
  • Misconduct: Non-civil offenses like record-keeping failures, license issues, or improper delegation of care. These are typically addressed by professional boards (e.g., OIIQ).
  • CCQ 10 & 11: Every person is entitled to the integrity of their person and may only undergo care with free and informed consent.
  • Invalid Consent: Consent given under duress, misrepresentation, or by an incapable person may be invalid.
  • Capacity: Presumed, unless a minor or someone deemed legally incapable.
  • Minors: Capacity varies based on age, with parental/guardian consent often necessary (CCQ articles 14, 15, 16, 17, 18).
  • Assessing Incapacity: A two-tiered approach (CCQ 16) might involve court-ordered psychiatric evaluations to determine treatment appropriateness.
  • Informed Consent Criteria: Patient must have capacity, consent freely and with an understanding of the situation (including risks and benefits).
  • Emergency Exception (CCQ 13): Consent not required in emergencies threatening life or well-being when obtaining consent is impossible.

Civil Liability

  • CCQ 1457 & 1458: Provides legal recourse for patients whose rights are violated (extra-contractual and contractual claims).
  • Elements of Liability (CCQ 1457): Fault, damages, and causation. Legal actions may include potential financial compensation for harm caused.

Ethics Workshop

  • Organ Donation Ethics: Discussion of consent, definition of death, scarcity, allocation, altruism, medical tourism.
  • Canada's Legal Framework: Explicit consent legislation (opt-in donation).
  • Ethical Principles: WHO guiding principles for organ donation emphasize voluntary donation and no financial compensation.

Additional Note:

  • Important Cases: Lapointe v. Hopital Le Gardeur (1992) and Ter Neuzen v. Korn (1995) are examples of civil cases involving medical professionals and patients. Drolet v Parenteau
  • Ciarlariella v. Schater: highlights informed consent challenges and legal precedent.

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Description

Explore the intricacies of civil law in Canada, particularly regarding healthcare rights and regulations. This quiz covers key legislation, the roles of provincial bodies, and the patient's rights outlined in the AHSSS. Test your knowledge on the legal frameworks that govern health services in Canada.

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