NUR1 424 Law 2: Confinement & Privacy

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Questions and Answers

What should be evaluated to determine if a person understands the proposed treatment options?

Their previous experiences with medical treatment

Their understanding of the benefits and risks involved (correct)

Their emotional state and current mood

Their financial situation and insurance coverage

Which of the following is a dangerous misconception about consent capacity?

Legal incapacity and capacity to consent are interchangeable terms (correct)

A person can be incapable of consenting to one treatment but capable for another

Cognitive impairment affects the ability to communicate

All individuals with vulnerabilities lack the ability to consent

What is a primary condition that justifies confinement in an institution?

The person prefers to be in a controlled environment

The person's decision-making abilities are questioned

The person poses a serious and immediate danger to themselves or others (correct)

The person has a history of non-compliance with treatment

Which type of confinement requires consent from the patient?

Voluntary confinement Signup and view all the answers

What document is typically required for preventive and provisional confinement?

A written Motion for Authorized confinement Signup and view all the answers

Which legal principles govern confinement in an institution?

Civil Code of Québec and Code of Civil Procedure Signup and view all the answers

What is a requirement for authorized confinement facilities?

They must be equipped with necessary facilities Signup and view all the answers

What is NOT a common consequence of not assessing capacity in individuals with cognitive impairments?

Accurate identification of risks of treatment Signup and view all the answers

What is the maximum duration for a motion for authorized confinement?

30 days Signup and view all the answers

Who must be served with the Motion for Confinement aside from the patient?

The Public Curator Signup and view all the answers

Under what condition can confinement in an institution be authorized by the court?

If both psychiatric reports recommend confinement Signup and view all the answers

What criteria must a psychiatric examination report address according to Art 29 CCQ?

The necessity of confinement if the person is a danger to self or others Signup and view all the answers

What discretion do judges have regarding the duration of confinement?

Judges can specify a shorter duration if 30 days is not necessary Signup and view all the answers

Who is referred to as the 'Mise-en-cause' in the context of Motion for Confinement?

A reasonable family member or close friend Signup and view all the answers

What is a significant factor the court considers before authorizing confinement?

Serious reasons to believe the person is dangerous Signup and view all the answers

What happens if reasonable members of the patient's family do not exist for the service of the Motion?

The Public Curator is served Signup and view all the answers

What is required once the 72-hour period expires if a physician determines that danger still exists?

A court order for provisional confinement Signup and view all the answers

Under what condition can a peace officer take a person to an institution without court authorization?

Upon request from a member of a crisis intervention unit Signup and view all the answers

What must the institution do upon the arrival of the person taken by a peace officer?

Examine the individual by a physician Signup and view all the answers

What provision allows for preventive confinement according to Section 8?

A physician's determination of danger Signup and view all the answers

Who can request the intervention of a peace officer for a minor?

The person having parental authority or the tutor Signup and view all the answers

What is the primary purpose of obtaining a court order for provisional confinement?

To extend the time for a psychiatric assessment Signup and view all the answers

Which of the following best describes the term 'preventive confinement'?

Temporary confinement while assessing immediate danger Signup and view all the answers

What is required from the peace officer before taking an individual without court authorization?

Good reason to believe the individual presents danger Signup and view all the answers

How often must a person under confinement be examined if the duration exceeds 21 days?

Every three months Signup and view all the answers

What is required before a person can be confined for a duration exceeding 21 days?

The court must set the duration of confinement Signup and view all the answers

Which of the following rights is guaranteed to a person under confinement?

The right to counsel at all stages Signup and view all the answers

When can the testimony of a person under confinement be exempted?

If the person is not located or has fled Signup and view all the answers

What must health establishments provide to a confined person?

Information about their care program and any changes Signup and view all the answers

Consent to care during confinement must be sought from which authority?

The Superior Court Signup and view all the answers

What is the protocol regarding the use of restraints in confinement?

They can only be used if ordered or in an emergency Signup and view all the answers

If a person under confinement is under 14 years of age, who gets informed about their care?

A guardian authorized to give consent Signup and view all the answers

What is the main conflict arising in the health care system described in the content?

Demand for healthcare services and limited budgets Signup and view all the answers

According to the content, what right do patients have in terms of communication?

Receive services in English Signup and view all the answers

What does Article 5 emphasize in the rights of patients?

The continuity and safety of services Signup and view all the answers

Which of the following is NOT a right listed in the content for patients?

Receive treatment without consent Signup and view all the answers

What role does LSSSS play in the healthcare system described?

To mediate conflicts between rights and realities Signup and view all the answers

Which article allows patients to choose a medical professional?

Article 6 Signup and view all the answers

What common issue is highlighted in the cases referenced (e.g., Jasmin c Cité de la santé de Laval)?

Conflicts between patient rights and resource limits Signup and view all the answers

In what manner should health services be provided according to Article 6?

In a scientifically and humanly safe manner Signup and view all the answers

Under what circumstance can a medical professional deny a patient's access to their medical records?

If there is significant likelihood of adverse effects on the patient's health Signup and view all the answers

Which statement reflects the conditions under which access to medical records may be temporarily denied?

Access may be denied based on the recommendation of a physician if it is deemed prejudicial to health Signup and view all the answers

In McInerney v. MacDonald, what did the Supreme Court establish regarding a doctor's discretion to deny record access?

The onus lies on the doctor to justify exceptions to general access rules Signup and view all the answers

What is a requirement for medical professionals when denying access to patient records?

They must have a continuing need for access to provide proper treatment Signup and view all the answers

At what age does an individual generally gain the right of access to their medical records without any special conditions?

14 years Signup and view all the answers

Why might an institution temporarily deny access to a patient's medical records?

If the access is believed to cause prejudice to the patient's health Signup and view all the answers

What does the principle of 'right of access not absolute' imply in a medical context?

Medical professionals can deny access under specific circumstances Signup and view all the answers

What role does the attending physician play in the context of a patient requesting access to their medical records?

The physician may recommend denying access based on health concerns Signup and view all the answers

Study Notes

Law 2 - Confinement, Privacy & Confidentiality, and Resources

Course: NUR1 424, Fall 2024
Lecturer: Daria Kapnik

Plan

Authorization for Treatment:
- Recap of Court Orders under CCQ
- Treatment order
Confinement Law:
- General Principles
- Parameters
- Types of Confinement
  - Preventative Confinement
  - Provisional Confinement
  - Authorized Confinement (Institutional)
    - Motion for Authorized Confinement (process, duration, PSY content, court order criteria, renewal, end of confinement, longer confinement)
- Rights of the person under confinement
- Potential issues in confinement
Privacy, Confidentiality, and Resources:
- Patient access to and medical records
  - General
  - Deceased patients
  - Confidentiality and care issues regarding minors
- Management of Limited Resources and Patient Rights
  - Key provisions
  - Caselaw

Outline

Authorization for Treatment
- Recap of Court Orders under CCQ
- Treatment order
Confinement in an Institution
- General Principles
- Parameters
- Types of Confinement
  - Preventative Confinement
  - Provisional Confinement
  - Authorized Confinement (Institutional)
    - Motion for Authorized Confinement - Process
    - Motion for Authorized Confinement - Duration
    - Motion for Authorized Confinement - PSY content
    - Motion for Authorized Confinement - Court order criteria
    - Motion for Authorized Confinement - Renewal
    - Motion for Authorized Confinement - End of Confinement
    - Motion for Authorized Confinement - Longer Confinement
- Rights of the person under confinement
- Potential issues in confinement
Caselaw
- Charles Le Moyne c. E.(F.)
- CSSS Côte-de-Gaspé c.P(C)-EYB 2013-227952
- J.M. c. Hôpital Jean-Talon du (CIUSSS) du Nord-de-l'Île-de-Montréal, 2018
Privacy - Patient access and medical records
- General
- Deceased patients
Management of Limited Resources and Patient Rights
- Key Provisions
- Caselaw
  - Jasmin c Cité de la santé de Laval (AZ-90021046)
  - Noël-Voizard c. CSSS Lasalle et du Vieux-Lachine (2007)
  - J.O. vs. Hôpital Royal Victoria (2011)

Recap of Court Orders under CCQ (page 5)

Article 16 CCQ: Person of full age incapable of giving consent, categorically refuses care, or no representative can be found for delegated consent.
Article 16 CCQ: Minor over 14 refuses care (not in cases of emergency & life/integrity threat)
Article 17/18 CCQ: Care entails serious risk for minor's health and potentially grave, permanent effects (even if over 14)
Treatment order (page 7)
- The party seeking authorization (usually the health establishment) has the burden of proof
- Must prove, on the balance of probabilities: (1) person lacks capacity to consent; (2) person is categorically refusing treatment; (3) proposed treatment is in patient's best interest
- How? Motion + expert reports
Nova Scotia criteria (page 8)
- Understanding the nature of the illness
- Understanding the proposed treatment and other options
- Understanding the benefits and risks of treatment
- Understanding risks and consequences of not undergoing treatment
- Patient's ability to understand affected by illness

Confinement in an Institution (page 10-11)

General Principles: Confinement is exceptional, violating integrity and inviolability; person must be a serious and immediate danger to themselves or others
Types of Confinement:
- Voluntary (patient consents)
- Forced (preventive, provisional, authorized)
Location: Institution operating a local community service centre, or hospital
No one: may be confined in a health or social services institution without consent
Danger: must be specific and detailed, not just a general statement, present and imminent danger
Preventive: A physician can authorize without a court order if danger is grave and immediate

Specific Confinement Processes (various pages)

Process and Procedures: Detailed motions for authorized confinement, with specific timeframes (e.g., 24-48-72-96-hours) and requirements for physicians performing examinations and documentation.
Renewal: Procedures and legal basis for renewing confinement for up to 90 days after an initial 30-day period
End of Confinement: How confinement ends, including court, tribunal, and physician actions
Longer Confinement: Periodic re-evaluations with specific timelines
Rights of a person in confinement: the use of restraint
AWOL: communicating with DPS, returning to hospital

Privacy/ Confidentiality/ Care Issues Regarding Minors

Parental access: Parental authority has access to a minor’s health information
Access by other bodies: Other bodies have access to minor's health information (determined by the statutory duties of disclosure)
Exceptions to access in regard to minors:
Duty to report: Professionals are required if a minor’s security or development is at risk. Examples of specific actions needing reporting
Consent: Minors under 14 years of age require consent from parental authority or tutor
Minors over 14 years of age: capable of giving their own consent

Management of Limited Resources/Patient Rights

Limited budgets in health sector and aging population create challenges
Specific Acts: Rights and obligations in Act Respecting Health Services and Social Services, details of the act
Caselaw: Legal conflicts, regulations and limitations of access to services
Case Example Issues: Discriminatory regulations, inadequate access, procedural errors, and the right to seek judicial review. Patient rights and access to services.

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Description

Test your knowledge on key concepts related to confinement, privacy, and confidentiality in healthcare law. This quiz covers important topics such as authorization for treatment, types of confinement, and rights of individuals under confinement. Prepare for discussions on managing resources and patient access to medical records.