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Full-Text Articles in Health Law and Policy
Foreseeably Unclear: The Meaning Of The "Reasonably Foreseeable" Criterion For Access To Medical Assistance In Dying In Canada, Jocelyn Downie, Kate Scallion
Foreseeably Unclear: The Meaning Of The "Reasonably Foreseeable" Criterion For Access To Medical Assistance In Dying In Canada, Jocelyn Downie, Kate Scallion
Dalhousie Law Journal
Canada's medical assistance in dying legislation contains the eligibility criterion "naturaldeath has become reasonably foreseeable." The phrase "reasonably foreseeable" is unfamiliar and unclear. As a result of ongoing confusion about its meaning, there is reason to be concerned that under- or over-inclusive interpretations of the phrase are adversely affecting access to MAID. With critical interests at stake (eg access to MAiD and potential criminal liability), it is essential that the meaning of the phrase be clarified. Furthermore, the meaning of "reasonably foreseeable" will be at issue in the Charter challenges to the federal MAiD legislation currently before the courts in …
Euthanasia By Organ Donation, Michael Shapiro
Euthanasia By Organ Donation, Michael Shapiro
Dalhousie Law Journal
Euthanasia, the administration of therapy designed to hasten death, particularly in patients with intolerable suffering, has been gaining in acceptance in countries around the world, most recently in Canada. Organ donation from deceased organ donors has always been performed under the strictures of the dead donor rule, the requirement that donors be declared dead prior to any organ recovery. Recent scientific and ethical investigations, however, have questioned whether all donors, whether pronounced based on neurologic (brain death) or circulatory criteria are, in fact, dead. One potential approach to this quandary would be to abandon the fiction imposed by the dead …
Informing The Future Of End-Of-Life Care In Canada: Lessons From The Quebec Legislative Experience, Michelle Giroux
Informing The Future Of End-Of-Life Care In Canada: Lessons From The Quebec Legislative Experience, Michelle Giroux
Dalhousie Law Journal
There have been numerous and challenging developments respecting endof-life care in Canada. In Quebec, political consensus and changes in public opinion led to the adoption of end-of-life care legislation. This paper discusses the context and foundation of that reform and reviews its content with the objective of informing the future of end-of-life care in Canada. In the first part of the paper I explore the balancing of the right to life and autonomy, with a focus on the approach chosen in Quebec by the Legal Experts Panel Report. In Part 11, I discuss Quebec's adoption of An Act Respecting End-of-Life …
Cross-Cultural Dynamics In Palliative Care: The Emerging Canadian Scenario, Chidi Oguamanam
Cross-Cultural Dynamics In Palliative Care: The Emerging Canadian Scenario, Chidi Oguamanam
Dalhousie Law Journal
As modern technologies leverage medical sciences, life expectancy is on the rise in Canada, and indeed globally with a remarkable increase in the elderly population in need of health care. The same is true of the diversity of cultural groups who are now patrons and stakeholders in Canada's health care landscape. An emergent feature ofthis landscape is the complexity ofcontexts for negotiating and mediating medical care delivery at the end of life. This paper examines the gaps in regulatory and legal interventions as well as the gaps and opportunities to negotiate the transition to palliative care in cross-cultural contexts that …
The Future Of Health Law: How Can Law Meet Emerging Health Challenges?, Colleen M. Flood, Lorian Hardcastle
The Future Of Health Law: How Can Law Meet Emerging Health Challenges?, Colleen M. Flood, Lorian Hardcastle
Dalhousie Law Journal
Canadians have often prided themselves on having one of the best health-care systems in the world, but in recent years our system has fallen to the bottom of relevant international comparisons. Incremental attempts to improve the system have not resulted in significant improvements and the reality is that our most pressing challenges can be addressed only through ambitious, systemic reforms. For example, it is well established that Canada's patchwork scheme for providing long-term care will not scale to meet growing needs as a quarter ofthe population enters retirement age over the next two decades.' As yet further examples, the Canadian …
Modernizing The Canada Health Act, Colleen M. Flood, Bryan Thomas
Modernizing The Canada Health Act, Colleen M. Flood, Bryan Thomas
Dalhousie Law Journal
The Canada Health Act (CHA) was adopted in 1984, to shore up a health-care system conceptualized in the 1960s. Under the CHA, universal coverage is limited to "medicallynecessary" hospital and physician services, to the exclusion of vital goods and services such as outpatient pharmaceuticals, dental care, long-term care, and many mental health services. Inequities resulting from these gaps in public coverage are partly to blame for pushing Canada's health system to the bottom ofrecent international rankings. But there is more to modernizing Canada s health care system, we argue, than filling these gaps in universal coverage. Every major health system …
A Goal-Oriented Understanding Of The Right To Health Care And Its Implications For Future Health Rights Litigation, Michael Da Silva
A Goal-Oriented Understanding Of The Right To Health Care And Its Implications For Future Health Rights Litigation, Michael Da Silva
Dalhousie Law Journal
International human rights law recognizes a right to health. A majority of domestic constitutions recognize health-related rights. Many citizens believe that they have a moral right to health care. Some theorists agree. Yet the idea of a right to health care remains controversial. Specifying the nature of such a right invites more controversy. Indeed, most models of the right face persistent problems that threaten to undermine the conceptual coherence of a right to health care. This article accordingly sketches preliminary arguments for a new, goal-oriented model of the right to health care. It explains that the model avoids most of …
And Miles To Go Before I Sleep: The Future Of End-Of-Life Law And Policy In Canada, Jocelyn Downie
And Miles To Go Before I Sleep: The Future Of End-Of-Life Law And Policy In Canada, Jocelyn Downie
Dalhousie Law Journal
This paper reviews the legal status of a number ofend-of-life law and policy issues that have, to date, been overshadowed by debates about medical assistance in dying. It suggests that law reform is needed in relation to palliative sedation without artificial hydration and nutrition, advance directives for the withholding and withdrawal of oral hydration and nutrition, unilateral withholding and withdrawal of potentially life-sustaining treatment, and the determination of death. To leave the law in its current uncertain state is to leavepatients vulnerable to having no access to interventions that they want or at the other extreme, being forced to receive …
How I Learned To Stop Worrying And Love The Gats: An Examination Of The Impact Of The General Agreement On Trade In Services On The Canadian Health-Care System, Brian N. Zeiler-Kligman
How I Learned To Stop Worrying And Love The Gats: An Examination Of The Impact Of The General Agreement On Trade In Services On The Canadian Health-Care System, Brian N. Zeiler-Kligman
Dalhousie Law Journal
There is perhaps no more cherished Canadian institution than our universal health-care system, Medicare. Despite Canadians' fondness for Medicare, there are often allegations that various external elements threaten Medicare's viability. One of these oft-cited elements is the General Agreement on Trade in Services (GATS), which some have claimed will force the privatization of all public services. The truth in such claims is tested by examining the effect the GATS is likely to have on the Canadian health-care system. The examination includes an interpretation of GATS Article 1.3 through a textual analysis. GATS' impact on this system is explored on three …
Balancing Regional Government Health Mandateswith Federal Economic Imperatives: Perspectives Fromnova Scotia And Illinois, John Blum
Dalhousie Law Journal
This article focuses on current health policy changes in Canada and the United States at the federal and regionallevels. The Canadian discussion centres on the integrity of the Canada Health Act in the era of the Canada Health and Social Transfer, and the strategies that provincial governments have pursued to cope with persistent funding constraints. On the American side, the article examines the role of private sector managed care plans in filling a health policy void resulting from the demise of the Clinton Health Security Act. Two specific regional government health reform initiatives in Nova Scotia and Illinois are discussed …
Managed Competition Reform In The Netherlandsand Its Lessons For Canada, Frederik T. Schut, Herbert Egm Hermans
Managed Competition Reform In The Netherlandsand Its Lessons For Canada, Frederik T. Schut, Herbert Egm Hermans
Dalhousie Law Journal
This article provides an economic and legal perspective on the managed competition reforms within the Netherlands. After an examination of the rationale and the main features of the reforms, a number of problems and dilemmas that were encountered during the implementation process will be highlighted. The authors conclude that although the logic of the managed competition model is appealing, its implementation is quite complicated and requires a strong government with a continued commitment to set and enforce the rules of competition. If these preconditions are not met, the prospects of a successful introduction of managed competition are bleak. Despite its …
Lessons From Away:An Interdisciplinary Collectionof Studies Exploring Whatcanada May Learn From Othercountries' Experiences Withhealth Care Reforms, Colleen M. Flood
Lessons From Away:An Interdisciplinary Collectionof Studies Exploring Whatcanada May Learn From Othercountries' Experiences Withhealth Care Reforms, Colleen M. Flood
Dalhousie Law Journal
The Canadian health care system is considered a shining example of what it is to be Canadian: to aspire to social justice goals and to achieve those goals at a reasonable cost.' Canadians take great pride in that, by any measure, their health care system is superior to the piece-meal, expensive, and unjust U.S. health care system.
Common Problems, Different "Solutions": Learningfrom International Approaches To Improving Medicalservices Access For Underserved Populations, Morris Barer, Laura Wood
Common Problems, Different "Solutions": Learningfrom International Approaches To Improving Medicalservices Access For Underserved Populations, Morris Barer, Laura Wood
Dalhousie Law Journal
Canada shares with most OECD countries the problems associated with inequitable geographic access to physician services, and improving the geographic distribution of physicians is a policy preoccupation of all ministries of health in Canada today. Recent court challenges by newly-entering physicians to physician supply controls in B. C. and New Brunswick have brought the issue into sharp relief. The authors explore the degree to which the provinces have adopted common approaches to addressing these problems, and whether Canadian policy-makers have learned from international experience. The recent judgment in the Waldman case in B.C. is analyzed in terms of likely implications …
Abortion Law In Canada: A Matter Of National Concern, Moira Mcconnell, Lorenne Clark
Abortion Law In Canada: A Matter Of National Concern, Moira Mcconnell, Lorenne Clark
Dalhousie Law Journal
Canada's newest abortion legislation, embodied in Bill C-43, was defeated in the Senate on January 31st, 1991. The Bill sought to remedy the state of "lawlessness" which has existed respecting abortion ever since the decision reached by the Supreme Court of Canada in R. v. Morgentaler in January, 1988. However, this determination is incorrect. The law is quite clear: there is no criminal prohibition against abortion in Canada. This follows directly from the Court's holding in the Morgentaler decision that the old law, s. 287 (formerly s.251) of the Criminal Code, infringed a woman's right to security and liberty of …