Legal and regulatory proceedings

A look at how the legalization of recreational marijuana may affect physicians’ practices, including whether it will eliminate patients’ requests for medical marijuana.

Physicians should participate in quality assurance activities such as debriefs and should reduce their medical-legal risks by ensuring the debriefs are properly structured.

A review of CMPA member enquiries following the legalization of cannabis for recreational use reveals that the new regulatory regime has generally not had a significant medical-legal impact for our members.

Certain provinces have legislation to prevent apologies for adverse events from being used in court proceedings.

End-of-life treatment decisions can be difficult for both physicians and patients, but many issues can be avoided by following the key concepts outlined.

Physicians who treat or who are asked to treat transgender individuals should be aware of the ethical and legal considerations in these circumstances to avoid allegations of discrimination.

Clarity about who is responsible for the care of a patient at any given time improves patient safety and reduces medico-legal risk.

Physicians should understand the role of coroners and medical examiners in Canada, and how and when to provide information to them.

Explanation of physicians’ mandatory and discretionary obligations to report patients who have a medical condition that may make it dangerous for them to drive.

Physicians who respond affirmatively to a request for a medical-legal report should prepare the report with care and in keeping with their College’s policies and guidelines.

Polices introduced by the medical regulatory authorities (Colleges) reflect concerns expressed by some in the medical community about the use of marijuana for medical purposes and the challenging role given to physicians and other healthcare providers.

A discussion of physicians’ obligations when certifying a patient’s death.

Physicians should consider encouraging patients to engage in advance care planning and appointing a substitute decision-maker early, before the patient no longer has the capacity to consent to end-of-life care.

When physicians offer a clinical comment or opinion that will be relied on to care for a patient, they may owe that patient a duty of care—even if they have never met the patient in person.

CMPA gives advice to physicians travelling across international borders and having border agents search mobile electronic devices, such as smartphones, that may contain confidential patient information.

The legal right to be treated fairly, known as natural justice, can have a huge impact in administrative proceedings against physicians (e.g. College or hospital proceedings).

A look at what’s involved when testifying as a treating physician, independent medical evaluator, or expert before a court, College, or administrative tribunal, and suggestions to do it confidently and effectively.

Dealing with the stress of a College complaint is easier when a physician understands the complaint process and receives support, advice, and coping strategies from the CMPA.

Greater clarity in patient care can be achieved through healthcare directives, and when physicians understand their purpose and the rules governing them.

Physicians who do administrative work require liability protection for the professional medical tasks they perform and also for the non-clinical administrative tasks they perform in support of an organization.

Typically, civil legal actions launched against physicians are initiated by a patient alleging negligence in care, but there are variations to this scenario that can result in more complex litigation involving multiple parties and claims.

Physicians can take reasonable steps to maintain the best interests of the patient in the midst of family disputes concerning the care of children or of elder patients.

The Supreme Court of Canada’s decision declaring the prohibition on physician-assisted dying unconstitutional concerns some CMPA members who object for moral or religious reasons to helping patients end their lives.

The practice of marking transcribed reports or entries “dictated but not read” gives rise to medical-legal risks and can create uncertainty for those relying on that information in providing patient care.

Medical regulatory authorities are making more information about physicians available to the public. This article provides an overview of this trend, and explains how the CMPA helps members.

Physicians providing emergency care as good Samaritans often have questions about their legal and ethical obligations and the liability protection available to them.

Changes to the Criminal Code have raised the age of consent for sexual activity. Physicians should be guided by legislation in each province and territory on their duty to report such activity to the appropriate authorities if there are reasonable grounds to believe the child is being abused.

Physicians participating in clinical research studies should be aware of their relevant legal, ethical, and professional obligations.

Physicians named in a hospital complaint can feel reassured that due process exists and will be followed, and that the CMPA is available to help.

Effective communication and awareness of legal requirements are key to obtaining consent for treatment of children.

While a Supreme Court of Canada decision clarifies that in Ontario, physicians must obtain consent before life support can be withheld or withdrawn, the effect of the decision in other jurisdictions is uncertain.

When working with nurse practitioners, physicians should understand the scope, responsibilities, and accountabilities of these independent healthcare providers, and should communicate clearly and in a timely manner.

Privacy legislation, regulatory policies and professional obligation require that CMPA members take reasonable measures to protect the privacy of their patients' personal health information. With the advent of electronic records, members should be cognizant that encryption can help secure personal health information and may be required by law.

Clarity about who is responsible for the care of a patient at any given time improves patient safety and reduces medico-legal risk.

Physicians considering various arrangements for practising medicine, other than the privileges-based model, need to consider any medico-legal implications.

A complaint to a medical regulatory authority (College) initiates a process that warrants a physician's attention and timely response.

Changes in the relationship between physicians and hospitals may have medico-legal implications that could lead to difficulties for physicians, institutions, and patients. Recommendations to address these implications are identified.

In legal proceedings where courts are determining if the care provided met the standard of care, authoritative clinical practice guidelines may be considered as one piece of evidence.

When treating non-resident patients, Canadian physicians are advised to ensure they have adequate liability protection.

Responding to patient requests for exemptions to wearing a seatbelt while driving.

A subpoena or summons to witness requires the person named to attend the court, tribunal, commission, inquiry, inquest or military board proceeding or hearing named in the subpoena.

Physicians should exercise care in modifying or correcting medical records. Suggestions on when and how to go about this are provided.

Considerations in responding to patients' requests for support in acquiring firearms.

Class actions are becoming more common in Canada.

Physicians may be asked to attest to the capacity of a patient if the patient's will is contested or at the time the will is being prepared.

Clinical care is increasingly provided by collaborative teams with the promise of better outcomes for patients. This document identifies potential medico-legal risks in collaborative care and proposes solutions to lessen those risks for patients and providers.

Certain practice management issues arise when a physician dies, and should be considered as part of estate planning.