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Updated: February 2, 2022
There is no perfect solution to address resource dilemmas, but you can take steps to reduce patient harm and minimize medico-legal risk.
Do I have a duty to provide usual medical care (e.g. routine screening, elective surgeries) during the COVID-19 crisis?
Physicians will need to exercise their clinical judgement to determine whether it is reasonable to see patients in-person and whether elective and non-urgent medical services should be delayed. Physicians will want to continue to follow guidance issued from their Colleges, hospitals, ministries of health, public health officials and medical specialty organizations regarding the necessary safety precautions for providing care in person. While virtual care may be appropriate in some cases, physicians will want to be mindful of its limitations and ensure patients are provided the opportunity for in-person care where appropriate.
Physicians may face criticism for shutting down their practices entirely or relying solely on virtual care, unless there are legitimate reasons to do so (e.g. the physician is ill or must self-isolate). Where physicians must temporarily close their practices, College policies generally suggest that physicians should attempt to make alternative arrangements for care of their patients. Physicians are encouraged to coordinate with colleagues to provide coverage in care where needed.
During this pandemic, resources are scarce. How do I balance my patients’ needs with the scarcity of resources?
The few legal cases touching on these issues signal that the courts are willing to consider the resources available to physicians when assessing whether the standard of care was met. A court in Ontario, for example, has indicated that "…a doctor cannot reasonably be expected to provide care which is unavailable or impracticable due to the scarcity of resources.”
A physician is expected, within resource constraints, to do the best he or she can for patients, and to act reasonably in such circumstances. It is also critical for health sector stakeholders to engage on these issues in order to help alleviate and prepare for resource shortages. In this regard, physicians have a role to play in health advocacy and are an important voice in an environment of scarce resources. Physicians should document any steps taken to address resource issues.
Emergency directives from government and public health authorities may also be issued regarding the systematic use of resources.
Need more medico-legal information amid COVID-19?
Browse other key topics in the CMPA COVID-19 Hub: