Welcome to the Nexus of Ethics, Psychology, Morality, Philosophy and Health Care

Welcome to the nexus of ethics, psychology, morality, technology, health care, and philosophy
Showing posts with label Canada. Show all posts
Showing posts with label Canada. Show all posts

Thursday, June 24, 2021

Updated Physician-Aid-in-Dying Law Sparks Controversy in Canada

Richard Karel
Psychiatric News
Originally posted 27 May 21

Here is an excerpt:

Addressing the changes for people who may be weighing MAID for severe mental illness, the government stated the following:

“If you have a mental illness as your only medical condition, you are not eligible to seek medical assistance in dying. … This temporary exclusion allows the Government of Canada more time to consider how MAID can safely be provided to those whose only medical condition is mental illness.

“To support this work, the government will initiate an expert review to consider protocols, guidance, and safeguards for those with a mental illness seeking MAID and will make recommendations within a year (by March 17, 2022).

“After March 17, 2023, people with a mental illness as their sole underlying medical condition will have access to MAID if they are eligible and the practitioners fulfill the safeguards that are put in place for this group of people. …”

While many physicians and others have long been sympathetic to allowing medical professionals to help those with terminal illness die peacefully, the fear has been that medically assisted death could become a substitute for adequate—and more costly—medical care. Those concerns are growing with the expansion of MAID in Canada.

Wednesday, March 21, 2018

Suicidal Ideation, Plans, and Attempts Among Public Safety Personnel in Canada

R. N. Carleton and others
Canadian Psychology
First published February 8, 2018

Abstract

Substantial media attention has focused on suicide among Canadian Public Safety Personnel (PSP; e.g., correctional workers, dispatchers, firefighters, paramedics, police). The attention has raised significant concerns about the mental health impact of public safety service, as well as interest in the correlates for risk of suicide. There have only been two published studies assessing lifetime suicidal behaviors among Canadian PSP. The current study was designed to assess past-year and lifetime suicidal ideation, plans, and attempts amongst a large diverse sample of Canadian PSP. Estimates of suicidal ideation, plans, and attempts were derived from self-reported data from a nationally administered online survey. Participants included 5,148 PSP (33.4% women) grouped into six categories (i.e., Call Centre Operators/Dispatchers, Correctional Workers, Firefighters, Municipal/Provincial Police, Paramedics, Royal Canadian Mounted Police). Substantial proportions of participants reported past-year and lifetime suicidal ideation (10.1%, 27.8%), planning (4.1%, 13.3%), or attempts (0.4%, 4.6%). Women reported significantly more lifetime suicidal behaviors than men (ORs = 1.15 to 2.62). Significant differences were identified across PSP categories in reports of past-year and lifetime suicidal behaviors. The proportion of Canadian PSP reporting past-year and lifetime suicidal behaviors was substantial. The estimates for lifetime suicidal behaviors appear consistent with or higher than previously published international PSP estimates, and higher than reports from the general population. Municipal/Provincial Police reported the lowest frequency for past-year and lifetime suicidal behaviors, whereas Correctional Workers and Paramedics reported the highest. The results provide initial evidence that substantial portions of diverse Canadian PSP experience suicidal behaviors, therein warranting additional resources and research.

The research is here.

Sunday, July 2, 2017

Religious doctors who don’t want to refer patients for assisted dying have launched a hopeless court case

Derek Smith
Special to National Post 
Originally posted June 12, 2017

In a case being heard this week in an Ontario divisional court, a group of Christian doctors have launched a constitutional challenge against the College of Physicians and Surgeons of Ontario. The college requires religious doctors who refuse to offer medical assistance in dying (MAID) to give an “effective referral” so that the patient can receive the procedure from a willing doctor nearby.

The doctors say that the college has limited their religious freedom under the Charter of Rights and Freedoms unjustifiably. They argue that a referral endorses the procedure and helps kill, breaking God’s commandment. In their view, patients should have to find willing doctors themselves and “self-refer,” sparing religious objectors from sin and a guilty conscience.

The college should certainly accommodate religious objectors more than it currently does, but the lawsuit will likely fail. It deserves to fail.

Religious freedom sometimes has to yield to laws that prevent religious people from harming others. The Supreme Court of Canada has emphasized this in limiting religious freedom on a wide range of topics, including denials of blood transfusions, witnesses wearing niqabs in criminal trials, child custody disputes, accountability for unaccredited church schools and bans on Sunday shopping.

The article is here.

Wednesday, April 5, 2017

Canada passes genetic ‘anti-discrimination’ law

Xavier Symons
BioEdge
Originally published 10 March 2017

Canada’s House of Commons has passed a controversial new law that prevents corporations from demanding genetic information from potential employees or customers.

The law, known as ‘Bill S-201’, makes it illegal for companies to deny someone a job if they refuse a genetic test, and also prevents insurance companies from making new customer policies conditional on the supply of genetic information. Insurance companies will no longer be able to solicit genetic tests so as to determine customer premiums.

Critics of the bill said that insurance premiums would skyrocket, in some cases up to 30 or 50 per cent, if companies are prevented from obtaining genetic data. And Prime Minister Justin Trudeau labelled the proposed legislation “unconstitutional” as it impinges on what he believes should be a matter for individual provinces to regulate.

The article is here.

Tuesday, July 12, 2016

Canada Legalizes Physician-Assisted Dying

By Merrit Kennedy
NPR.org
Originally posted June 18, 2016

After weeks of debate, Canadian lawmakers have passed legislation to legalize physician-assisted death.

That makes Canada "one of the few nations where doctors can legally help sick people die," as Reuters reports.

The new law "limits the option to the incurably ill, requires medical approval and mandates a 15-day waiting period," as The Two-Way has reported.

The Canadian government introduced the bill in April and it passed a final Senate vote Friday. It includes strict criteria that patients must meet to obtain a doctor's help in dying.

The article is here.

Wednesday, February 17, 2016

Complaints about doctors rarely lead to formal discipline

By Holly Moore
CBC News 
Originally posted January 29, 2016

Nearly 8,000 Canadians filed a complaint about a physician last year, but on average only about 54 doctors were formally disciplined in each of the past 15 years. Of those complaints, just over half were determined to require no further action.

Historical data examined by CBC News found cases of 817 physicians that resulted in formal discipline, which is the only part of the disciplinary process for colleges of physicians and surgeons that is consistently made public across Canada.

"That number's not anywhere near what's actually happening. Those are the ones you could get to," said Ann Van Regan, a volunteer responder with TELL (Therapy Exploitation Link Line), a network of survivors of sex abuse by physicians and psychotherapists. "They say they're taking it seriously, but their actions show that they are not."

The article is here.

Wednesday, February 10, 2016

End-of-life care in U.S. not as costly as in Canada

By Jessica McDonald
newsworks.org
Originally posted January 10, 2016

The United States has a reputation for providing costly -- and often unwanted -- end-of-life care. But the first study to do an international comparison finds it's not as egregious as we thought.

Compared with patients in other developed nations, Americans diagnosed with cancer spend more time in the intensive care unit and get more chemotherapy in the last months of their lives.

But fewer patients are in the hospital when they die. And the overall bill, while high, isn't the steepest. That honor goes to Canada.

"We found that end-of-life care in the United States is not the worst in the world, and I think that surprises a lot of people," said Dr. Ezekiel Emanuel, a medical ethicist at the University of Pennsylvania.

The article is here.

Sunday, November 27, 2011

Canadian Model Standards for Telepsychology Service Delivery

Adopted June 4, 2011

Canadian Model Standards for Telepsychology

Thursday, August 11, 2011

Canadian Psychology: Ethical and Legal Considerations of record keeping

An updated account of the ethical and legal considerations of record keeping.
Bemister, Taryn B.; Dobson, Keith S.

Abstract:

The Canadian literature is void of contemporary guidelines for clinical record keeping for psychologists, as the most recent article was published more than two decades ago (Eberlein, 1990). However, the techniques used in record keeping have greatly advanced, specifically with regard to the role of computers and the use of electronic documents. Furthermore, new legislation and guidelines have been developed in response to these technological advancements. The purpose of this article is to provide a concise, accessible, and up-to-date set of guidelines on record keeping in psychology. The professional and legal requirements of psychologists are discussed with regard to the use, content, access, ownership, and retention of records with special consideration given to electronic documents. Recommendations are made for Canadian psychologists that are consistent with the current legal and professional standards of the field.

Beginning of the article:

The Canadian literature is void of contemporary guidelines for clinical record keeping.

Although books that contain information regarding record keeping have been published more recently (e.g., Evans, 2004 and Truscott & Crook, 2004), the most recent article dates back to 1990 (Eberlein, 1990).
Eberlein's article was written largely in response to the establishment of the Canadian Code of Ethics for Psychologists (Canadian Psychological Association [CPA], 1988; herein referred to as the Code of Ethics).

However, two revisions of the Code of Ethics have been published (1999 and 2001), and the techniques used in record keeping have advanced, specifically with regard to the role of computers and the use of electronic documents.

Beyond the above developments, the federal Personal Information Protection and Electronic Documents Act (PIPEDA) was introduced in 2000, and it has modified the statutes relevant to records.

Similarly, a draft of guidelines for psychologists who provide psychological services via electronic media was developed (CPA, 2006; to be finalized).

A second exerpt:

The purpose of this article is to provide a concise and accessible resource on record keeping that is up-to-date with the advances that have occurred since 1990.

This article provides a comprehensive overview of the issues related to record keeping and provides recommendations for Canadian psychologists.

More specifically, the professional and legal requirements of psychologists are discussed with regard to the use, content, access, ownership, and retention of records with special consideration given to electronic documents.

The implications of technological advances on client confidentiality and privacy are also considered.
The suggestions made in this paper are consistent with the Code of Ethics, as well as legislative and provincial laws and regulations, including the Code of Conduct (or its equivalent) of each province and territory.

The author note provides the following contact information: Taryn B. Bemister, Department of Psychology, University of Calgary, Calgary, AB T2N 1N4, Canada. E-mail: tbbemist@ucalgary.ca.

Thanks to Ken Pope for the information.