Category: Health Law Page 7 of 9

By: Lorian Hardcastle

PDF Version: Court Dismisses Allegations that Long-Term Care Residents Subsidize Their Health Care Costs

Cases Commented On: Alberta v Elder Advocates of Alberta Society, 2011 SCC 24 (CanLII) and Elder Advocates of Alberta Society v Alberta, 2018 ABQB 37 (CanLII)

Under provincial health insurance laws and the Canada Health Act, RSC 1985, c C-6, governments fund medically necessary hospital and physician care. There is also a patchwork of public programs (with varying eligibility criteria and co-payments) to subsidize services such as dental care, pharmaceuticals, home care, and long-term care. While the Alberta government pays for health services provided in long-term care facilities, residents pay accommodation charges. These charges, which cover such costs as housing, housekeeping, and meals, are borne by residents on the theory that they would incur such expenses if they were living in their homes in the community. The current accommodation charge ranges from $53.80 per day for a shared room to $65.50 per day for a private room.

Is Alberta Doing Enough to Protect Patients from Abuse by Health Professionals?

By Lorian Hardcastle

On October 25, 2017

In Health Law

By: Lorian Hardcastle

PDF Version: Is Alberta Doing Enough to Protect Patients from Abuse by Health Professionals?

Headlines such as “Grande Prairie doctor suspended, charged over inappropriate examinations”, “Disgraced Calgary psychiatrist Aubrey Levin facing new abuse allegations” and “Southern Alberta doctor accused of sex assault on disabled patient” are not isolated incidents. Despite limited data, one news report found that at least 250 Canadian doctors were disciplined by self-regulatory bodies for boundary offences between 2001 and 2016. The term “boundary offences” encompasses a wide range of conduct including sexual comments, inappropriate touching (often under the guise of a physical exam), taking photographs or videos without a patient’s knowledge, or sexual intercourse with a patient (without or with consent—if a patient can truly provide valid consent in this context). Although evidence on the prevalence of sexual misconduct by health professionals is limited, in a study of 10,000 US doctors, 9% reported sexual contact with patients. Ten of the 21 disciplinary decisions currently listed on the website of the Alberta College of Physicians and Surgeons relate to boundary offences. The harm resulting from sexual abuse by health professionals is substantial. Patients are often in a vulnerable position and, when a health professional exploits his or her position of trust and power, victims report feeling shame, confusion, anxiety, and depression. These cases not only damage the relationship between the victim and the perpetrator, but harm public trust in health professionals and self-regulation. In what follows, I recommend several reforms to better protect patients from abuse.

JH v Alberta Health Services: The Constitutional Implications of Indefinite Psychiatric Detention

By Kaye Booth

On October 2, 2017

In Constitutional, Health Law

By: Kaye Booth and Heather Forester

PDF Version: JH v Alberta Health Services: The Constitutional Implications of Indefinite Psychiatric Detention

Case Commented On: JH v Alberta Health Services, 2017 ABQB 477 (CanLII)

In 2015, JH appealed a decision by a Review Panel, appointed to determine the need for his continued detention under the Mental Health Act, RSA 2000, c M-13 (Alberta MHA), that he should be held indefinitely in the care of the Foothills Hospital (JH v Alberta Health Services, 2015 ABQB 316 (CanLII)). JH had come to the Foothills with a fever and an infected knee injury the year prior, and was then kept there against his will, based on the Review Panel’s determination. The Review Panel’s conclusion that JH should continue to be detained was based on its view that JH lacked insight into his medical needs and exhibited poor judgment, both of which might put him at risk of harm. The outcome of the case and whether JH would continue to be held in detention was contingent on whether JH fit the criteria for detention set out in section 8(1) of the Alberta MHA, namely that he: (a) suffered from a mental disorder; (b) was likely to cause harm to himself or others, or to suffer substantial physical or mental deterioration if not kept in detention; and (c) was unable to continue at the facility other than as a formal patient. JH’s consulting psychiatrist testified that it was his opinion that JH fit these criteria, as he suffered from a neurocognitive disorder which manifested itself as poor judgment and memory, and that without mental health support in the form of psychiatric detention, JH would deteriorate both mentally and physically. However, an assessment completed by another doctor concluded that JH only had mild memory impairment, and that he understood his health problems enough to maintain health treatment on his own. Justice Eidsvik of the Alberta Court of Queen’s Bench considered JH’s steady employment history prior to the car accident that had left him with cognitive issues, his ability to obtain help both financially and medically on his own, and his commitment to continue on his medication. Based on this evidence, the Court concluded that Alberta Health Services (AHS) failed to prove that JH should continue to be detained, and that any risks to him were not severe enough to justify constraints on his liberty and self-determination.

Is Alberta’s Mental Health Act Sufficiently Protecting Patients?

By Lorian Hardcastle

On September 18, 2017

In Constitutional, Health Law

By: Lorian Hardcastle

PDF Version: Is Alberta’s Mental Health Act Sufficiently Protecting Patients?

Case Commented On: JH v Alberta Health Services, 2017 ABQB 477 (CanLII)

At first blush, JH v Alberta Health Services does not seem to warrant much attention. It is an oral judgement relating to a procedural matter—whether a plaintiff can proceed with a moot claim. However, this case highlights several important issues in mental health law and its resolution could result in significant reforms to Alberta’s Mental Health Act, RSA 2000, c-13. The plaintiff, who was involuntarily detained and treated at Foothills Hospital for nine months, disputed his detention and challenged the constitutionality of several provisions of the Mental Health Act. He was diagnosed with a neuro-cognitive disorder and had also struggled with alcoholism and the physical injuries resulting from a car accident.

Squabble Over Alberta Dental Fees Highlights Broader Need to Rethink What is Publicly Insured

By Lorian Hardcastle

On September 5, 2017

In Health Law

By: Lorian Hardcastle

PDF Version: Squabble Over Alberta Dental Fees Highlights Broader Need to Rethink What is Publicly Insured

A 2016 government report revealed that dental procedures cost up to 44% more in Alberta than in neighbouring provinces. In addition, 62% of Albertans reported limiting dental visits due to cost concerns. The resulting fallout from this 2016 report led the Alberta Dental Association and College (ADAC) to respond with a new fee guide on August 17, 2017. When the ADAC stopped publishing its fee guide in 1997, Alberta became the only province without such a guide, which may have contributed to the current high cost of dental care. Although dentists are not bound by the fees listed in these guides, they can encourage price competition, improve transparency, and better inform patients. Alberta’s Minister of Health was “not satisfied” with the new guide, which proposed a 3% across-the-board reduction in dental fees. She stated that Albertans “deserve better” and has sent the ADAC back to the table to rethink the new fee guide.