A Shot in the Dark: The Legality of Mandatory Immunization

Contributed by Ian Bernstein

Introduction

Following the recent approvals of COVID-19 vaccines, it is reasonable to wonder whether or not it will eventually be mandatory for people to receive a vaccine. Once the vaccines become more widely available, they can be used as a means to attenuate the severity of the global pandemic and return to a greater sense of normalcy in society. The following article will address if and how governments in Canada and the United States can legally impose mandatory vaccination programs, as well as how likely they would be to implement such measures. In addition, whether or not mandatory vaccination for specific sectors of the population can be imposed will be discussed, along with alternative methods that are being derived to incentivize populations to receive a COVID-19 vaccine.


Many may be wondering whether mandatory immunization against COVID-19 will be implemented now that vaccines for the virus have been approved and rolled out. || (Source: Pixabay // Arek Socha)

Governments and Public Health

To date, no government in Canada has implemented compulsory immunization against COVID-19, and it is unlikely that they will do so. However, these governments do have jurisdiction to enforce mandatory vaccines through their power to regulate matters of public health in each particular province. For instance, in Quebec, upon the declaration of a public health emergency, which has been done amidst the COVID-19 pandemic, the Public Health Act grants the provincial government and the Minister of Health a high degree of power as a means to respond to the emergency. Such powers include the ability to “order compulsory vaccination of the entire population or any part of it against…any…contagious disease seriously threatening the health of the population.”

Moreover, the Alberta Public Health Act grants the Lieutenant Governor in Council the powers to order immunization against a disease in the presence of an epidemic or public health emergency. However, Jason Kenney, the current Premier of Alberta, wants to change this by amending the statute. If he is successful, this would constitute a striking difference between Alberta’s Public Health Act and that of Quebec. A future government would have the ability to reinstate this section of Alberta’s Public Health Act if they are in favour of mandatory immunization, but this would require the development and passing of legislation.


While governments in Canada have not signalled plans to mandate immunization against COVID-19, their power to regulate public health enables them to do so. || (Source: creativecommons // Mightydrake)

In the United States, individual states are granted similar powers as the Canadian provinces, as they have the authority to regulate public health, and have previously mandated vaccines in extraordinary circumstances similar to those we are currently facing. Indeed, the constitutionality of state-mandated vaccines as a means to protect public health and safety was upheld by the Supreme Court in Jacobson v. Massachusetts, in which case a mandatory vaccination program against smallpox was at issue. In fact, even cities can be granted such powers, which was done in Williamsburg, Brooklyn in 2019 amidst a measles outbreak. Thus, in the context of COVID-19, the question is not whether mandatory vaccination is legal, but rather, whether it will be enforced.

Mandatory Vaccination for Specific Groups

Although the majority of Canadian provinces do not intend on imposing mandatory vaccination against COVID-19, statutory legislation geared towards particular sectors of the population can leave certain individuals with essentially no choice but to get a vaccine. For instance, Ontario’s “Occupational Health and Safety Act stipulates that employers have an obligation to get rid of known hazards in the workplace and protect employees from work-related illness or injury,” and the British Columbia Workers Compensation Act requires employers in the province to maintain a safe workspace for its employees. As such, employers have a duty to “take precautions to limit the spread of infectious diseases in the workplace,” thus granting them the authority to mandate immunizations for their employees. In the United States, “the U.S. Occupational Safety and Health Administration has stated that employers can legally impose a flu vaccine requirement on their workforce,” and employees can be terminated for refusing to get immunized.


Certain sectors of the population, such as employees, may be subject to mandatory immunization against COVID-19 even without a government-imposed mandate. || (Source: creativecommons // CulturaGovBr)

Furthermore, Ontario and New Brunswick require schoolchildren to be vaccinated against certain diseases such as “diphtheria, tetanus, polio, measles, mumps and rubella, while Manitoba requires a measles vaccination.” Whether COVID-19 will be added to this list remains unknown, as the vaccine has not yet been approved for children under 16 years of age. It appears, however, that subsets of the population such as employees and schoolchildren are generally more susceptible to being subject to mandatory vaccination.

These mandates raise legitimate legal and constitutional concerns, as they must accord with human rights laws and constitutionally protected freedoms. Indeed, an employer terminating an employee who cites a valid reason for refusing to get a COVID-19 vaccine can amount to a human rights violation. For example, this may constitute discrimination based on a prohibited ground under the British Columbia Human Rights Code. Vaccine mandates in the workplace must also not be discriminatory towards employees who do not receive the vaccine for religious or medical reasons. Similarly, Ontario’s Immunization of School Pupils Act enables schoolchildren to be exempted from mandatory vaccines for religious or medical reasons. In the United States, employees have the right to request accommodations as well as medical or religious exemptions from mandatory vaccines under federal anti-discrimination laws, such as the Americans with Disabilities Act of 1990 and the Civil Rights Act of 1964, and employees who are part of a union may be entitled to exemptions as well.

Incentivizing Mandatory Vaccination

Even if mandatory immunization against COVID-19 is not enforced by governments, members of the general public who choose not to receive a vaccine may nonetheless find themselves rendered unable to partake in daily life. For instance, Quebec’s Director of Public Health can order people not to visit certain places where there is an outbreak if they have not been vaccinated, including educational institutions, workplaces, and other gathering places. Airlines, restaurants, stores and stadiums can make immunization a condition of doing business with customers, and it is possible that the use of such conditions will be widespread as more people get immunized against COVID-19. In the United Kingdom, places like bars, cinemas, restaurants and concerts plan on demanding proof of vaccination in the near future. Even within Canada, there is talk of a ‘vaccine passport’ to store immunization records, which would allow establishments to know who has been vaccinated and who has not.

Although such measures do not necessarily make immunization mandatory, they have the effect of precluding those who do not get vaccinated from attending certain locations or establishments. However, they are legal, as businesses generally have the right to refuse customers and in the current circumstances, courts are likely to uphold these decisions in the name of health and safety. In addition, under the International Health Regulations, countries can require travellers to provide vaccination certificates, which is currently enforced for yellow fever and has been enforced in the past for polio. Only time will tell whether the same will be done for COVID-19, but nonetheless, it is clear that the notion of immunization passports is not new.

Conclusion

The general public in Canada and the United States most likely do not need to worry about a mandatory COVID-19 vaccine being imposed on them at the provincial, state, or federal levels of government. However, specific groups within the population, such as employees, are more restricted with regards to their choice to receive a vaccine. This in conjunction with measures such as proof of immunization can perpetuate the appearance of a mandate, and may have the effect of placing a high degree of pressure on individuals to get vaccinated against COVID-19, despite the absence of a government-imposed mandate.

Ian Bernstein is a Junior Online Editor for the McGill Journal of Law and Health, and a second year JD/BCL student at McGill University’s Faculty of Law. Prior to beginning law school, Ian completed an undergraduate degree in psychology and linguistics at McGill. During his undergraduate studies, Ian completed two honours theses, one of them being in the McGill Health Psychology Laboratory, which is where his interest in health law stems from. Ian was also involved in research through having been the recipient of an NSERC Undergraduate Student Research Award in 2017, as well as a Psychology Undergraduate Research Award in 2018.

Litigation and the Opioid Crisis: Purdue’s US Settlement in the Canadian Legal Context

Contributed by Dylan Yan

Introduction

On November 24, 2020, the manufacturers of OxyContin, Purdue Pharmaceuticals, settled on a guilty plea with United States (US) federal prosecutors for their role in the opioid epidemic. They pled guilty to charges of conspiracy to defraud the US, violation of federal healthcare reimbursement laws, and sale of opioids to doctors they suspected of writing illegal prescriptions. The guilty plea provides for over 8 billion USD in forfeitures, which could bring the company’s cost from opioid litigation to as much as 12 billion USD.

The settlement has already prompted consideration from the Canadian legal community as to how the American settlements could affect recent analogous class-action lawsuits launched in Canada. This article aims to examine the Purdue settlement’s potential impact on opioid litigation in Canada by outlining the history of the epidemic, analyzing the American proceedings, and applying their lessons to the Canadian legal context.

Overview of the Opioid Epidemic

Prescribed as a treatment for chronic pain, opioid medications like OxyContin, Vicodin, and Percocet saw their popularity skyrocket in the 1990s in Canada and the US. This was primarily due to aggressive marketing by pharmaceutical companies like Purdue. While prescriptions have decreased since 2017 with intervention from the American federal government and the Centre for Disease Control, the US and Canada remain the highest-ranking countries worldwide in terms of opioid prescriptions.

Opioids have been responsible for almost 450,000 deaths since 1999 in the United States. In a year, roughly 3,000 Canadians and 65,000 Americans die from opioid-associated poisoning. While the crisis affects people of all ages and backgrounds, those at highest risk are within Black and Hispanic communities, as well as young adult men.

In 2016, Canada’s Minister of Health declared the opioid crisis a public health emergency, putting the epidemic at the forefront of government oversight, funding and legislative reform. The US Department of Health and Human Services followed suit in 2017.


Prescribed as a treatment for chronic pain, opioid medications like OxyContin, Vicodin, and Percocet saw their popularity skyrocket in the 1990s in Canada and the US. || (Source: Wikimedia Commons // Psiĥedelisto)

Oxycontin Profits and Purdue

Between 2008 and 2018, OxyContin accounted for over 28% of the American opioid market, grossing over 35 billion USD since its FDA approval in 1996. The Sacklers family, owners of Purdue Pharmaceuticals, have accumulated over 10.7 billion dollars in personal wealth due to OxyContin sales.

Documents obtained during the American lawsuits, including personal emails from the Sacklers, indicate that Purdue understood the dangers of OxyContin and aimed to mislead medical professionals and the North American public. As a company executive in 2001, Dr. Richard Sackler wrote an email outlining a plan to shift the blame for OxyContin-related deaths away from Purdue onto opioid abusers.

Purdue Pharmaceutical Litigation in the United States

The recent settlement concludes a drawn-out litigation process for Purdue Pharmaceuticals.

The agreement covers over 2,400 individual lawsuits proceeding by way of multidistrict litigation, a civil procedure mechanism in the US that combines lawsuits into one cohesive hearing. For cases with common questions of fact, a judicial panel transfers pretrial proceedings from multiple municipalities into one federal district court. After determining the facts, the case is sent back to the original court for trial. Parties may also settle in multidistrict litigation, which resolves all the individual lawsuits.

Although the settlement contains over 8 billion USD in penalties, only about three billion dollars will be paid directly by the Sacklers family. The remaining fines are an estimate of what will be recouped from Purdue Pharmaceutical’s bankruptcy proceedings: the company will be placed in a “public benefit trust” which will oversee the dissemination of Purdue’s resources to combat the opioid crisis. Over the next decade, Purdue Pharmaceuticals will continue to manufacture OxyContin and overdose treatment medications, using the profits from the drugs to pay its debtors and fund opioid interventions like addiction treatment clinics. 

The settlement has also created public controversy. Critics of the settlement opine the lack of criminal convictions for the Sacklers and the low fines relative to the family’s pharmaceutical fortune. Steven Miller, chairman of Purdue Pharmaceuticals, voiced his support for the settlement in the Wall Street Journal. Miller labelled the agreement a “real long-term solution” in procedural justice, noting that it expedited access to Purdue’s monetary resources.


Over the next decade, Purdue Pharmaceuticals will continue to manufacture OxyContin and overdose treatment medications, using the profits from the drugs to pay its debtors and fund opioid interventions like addiction treatment clinics. || (Source: pxhere // Mohamed Hassan )

Purdue Pharmaceutical Lawsuits in Canada

Multidistrict litigation does not exist in Canadian law. As an alternative, most Canadian lawsuits against Purdue are proceeding by way of class action, in which a single lawsuit is filed on behalf of a group of wronged individuals. Unlike multidistrict proceedings in the US, which bring together many lawsuits in a single forum for efficiency purposes, class-action lawsuits aim to provide justice for this “class” of harmed persons.

In 2018, the provincial government of British Columbia launched a class-action lawsuit against multiple opioid manufacturers including Purdue, alleging that pharmaceutical companies deceptively marketed opioid products, and were aware of the dangers they present to public health. Class action lawsuits against Purdue Pharmaceuticals have since been launched in every Canadian province except Manitoba. The Manitoban government plans to join the lawsuit within the next year, pending approval of provincial legislation expanding class-action capabilities. Altogether, the provinces seek to recover 67 billion USD in damages. Most of these class-action lawsuits have yet to be certified, meaning that a judge must grant procedural approval for the lawsuit to proceed in this specific legal process.

Understanding the United States Settlement in Canadian Litigation Context

Purdue’s Canadian opioid litigation has been temporarily stayed as a result of its bankruptcy filing in the US. Initially, this motion was granted to prevent Canadian cases from draining Purdue’s funds, as the bankrupt company will not be able to pay all of its Canadian and American debtors. Now, a significant portion of the American settlement will get paid out before Canadian litigation resolves, leaving fewer of Purdue’s resources available to plaintiffs in Canada.

Canadian litigators understand that Purdue, having already declared bankruptcy, does not possess sufficient resources to pay even half of the 67 billion in charges. In Canada and the US, recovering the full amount of the opioid crisis is impossible – Americans recouped 13 billion USD in settlements from an epidemic that cost the country over 2.5 trillion dollars over the past four years alone. Similarly, a potential Canadian settlement would recover only a fraction of the proposed damages. However, Canadian class-action proceedings provide greater leverage than American multidistrict litigation.


In Canada and the US, recovering the full amount of the opioid crisis is impossible – Americans recouped 13 billion USD in settlements from an epidemic that cost the country over 2.5 trillion dollars over the past four years alone. || (Source: Pixabay // Matvevna)

In terms of representation, Canadian class-action lawyers are better incentivized to pursue their client’s interests than their US multidistrict counterparts. American judges appoint the plaintiff’s legal representative in multidistrict litigation, and can be influenced by personal factors, including friendship and professional familiarity. Thus, multidistrict litigation in the US is fraught with “repeat players” – lawyers who are incentivized to curry favour with judges and adopt group-think practices instead of best serving their client’s interests. In Canada, the initial plaintiffs who file the class-action lawsuit have the right to choose their representation. Furthermore, lawyers’ fees are calculated as a percentage of the plaintiff’s awards, which encourages class-action representatives to pursue the highest monetary return for their clients.

In terms of judicial oversight, class-actions also afford Canadians greater protection than American multidistrict proceedings. US judges in a multidistrict lawsuit are selected in a “fact-intensive” process, without any clear regulations, and are not statutorily required to inspect the fairness of any settlement agreements that result from the proceedings. By contrast, Canadian class-actions appoint specialized judges for case-management and require judicial approval of fairness in any proposed settlement.

Conclusion

Opioid litigation against Purdue Pharmaceuticals in Canada is in its early stages – Manitoba has yet to join the other provinces in the proceedings, and the class-action lawsuits still require certification. Any potential class-action settlement would only recoup a fraction of the proposed 67 billion USD in damages. However, Canadians can leverage a more favourable legal process – both in representation and judicial oversight – than American multidistrict litigants. Hopefully, these proceedings will provide justice for the victims of Purdue Pharmaceuticals and the opioid crisis.

Dylan Yan is a Junior Online Editor for the McGill Journal of Law and Health. Dylan is a recent transfer BCL/JD student at McGill University’s Faculty of Law.

Previously, Dylan studied law at Osgoode Hall Law School, where he was awarded the Ivan Cleveland Rand Prize and the Samuel Rubinoff Prize for Legal Research and Writing. During his time at Osgoode, Dylan was a student caseworker for Mahdi Weinstock LLP and Community Legal Aid Service Providers, focusing on immigration and refugee practice.

Dylan also attended McGill’s Faculty of Science, in which he holds a bachelor’s degree in Microbiology and Immunology and the J.W. McConnell Entrance Scholarship. During his undergraduate studies, Dylan conducted research as part of the Lady Davis Institute. His efforts there focused on HIV enzymes, characterizing the effects of HIV drugs in order to optimize combination HIV therapies.

L’avenir incertain de Roe v. Wade : Ce que l’affaiblissement ou le renversement de Roe v. Wade signifierait pour le droit à l’avortement aux États-Unis

Contribué par Laiba Asad

Introduction

Le 26 octobre 2020 le Sénat américain confirme Amy Coney Barrett à la Cour suprême. Elle est une fervente catholique et grande admiratrice d’Antonin Scalia, un ancien juge conservateur de la Cour suprême. Barrett a mentionné lors de son audition qu’elle ne considère pas Roe v Wade comme un « super précédent », c’est-à-dire une décision qui ne peut pas être renversée à toute fin pratique. Ainsi, avec dix-sept dossiers sur l’avortement qui sont près d’être entendus par la Cour suprême et une majorité conservatrice qui y siège, il est possible que Roe v. Wade soit renversé ou affaibli dans l’avenir.


Ainsi, avec dix-sept dossiers sur l’avortement qui sont près d’être entendus par la Cour suprême et une majorité conservatrice qui y siège, il est possible que Roe v. Wade soit renversé ou affaibli dans l’avenir.|| (Source : creativecommons // zacklur)

Les lois sur l’avortement avant Roe v. Wade

L’avortement était légal aux États-Unis jusqu’en 1821, s’il était performé avant le mouvement fœtal. En 1821, le Connecticut passe la première loi criminalisant l’avortement, et vers la fin du 19ème siècle, les autres l’États l’interdisent également. Dans les années 1950, un changement survient lorsqu’un groupe de professionnels, formé principalement d’avocats, de médecins et de membres du clergé, commencent à s’interroger sur l’interdiction à l’avortement. Vers les années 1960, les débats sur l’avortement s’intensifient considérablement et impliquent des préoccupations à propos de la pauvreté, la liberté sexuelle et le féminisme, entre autres. Ils encouragent les États à élaborer des mesures législatives afin de permettre aux femmes d’avoir accès à l’avortement sous certaines circonstances. Vers les années 1970, vingt États mettent en place des lois pour reformer leurs lois sur l’avortement existantes alors que quatre États (New York, Washington, Alaska et Hawaii) légalisent l’avortement. Les autres États interdisent l’avortement dans presque toutes les circonstances.

Roe v. Wade et son impact sur le droit à l’avortement et d’autres lois sur l’avortement aux États-Unis

L’affaire Roe v. Wade (1973) concerne Jane Roe, une femme au Texas qui disait être tombée enceinte après avoir été victime d’un viol collectif. La loi sur l’avortement au Texas permettait l’avortement seulement si la vie de la femme était en danger. Ainsi, Jane Roe décide de poursuivre l’État du Texas, et en 1970, elle dépose un recours collectif à la Cour de district fédéral de Dallas. La Cour conclue que la loi sur l’avortement du Texas était inconstitutionnellement vague et brimait le droit des femmes à la liberté reproductive. L’État du Texas va en appel à la Cour suprême, ce qui mène à l’arrêt Roe v. Wade.

En 1973, la Cour suprême a trouvé la loi sur l’avortement du Texas inconstitutionnelle pour deux raisons principales. Premièrement, cette loi interdisait le droit à la vie privée aux femmes – une liberté fondamentale protégée par le 14ème amendement de la Constitution. Ainsi, le droit à l’avortement, compris dans le droit à la vie privée, est protégé par la Constitution. Deuxièmement, cette loi interdisait l’avortement à une exception près sous le prétexte que le fœtus était considéré comme une personne sous le 14ème amendement de la Constitution. Cependant, la Cour établit que le fœtus n’est pas reconnu comme une personne par la loi et par conséquent ne peut pas être protégé par la Constitution.

L’arrêt Roe v. Wade précise que les États doivent permettre l’avortement non seulement dans les cas de viol, mais tous les cas. En établissant le droit à l’avortement, qui est maintenant protégé par la Constitution, il a légalisé l’avortement partout aux États-Unis et chaque État doit avoir au moins une clinique d’avortement.

Le droit à l’avortement et l’accès aux soins de santé aux États-Unis

La décision de Roe v. Wade affirme que le droit à l’avortement est constitutionnel, elle intègre également l’accès aux soins de santé à ce droit. Cependant, l’accès à l’avortement comme soin médical a été limité notamment par des restrictions quant aux procédures d’avortement permises. Par exemple, dans l’affaire Gonzales v Carhart, la Cour suprême soutient l’interdiction fédérale d’une procédure d’avortement nommée l’avortement par naissance partielle. Avec des restrictions de ce type, les médecins ne peuvent pas toujours offrir les meilleures procédures d’avortement à leurs patientes.

De plus, malgré Roe v. Wade, des restrictions sur l’avortement ont été mises en place dans plusieurs États. Que ce soient exiger les cliniques à répondre à des normes similaires à celles imposées dans les hôpitaux ou limiter la couverture d’assurances pour les avortements, ces restrictions ont un impact important sur l’accès à l’avortement. Elles font que certaines régions américaines sont laissées avec peu ou aucune clinique d’avortement, ce qui rend l’accès à l’avortement très difficile, surtout pour les femmes qui se trouvent loin de ces cliniques.

Il existe aussi des règlements dans les États régissant l’information concernant l’avortement à laquelle les femmes ont accès. En Oklahoma, la législation requiert que les patientes aient une échographie et permet aux médecins de ne pas divulguer l’information quant aux anomalies fœtales aux patientes. Cette législation force les patientes à avoir de l’information qu’elles ne désiraient pas nécessairement avoir, et les prive d’informations qui pourraient avoir un impact sur leur décision d’avoir un avortement ou pas.

Sous certaines lois fédérales et étatiques avec des « clauses de conscience », des institutions et des individus peuvent refuser d’offrir l’avortement et d’autres soins médicaux à des patientes. Il existe aussi des lois étatiques restreignant l’accès à des médicaments pour l’avortement.

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Il existe des règlements dans les États pouvant limiter l’information sur l’avortement à laquelle les femmes ont accès.|| (Source : creativecommons // ConwayStrategic)

Effets du renversement ou de l’affaiblissement de Roe v. Wade à l’accès à l’avortement dans les États

Le renversement ou l’affaiblissement de Roe v. Wade ne signifierait pas que l’avortement devient automatiquement illégal aux États-Unis. Il aurait plutôt comme effet de laisser les États décider du droit à l’avortement. Selon des recherches de Middlebury College (2019), dans plus de la moitié des États, y compris l’ouest et le nord-est du pays, l’avortement serait encore accessible sans Roe v. Wade. Toutefois, ça ne serait pas la même situation dans d’autres États puisque ces recherches ont également trouvé que le taux d’avortement pourrait diminuer de 13% dans le pays avec le renversement de Roe v. Wade.

En 2019, l’Alabama, l’Arkansas, la Géorgie, le Kentucky, le Missouri et l’Ohio, entre autres ont passé des lois interdisant l’avortement, mais les tribunaux les ont invalidées avant qu’elles n’aient  pu prendre effet. Selon des experts légaux, ces États qui ont déjà passé des « trigger law » (des lois qui peuvent devenir opérantes avec un changement de législation), interdiraient l’avortement immédiatement après le renversement de Roe v. Wade. Treize autres États interdiraient probablement l’avortement également. Dans ces États généralement, il n’y a qu’une seule clinique d’avortement ; Roe v. Wade étant la seule chose qui y rend le droit à l’avortement légal parce qu’il n’est pas protégé par des lois étatiques, ni la constitution de l’État. Ainsi, avec le renversement de Roe v. Wade, la seule clinique d’avortement disponible dans ces États pourrait fermer ses portes. Il serait tout de même possible pour les femmes de se déplacer à des États voisins, ce qui peut être difficile pour plusieurs, comme les femmes à faible revenu. Celles qui ne peuvent pas se déplacer à une clinique pour des raisons diverses seraient généralement les plus affectées par l’interdiction du droit à l’avortement. Si elles n’arrivaient pas à se rendre à une clinique d’avortement, ces femmes pourraient chercher des alternatives comme des pilules abortives procurées clandestinement d’autres États, ou encore des procédures illégales et moins sécuritaires d’avortement.

Effets du renversement ou de l’affaiblissement de Roe v. Wade sur le Canada

En 1988, avec l’affaire R v. Morgentaler, la Cour suprême du Canada conclut que, la disposition 251 du Code criminel qui criminalisait l’avortement est inconstitutionnelle en vertu de l’article 7 de la Charte canadienne des droits et libertés. L’article 7 accorde le droit à la liberté, ce qui comprend l’autonomie des femmes dans les choix touchant leurs vies privées. Cette affaire décriminalise l’avortement partout au Canada et devient un précédent important qui n’a pas été changé depuis 1988.  

Il n’y a donc pas de loi sur l’avortement au Canada étant donné qu’il a été décriminalisé. Il est considéré comme étant une procédure médicale, dont l’accès est contrôlé par les provinces. Étant donné que le droit criminel est une compétence fédérale, les provinces n’ont pas les mêmes capacités que les États américains. De plus, au Canada, le débat sur l’avortement n’est pas abordé par les dirigeants fédéraux et provinciaux, contrairement aux États-Unis où ce débat est ranimé constamment. Il est donc improbable que l’avortement serait criminalisé au Canada si Roe v. Wade est renversé. Toutefois, il est indéniable que le mouvement pro-vie américain affecte le mouvement pro-vie au Canada.

Une préoccupation au Canada est l’accès à l’avortement. L’accès est souvent mieux dans les milieux urbains par rapport aux milieux ruraux. Dans les milieux ruraux, plusieurs services de santé n’offrent pas l’avortement ou n’offrent que certaines procédures comme l’avortement chirurgical. Certaines femmes canadiennes qui vont aux États-Unis, dans les États de Washington, Colorado et Nouveau-Mexique par exemple, pour se procurer des services d’avortement. Toutefois, si Roe v. Wade est renversé, ces femmes canadiennes auront plus de difficulté à accéder à ces services aux États-Unis parce que les lois étatiques sur l’avortement changeraient.

Conclusion

Roe v. Wade est une décision historique de la Cour suprême qui a légalisé l’avortement aux États-Unis. Malgré cette légalisation, l’accès à l’avortement reste un enjeu important. Le problème d’accès à l’avortement s’aggraverait probablement si Roe v. Wade est affaibli ou renversé par la Cour suprême puisque ceci donnerait aux États le pouvoir de légiférer leurs propres lois sur l’avortement.

Laiba Asad est une rédactrice junior en ligne pour la Revue de droit et de santé de McGill et étudiante en première année de BCL/JD à la Faculté de droit de l’Université McGill. Avant de rentrer à la faculté de droit, elle a obtenu son DEC en sciences de la santé (BI) du Collège Jean-de-Brébeuf.

Mindfulness and the Law: Examining the Increased Presence of Mindfulness-Based Interventions in the Legal Context

Contributed by Ian Bernstein

Introduction

Legal and policy initiatives exist internationally to address and reduce psychosocial hazards in the workplace. In many countries, such initiatives include efforts to protect workers’ mental health, which thus imposes a duty of care on employers to safeguard the mental well-being of their employees, and to provide help where possible to tackle mental health problems. This includes Canada, as for instance, Saskatchewan explicitly includes mental health in the purview of its Occupational Health and Safety Act. Preventing or helping to reduce adverse mental health outcomes in employees is especially important amidst a pandemic. Luckily, although unbeknownst to many of them, employers have resources at their disposal that can be used to help them exercise this duty, one of them being mindfulness training.

What is Mindfulness?

Mindfulness is defined as an awareness that emerges through paying purposeful attention to the unfolding of an experience in the present moment. Practicing mindfulness, typically through meditation in groups or alone, allows us to be fully aware of our environment and our inner thoughts, feelings, and emotions on a moment-by-moment basis, without judgment or criticism. Mindfulness can help reduce stress through working as a circuit breaker for the cycle of stressor and reaction, because it helps to counteract our unconscious reactivity to stress by bringing it to our awareness. This in turn allows us to acknowledge, but take a step back from the stress and to see it from a different perspective, rather than repressing it and allowing it to fester. The ability to simply accept things as they are, without attempting to control them, is at the heart of mindfulness practice. Mindfulness is a great solution as it is relatively low cost, time-efficient, and can be practiced alone in any setting. This is particularly helpful during a pandemic with the implementation of physical and social distancing measures.

Benefits of Mindfulness for Professionals and Students

Mindfulness practice can benefit those in any profession, and this includes lawyers, who often work highly demanding jobs with long hours and encounter many sources of stress. According to the Mindfulness in Law Society, practicing mindfulness cultivates many skills and mental qualities that can be helpful to those in the legal profession, including the ability to focus, concentrate, recognize and let go of distractions, manage stress and other emotions, and accept others openly, compassionately, and authentically. Moreover, the National Task Force on Lawyer Well-Being discussed in their 2017 comprehensive report how practicing mindfulness can also enhance many competencies related to lawyer effectiveness, including increased working memory, critical cognitive skills, reduced burnout, and ethical and rational decision-making, while simultaneously reducing rumination, stress, depression, and anxiety.

These aforementioned benefits associated with mindfulness training also apply to students. Particularly given the present circumstances which include online classes on Zoom and studying predominantly from home, the boundary between students’ social and academic lives has been attenuated, and students are being rendered dependent upon technology in order to succeed and advance in their academic careers. It is thus unsurprising that many students, including law students, are continuously distracted by their cell phones and laptops. Such distraction can have adverse effects on the students’ ability to pay adequate attention to their lectures, and effectively learn the required material. Mindfulness training can help, as it has been demonstrated to improve attention, working memory, academic achievement, and creativity by reducing various sources of stress and negative emotions which interfere with focus and learning.


New teaching methods amidst the COVID-19 pandemic have increased distractions and stress levels among students. || (Source: creativecommons // bastamanography)

Dissemination of Mindfulness Interventions

Increased mindfulness research has culminated in a push to implement mindfulness interventions in the workplace, including the legal profession. In Canada, mindfulness workshops, in particular those that teach people how to prevent, identify, and cope with sources of stress that can contribute to or exacerbate mental illness, have been promoted by the Canadian Bar Association and the Law Society of Ontario. In the United States, similar mindfulness programs created by experts have been implemented in some of the most prestigious law firms in the nation. Moreover, at least a dozen American bar associations have programs related to mindfulness. Dentons, a multinational law firm, developed a pilot mindfulness program in 2018 and recruited lawyers from across their European offices to participate. The results of the pilot demonstrated a statistically significant decrease in overall stress and improvement in social and emotional well-being.


Implementing mindfulness interventions in the workplace can be beneficial for professionals. || (Source: creativecommons // jurvetson)

A similar trend can be observed in universities. For instance, one of the recommendations for law schools in the National Task Force on Lawyer Well-Being Report is to create a well-being course and lecture series for students, which focuses on stress-reduction techniques and how substances like alcohol and marijuana affect cognitive function, among other things. Accordingly, Western University’s law school in London, Ontario, has introduced a course about exercising mindfulness, which is thought to be the first of its kind in Canadian law schools. In addition, the University of Toronto Faculty of Law has implemented a mindfulness program comprised of multiple sessions that students can attend, and Dalhousie University’s Schulich School of Law has followed suit. Mindfulness has made its way into American law school curricula as well, with mindfulness courses being offered at law schools across the country, including at Ivy League universities such as Yale and Columbia.

Potential Concerns

Despite the evidence corroborating the effectiveness of mindfulness training for employees and students, there remains apprehension regarding the utilization of mindfulness. In the legal context, some fear that the development of a deeper understanding of one’s own motives and decisions might make it difficult for some lawyers to undertake certain activities that are widely considered essential for proper lawyering, such as questioning a hostile witness or steadfastly advocating for a client’s positions. However, the skills acquired through mindfulness practice can help nurture a service orientation in some lawyers and law students, connecting them with the service-oriented motivations that ultimately drew them to the legal profession.

Conclusion

Mindfulness training can be helpful in mitigating many of the stressors and negative emotions that employees and students alike tend to experience in their daily lives, particularly amidst the ongoing pandemic. It must be remembered that a healthy employee is a good employee, and a healthy student is a good student. Therefore, nurturing the mental health of employees and students is crucial, and practicing mindfulness is an ideal way to cultivate feelings of positivity and relaxation at a time when they are much needed.

Ian Bernstein is a Junior Online Editor for the McGill Journal of Law and Health, and a second year JD/BCL student at McGill University’s Faculty of Law. Prior to beginning law school, Ian completed an undergraduate degree in psychology and linguistics at McGill. During his undergraduate studies, Ian completed two honours theses, one of them examining the efficacy of a mindfulness-based intervention for weight loss, which is where his interest in mindfulness stems from. Ian was also involved in research through having been the recipient of an NSERC Undergraduate Student Research Award in 2017, as well as a Psychology Undergraduate Research Award in 2018.

MJLH Podcast 2020 – Covid Conversations

Did you know that the McGill Journal of Law and Health has a podcast? 

The MJLH/RDSM Podcast aims to share informative and interesting episodes about current issues of law and policy relating to health. There are currently two episodes released as part of the Podcast’s new series, Covid Conversations

In the first episode, Sidney Black-Rotchin spoke with licensed psychologist Eric Widdicome. Eric holds a position at a university in Montreal, where he provides mental health services to students, and is also a service provider for Kahnawake Shakotiia’takenhas Community services. Sidney and Eric discussed student mental health in the age of COVID-19, how to build and maintain connections with your peers while remote learning, and more.

In the second episode, Bianca Braganza looked at the findings of the May 2020 report from Public Health Ontario, which examined neighborhood-level trends among COVID-19 cases through a health-equity perspective. She then sat down with Dr. Vinita Dubey, Associate Medical Officer of Health at Toronto Public Health. Bianca and Dr. Dubey talked about the report’s findings of social determinants of health, the long-term effects of COVID-19, and the role youth play in flattening the curve, along with several other topics.

Episodes can be found on Spotify and other platforms, as well as at this link:  https://anchor.fm/mcgill-journal-of-law-and-health/episodes/Welcome-to-the-new-MJLHRDSM-Podcast-series-COVID-Conversations-ehngrr

Ep. 7: The Impact of COVID-19 on Employment and the Future of Remote Work with Phil Lord McGill Journal of Law and Health Podcast

In Episode 7 of COVID Conversations, Sidney and Bianca sat down with Phil Lord, who is currently completing an LL.M. at McGill University as a Bombardier scholar.  In this episode, Phil, Sidney, and Bianca discussed how COVID-19 has impacted employment, with a specific focus on the uneven consequences of the move to remote work, the connection between these impacts and existing social issues, and potential government interventions to mitigate these issues.  If you enjoyed this episode, subscribe to the MJLH/RDSM podcast. If you have any questions about the podcast, please email info.mjlh@mcgill.ca.
  1. Ep. 7: The Impact of COVID-19 on Employment and the Future of Remote Work with Phil Lord
  2. Ep. 6: COVID-19 and Gender-Based Violence with Dr. Annelise Trudell
  3. Ep. 5: Mandatory School Attendance with Professor Daniel Weinstock
  4. Ep. 4: The Government's Role in Pandemic Management with Professor Daniel Weinstock
  5. Ep. 3: A Harm Reduction Approach to COVID-19 with Professor Daniel Weinstock