Contributed by Alanna Crouse
In 1998, Andrew Wakefield published a scientific paper in the highly prestigious journal The Lancet proclaiming a connection between autism and the measles, mumps, and rubella (MMR) vaccine. It was later discovered that Wakefield’s study not only exemplified bad science but was outright fraudulent. An extensive investigation revealed that Wakefield altered the data to make it fit his claim and that his research was funded by lawyers who were representing parents involved in a lawsuit against vaccine manufacturers. Together, these findings shook the scientific community and led The Lancet to retract the paper. Unfortunately, it was too late, as the anti-vaccination movement had already begun.
Contrary to Wakefield’s claim, vaccines are one of the great marvels of the medical world. Prior to their discovery, infectious diseases were the leading cause of death worldwide. After they came into use in Canada, death by infectious disease fell to 5% of all deaths across the country. Accordingly, cases of measles, mumps, rubella, and diphtheria all dropped by 99%, while polio was eradicated altogether. Thus, in a matter of decades, we put to rest some of the most prominent causes of death in the world.
Despite the drastic improvement in public health and two decades’ worth of evidence establishing the safety of vaccines, Wakefield’s unscientific and unethical publication has emboldened a public health crisis that remains in full effect today. A Canadian study in 2010 revealed that 65% of women and 72% of men either believed the MMR vaccine was unsafe, or they were unsure whether or not it caused autism. This attitude has manifested in what organizations like the Public Health Agency of Canada and the Canadian Paediatric Society have deemed “suboptimal” coverage rates of immunization, and subsequently, a rise in measles outbreaks since 2011.
Given the serious and widespread impact of the anti-vaccination movement, it’s no surprise that legislators and academics alike have begun to ask if and how the law can provide a solution to the rising threat. Two potential solutions include enacting legislation, and the law of extra-contractual obligations. Continue reading “Using the Law to Respond to the Anti-Vaccination Movement”
Contributed by Anita Sengupta
In early 2010, Kathleen Carter, an 89-year-old Canadian woman, decided to die with dignity and travelled to Switzerland, where medically assisted dying is legal. Kathleen suffered from spinal stenosis, a terminal disease, and worried that her death would be “slow, difficult, unpleasant, painful, [and] undignified” (para 12). Although Kathleen was able to die on her own terms, her family believed that she should have been allowed to die at home in Canada, surrounded by her family and friends. This led to the landmark Supreme Court of Canada case, Carter v. Canada (Attorney General), February 2015, which ruled that the criminalization of Medical Assistance in Dying (MAiD) in Canada was contrary to section 7 of the Canadian Charter of Rights and Freedoms, namely an individual’s right to life, liberty and security of the person. In June 2016, in response to this decision, the government passed Bill C-14 to amend the Criminal Code, thereby allowing physicians in Canada to provide medical assistance in dying if certain conditions are met.
An important condition to providing medical assistance in dying is that the patient must give informed consent. In Carter v. Canada, the trial judge said, “[…] physicians should ensure that patients are properly informed of their diagnosis and prognosis and the range of available options for medical care, including palliative care interventions aimed at reducing pain and avoiding the loss of personal dignity” (para 106). This ruling not only made MAiD legal, but it also prompted the development of legislation focused on improving palliative care, which was recognized as a viable alternative to MAiD. Continue reading “Dying with Dignity: The Growing Importance of Palliative Care in Canada”
Contributed by Maya Gunnarsson
The McGill Journal of Law and Health and the Indigenous Law Association at McGill Blog are collaborating on our blogs this year, in order to connect our readers with more content at the crossroads of health law, and Indigenous law and legal traditions. You can find this article cross-posted on their website.
The Canadian Human Rights Tribunal released their latest decision in First Nations Child and Family Caring Society of Canada et al. v. Attorney General of Canada (representing the Minister of Indigenous and Northern Affairs Canada) in September 2019. This ruling was the 9th issued by the Tribunal since 2016, when they found the Caring Society’s allegations that Canada was discriminating against First Nations children in their provision of child and family services were substantiated.
“This ruling is dedicated to all the First Nations children, their families and communities who were harmed by the unnecessary removal of children from your homes and your communities. The Panel desires to acknowledge the great suffering that you have endured as victims/survivors of Canada’s discriminatory practices.”
Caring Society v. Canada, 2019 CHRT 39 at para 13.
The purpose of this ruling was to determine the compensation Canada would be ordered to pay due to their discriminatory practices. More broadly, however, this decision attempted to bring justice to an extremely vulnerable group of people who have historically been denied access to justice through Canadian institutions. Since the initial ruling in 2016, the Tribunal had issued multiple remedial orders against Canada, finding that they were continuing to discriminate, and giving clear orders on what the federal government needed to do to comply with its 2016 decision. While the federal government may have been dragging its heels, the Tribunal firmly took a step towards reconciliation in Canada with this decision. Continue reading “First Nations Child and Family Caring Society of Canada v. Canada, 2019 CHRT 39”
Contributed by: Gary Lai
The following is Part II of Gary Lai’s investigation into the link between poverty and health outcomes. Part I is available here.
Economic Inequality and Health Inequality
There is a large array of political tools to advocate for the poor in the framework of The Canada Health Act (1984). For Example, Dennis Raphael, from York University, proposed a series of actions to reduce poverty and health inequality. He cited the Health of Canada’s Children Report, which reported a deep divide between the health of children who are poor and those who are not. Statistics Canada attributes 22% of mortality differences among Canadians to income differentials. In the University of Sussex’s Richard Wilkinson’s book Unhealthy Societies, he writes, “increasing economic inequality decreases social cohesion, increases individual malaise, and produces the conditions by which increased mortality and morbidity occur.” Raphael also mentioned that the Ottawa Charter for Health Promotion included income as a basic prerequisite for health. He wrote that the public, organizations, and the government could respond to a public health issue like this through recognition of the impact of politics, government policy development and implementation, and community involvement on health.
Raphael is not the only scholar advocating a political solution. Deanna Williamson, of the University of Alberta, claimed that the health of individual Canadians in poverty requires a concerted effort to alter the “fundamental structural conditions contributing to poverty.” She suggested more research in this area. Continue reading “Improving Health Outcomes through Poverty Reduction: Part II”
Contributed by: Gary Lai
The Canada Health Act (1984) established universal health care in Canada with five principles, one of which is accessibility—insured Canadians should not be impeded from reasonable hospital and physician services. But there is ample evidence that the medical outcome of low-income people is not what was originally intended by the legislation; they are disproportionately less healthy than the rest of the population. The late sociologist and former University of Laval professor André Billette highlighted two studies that looked at health outcomes of the poor in Canada in 1979. One, led by Philip Enterline, formerly a biostatistician at the University of Pittsburgh, found that in Montreal, the poor made the most doctors’ visits. Another was by University of Ottawa’s Pran Manga, who found that, between 1974 and 1975, the lower the family income, the greater the use of all types of medical services – significantly more for members of families making under $4,000 (approximately $18,000 in 2019, when adjusted for inflation).
The lower the family income, the greater the use of all types of medical services || (Source: Flickr // Aimee Dars Ellis )
Nicholas Vozoris and Valerie Tarasuk, of the University of Toronto, observed in 2004 that a family on welfare was more likely to report diseases associated with general, mental, and social health than a respondent household that was not on welfare. In fact, they were even found to be more at risk than members of other low-income groups, including the working poor. Despite finding a correlation, the researchers cautioned that their model could not prove a causal link. That being said, more than 3.4 million Canadians are currently eligible for welfare and Vozoris and Tarasuk’s conclusions would suggest that a significant portion of them may be at risk for income-related health issues, due to problems with hunger, affording special diets and exercise, and buying essential medicine and medical supplies. Continue reading “Improving Health Outcomes through Poverty Reduction: Part I”