The Last Line of Defence for [Which?] Citizens : Accountability, Equality, and the Right to Health in Chaoulli

This article explores the legal and health policy significance of the Supreme Court of Canada\u27s decision in Chaoulli c. Ouebec (Procureur general). Through an in-depth examination of the judgments in the case, the author suggests that the majority\u27s approach to the evidentiary, section 7, and remedial issues raised negates the potential of Charter review as a mechanism for promoting accountability and substantive equality in the health care context. The article goes on to consider the longer-term implications of the decision, including the likely impact of Chaoulli on the health rights of people living in poverty and on the evolution of the single-payer health care system

Protecting Rights and Promoting Democracy: Judicial Review under Section 1 of the Charter

The author argues that, under section 1 of the Charter, the courts must weigh carefully the democratic potential of rights guarantees against the democratic quality of government decisions which undermine those rights. The article points to the Egan and Eldridge cases as examples of decisions in which the willingness to uphold rights violations under section 1, in the name of deference to the legislature, actually undermines democratic values. The article examines the RIR-MacDonald decision as a starting point for a section 1 analysis which identifies the characteristics of government decisionmaking that must be present if rights violations are to be justified under section 1, understood in terms of the Charter\u27s combined objectives of protecting rights and of promoting democracy

The Last Line of Defence for [Which?] Citizens : Accountability, Equality, and the Right to Health in Chaoulli

This article explores the legal and health policy significance of the Supreme Court of Canada\u27s decision in Chaoulli c. Ouebec (Procureur general). Through an in-depth examination of the judgments in the case, the author suggests that the majority\u27s approach to the evidentiary, section 7, and remedial issues raised negates the potential of Charter review as a mechanism for promoting accountability and substantive equality in the health care context. The article goes on to consider the longer-term implications of the decision, including the likely impact of Chaoulli on the health rights of people living in poverty and on the evolution of the single-payer health care system

Protecting Rights and Promoting Democracy: Judicial Review under Section 1 of the Charter

The author argues that, under section 1 of the Charter, the courts must weigh carefully the democratic potential of rights guarantees against the democratic quality of government decisions which undermine those rights. The article points to the Egan and Eldridge cases as examples of decisions in which the willingness to uphold rights violations under section 1, in the name of deference to the legislature, actually undermines democratic values. The article examines the RIR-MacDonald decision as a starting point for a section 1 analysis which identifies the characteristics of government decisionmaking that must be present if rights violations are to be justified under section 1, understood in terms of the Charter\u27s combined objectives of protecting rights and of promoting democracy

PANC Study (Pancreatitis: A National Cohort Study): national cohort study examining the first 30 days from presentation of acute pancreatitis in the UK

Abstract Background Acute pancreatitis is a common, yet complex, emergency surgical presentation. Multiple guidelines exist and management can vary significantly. The aim of this first UK, multicentre, prospective cohort study was to assess the variation in management of acute pancreatitis to guide resource planning and optimize treatment. Methods All patients aged greater than or equal to 18 years presenting with acute pancreatitis, as per the Atlanta criteria, from March to April 2021 were eligible for inclusion and followed up for 30 days. Anonymized data were uploaded to a secure electronic database in line with local governance approvals. Results A total of 113 hospitals contributed data on 2580 patients, with an equal sex distribution and a mean age of 57 years. The aetiology was gallstones in 50.6 per cent, with idiopathic the next most common (22.4 per cent). In addition to the 7.6 per cent with a diagnosis of chronic pancreatitis, 20.1 per cent of patients had a previous episode of acute pancreatitis. One in 20 patients were classed as having severe pancreatitis, as per the Atlanta criteria. The overall mortality rate was 2.3 per cent at 30 days, but rose to one in three in the severe group. Predictors of death included male sex, increased age, and frailty; previous acute pancreatitis and gallstones as aetiologies were protective. Smoking status and body mass index did not affect death. Conclusion Most patients presenting with acute pancreatitis have a mild, self-limiting disease. Rates of patients with idiopathic pancreatitis are high. Recurrent attacks of pancreatitis are common, but are likely to have reduced risk of death on subsequent admissions. </jats:sec

Un pas en avant, deux pas en arrière : la pauvreté, la Charte canadienne des droits et libertés et l’héritage de l’affaire Gosselin c. Québec

En 2002, la Cour suprême du Canada a rejeté la demande de Louise Gosselin fondée sur la Charte canadienne des droits et libertés qui contestait un règlement d’application relatif au programme d’aide sociale du Québec prescrivant une réduction aux deux tiers du montant des prestations de base pour les moins de 30 ans, obligeant ces derniers à choisir entre la faim et l’itinérance. Dans le présent texte, l’auteure analyse les conséquences de la décision rendue dans l’affaire Gosselin c. Québec sur les droits et l’inclusion constitutionnelle des personnes vivant en situation de pauvreté. Elle considère d’abord l’important pas en matière de jurisprudence franchi dans cette affaire : le rejet par la Cour suprême de l’argument, étant en contradiction avec les attentes des groupes défavorisés et les obligations internationales du Canada en matière de droits socioéconomiques, selon lequel l’article 7 de la Charte ne peut imposer d’obligations positives aux gouvernements. L’auteure s’intéresse ensuite au recul constaté dans l’affaire Gosselin : plus précisément, à l’approche des juges majoritaires à l’égard de la preuve et au traitement de l’argument de fond articulé par Louise Gosselin. L’auteure soutient que les demandeurs qui invoquent la Charte dans les dossiers relatifs aux droits des personnes en situation de pauvreté continuent d’être confrontés à des stéréotypes préjudiciables et à des fardeaux de preuve disproportionnés. Leurs demandes en vertu de l’article 7 sont aussi constamment reformulées par les tribunaux, puis jugées non recevables. L’auteure conclut que, en n’ayant pas procédé à la révision de l’arrêt Gosselin, ni même accordé l’autorisation d’interjeter appel dans toute affaire soulevant la question de la pauvreté depuis lors, la décision de la Cour suprême représente un échec important du constitutionnalisme au Canada.In 2002, the Supreme Court of Canada rejected Louise Gosselin’s Canadian Charter challenge to a Quebec welfare regulation that reduced benefits for those under-30 by two-thirds, forcing them to choose between hunger and homelessness. This article examines the legacy of Gosselin v. Canada for the rights and constitutional inclusion of people living in poverty. The article first considers the important jurisprudential step forward in the case : the Supreme Court’s rejection of the argument, at odds with the expectations of disadvantaged groups and with Canada’s international socio-economic rights obligations, that section 7 cannot impose positive obligations on governments. The article then considers the Court’s two steps back in the Gosselin case : the majority’s approach to the evidence and its treatment of Louise Gosselin’s substantive argument. The article argues that Charter claimants in poverty cases continue to face prejudicial stereotypes and disproportionate evidentiary burdens. Their section 7 claims are also consistently reframed by the courts and then dismissed as nonjusticiable. The article concludes that the Supreme Court’s failure to revisit Gosselin, or even to grant leave to appeal in any poverty case since then, represents a serious failure of constitutionalism in Canada.En el año 2002, la Corte Suprema de Canadá desestimó la demanda interpuesta por Louise Gosselin la cual se fundamentaba en los principios consagrados de la Carta Canadiense de Derechos y Libertades, y en la que se contestaba un reglamento de aplicación relacionado con el programa de asistencia social de Quebec, en el que se prescribe una reducción de las dos terceras partes del monto de las prestaciones básicas para los menores de 30 años, lo cual obligaba a estos últimos a escoger entre el hambre y la vagancia. En este documento, la autora analiza las consecuencias de la decisión dictada en el caso de Gosselin c. Canada acerca de los derechos sobre la inclusión de carácter constitucional de las personas que viven en situación de pobreza. La autora considera en primer lugar el importante paso que se ha dado en materia de jurisprudencia en este caso : el rechazo del argumento por parte de la Corte Suprema, el cual contradice las expectativas de los grupos desfavorecidos y las obligaciones internacionales de Canadá en materia de derechos socioeconómicos y según el cual el artículo 7 no puede imponer obligaciones positivas a los gobiernos. Seguidamente, la autora abarca el constatable retroceso en el caso Gosselin : más precisamente en la perspectiva de los jueces mayoritarios con respecto a la prueba y al procesamiento del argumento de fondo expuesto por Louise Gosselin. La autora sostiene que los demandantes que invocan la Carta Canadiense de Derechos y Libertades en los expedientes relacionados con los derechos de las personas en situación de pobreza siguen estando confrontados con los estereotipos perjudiciales y a cargas de prueba desproporcionadas. Sus solicitudes basadas en virtud del artículo 7 han sido constantemente reformuladas por los tribunales, y posteriormente decididas como no justiciables. Para concluir, la autora expone que al no proceder a la revisión de la decisión del caso Gosselin, y al no acordar la autorización para interponer el recurso de apelación en el caso, con respecto a la cuestión de la pobreza, la decisión de la Corte Suprema representa, desde entonces, un fracaso considerable del constitucionalismo en Canadá