A Choice for K\u27aila: Child Protection and First Nations Children

K\u27aila\u27s story raises serious questions about child protection and First Nations children. Was it appropriate that a non-First Nations social services agency made the initial assessment of whether K\u27aila was in need of protection, that a non-First Nations court had the power to decide whether K\u27aila was in need of protection, and that Francois and Leslie\u27s decision was held to a non-First Nations standard of care? Was K\u27aila well-served by the child welfare system

Achieving National Altruistic Self-Sufficiency in Human Eggs for Third-Party Reproduction in Canada

To avoid the commercialization of reproduction, the Canadian Assisted Human Reproduction Act (AHR Act 2004) prohibits the purchase of human eggs. We endorse this legal prohibition and moreover believe that this facet of the law should not be allowed to have as an unintended consequence an increase in transnational trade in human eggs. In an effort to avoid this consequence, and to be consistent with the AHR Act, we advocate a system of national altruistic self-sufficiency. This article briefly outlines a number of strategies to increase the domestic altruistic supply of third-party eggs and decrease the domestic demand for third-party eggs

Information/Consent/Authorization for Minors\u27 Participation in Research

Following the workshop described in the previous article Children and Decision-Making in Health Research, I decided to operationalize the approach taken to the issue of minors and consent/authorization. What follows is a proposed set of instructions for investigators that could be provided by REBs to investigators to facilitate the process of applying for ethical approval for research involving minors and to ensure respect for minors who are participating in research

Medical Assistance in Dying: Lessons for Australia from Canada

Canada has recently witnessed dramatic changes in end-of-life law and policy. Most notably, we have moved from a prohibitive to a permissive regime with respect to medical assistance in dying (MAiD). As a number of Australian states are actively engaged in debates about whether to decriminalise MAiD, it is worth reviewing the Canadian experience and drawing out any lessons that might usefully inform the current processes in Australia

Glass houses: The power of money in bioethics research

In this paper I explore the power of money in bioethics research and ask whether, while casting stones regarding financial conflicts of interest in health research, bioethics researchers are in fact living in glass houses. I first review the need for money in bioethics research, the sources of money, and key features of the money (specifically, the amount of money involved and the fact that the money often is embedded, encumbered, and required to be matched). Next, I explore a range of possible objectives for the money transfer. I then examine the effects of this transfer and raise some questions and concerns about the role of money in bioethics research. I close with some suggestions for possible responses to these questions and concerns—suggestions concerning what bioethics researchers as individuals and as a community could do to more positively and progressively harness the power of money in bioethics research

Draft Provincial/Territorial Legislation to Implement a Regulatory Framework for Medically-Assisted Dying Consistent with Carter v. Canada (Attorney General) 2015 SCC 5 and the Final Report of the Provincial-Territorial Expert Advisory Group on Physician-Assisted Dying

On February 6, 2015, the Supreme Court of Canada unanimously declared that the Criminal Code prohibitions on physician-assisted dying (both assisted suicide and voluntary euthanasia) violate the Canadian Charter of Rights and Freedoms. They immediately suspended the declaration for 12 months thus allowing the government time to craft new legislation. This paper is a contribution to the project of meeting that deadline -- it presents draft provincial/territorial legislation. This draft legislation is based on: 1) a thorough review of existing legislation in all permissive regimes throughout the world (reviewed through a lessons learned lens); 2) the requirements for constitutional validity set out by the Supreme Court of Canada in Carter v. Canada (Attorney General); 3) the Final Report of the Provincial-Territorial Expert Advisory Group on Physician-Assisted Dying; and 4) other relevant case law. Specifically, medically-assisted dying includes both assisted suicide and voluntary euthanasia. Access is limited to assistance provided to individuals who have a grievous condition (including illness, disease or disability) that cannot be alleviated by means acceptable to the person and causes enduring physical or psychological suffering that is intolerable to the individual in the circumstances of his or her condition. Assisted dying is only permitted with the free and informed consent of the individual. The rights and interests of patients and health care providers are reconcile rights to and interests in both access and conscience. Procedural safeguards and a national oversight system are established

Template Policy Re: Access to Medical Assistance in Dying in Publicly-Funded Institutions

Patients are being denied access to assessments for, and provision of, medical assistance in dying (MAiD) in publicly-funded institutions in Canada. Health authorities should implement policies that prohibit forced transfer for MAiD (assessments and provision) unless it can be achieved without undue delay or harm to the patient (as determined by the MAiD Program, not the institution). This is a template policy that health authorities could adopt to ensure access to a legal health service in all publicly-funded institutions (including faith-based institutions) under their authority

Industry and the Academy: Conflicts of Interest in Contemporary Health Research

The case of Dr. Nancy Olivieri, the Hospital for Sick Children (HSC), the University of Toronto, and Apotex Inc. (hereinafter the Olivieri case ) is critically important to an understanding of the issues central to contemporary health research and the safety of research participants. First, the case illustrates the huge stakes in such research – not only billions of dollars, but the health of Canadians. Second, the case played out at a crucial time in the history of the regulation of health research. Like other recent high-profile cases, it challenged the ways in which research is governed at the local and national levels and fuelled calls for significant governance reform. Finally, it is relevant not only nationally but in individual communities right across the country. What happened in Toronto could have happened (and could still happen) anywhere in Canada. To pursue the promises and avoid the perils of contemporary health research, it is essential to attend to the lessons of this case

And Miles to Go Before I Sleep: The Future of End-of-Life Law and Policy in Canada

This paper reviews the legal status of a number ofend-of-life law and policy issues that have, to date, been overshadowed by debates about medical assistance in dying. It suggests that law reform is needed in relation to palliative sedation without artificial hydration and nutrition, advance directives for the withholding and withdrawal of oral hydration and nutrition, unilateral withholding and withdrawal of potentially life-sustaining treatment, and the determination of death. To leave the law in its current uncertain state is to leavepatients vulnerable to having no access to interventions that they want or at the other extreme, being forced to receive interventions that they do not want. This can either inappropriately shorten life or extend suffering. It can also leave individuals at risk ofbeing declared dead earlier than appropriate or much-needed organs not being available for transplantation because individuals are being declared dead later than appro