Personal Injuries in Canadian Motor Vehicle Insurance Policies and the Conflict of Laws: An Introductory Foray

At one time the personal injuries aspects of a motor vehicle insurance policy were relatively simple. The insurer agreed to meet the cost of personal injuries caused to a third party by the fault of the insured. These are normally referred to as Section A benefits. In time, however, the coverage of the policy could be increased by the payment of additional sums so as to permit: i) the insured persons to recover against their own insurer for injuries or loss caused by an uninsured or under-insured driver in circumstances in which liability existed at common law; ii) recovery by the owner or driver regardless of proof of fault for injury or loss arising out of the use or operation of a car; iii) persons other than the driver or owner of a car (who came within the extended definition of insured person) to recover defined amounts from the insurer in circumstances (i) and (ii). The so-called Section B or no-fault benefits usually benefitted the owner or driver of a car (first-party claims) and members of his family or others riding in the insured\u27s car but could cover other passengers. The inclusion of some no-fault benefits has become mandatory in motor insurance policies. This increase in coverage runs into actual or potential conflict with common law or statutory defences such as those restricting or preventing actions between spouses or gratuitous passengers and the driver who volunteered to drive them

Family Violence-Investigating child abuse and learning from British Mistakes

It seems appropriate at the onset to set out something of what the disciplines of law, medicine and social work know about family violence and when, during recent years, this knowledge came to the attention of professionals, the public and legislature. We can then, perhaps, judge whether our existing laws, rules of evidence and procedure take this information adequately into account in dealing with cases of violence within the family. Whilst solving these problems takes time, and law often lags behind the behavioural sciences, the question arises whether the lag is too long and whether differences between experts in the behavioural sciences have become an excuse for inactivity. Moreover, many ostensibly neutral legal rules have differential impact on the family members. For example, in the field of spousal violence if the existing criminal law rules on self defence and provocation, with their emphasis on imminent danger, reasonable force, the dignity to retreat and immediacy of response, do not provide women with as useful a defence to a woman who commits an assault following repeated assaults by her partners as they do a man who finds his partner having sexual relations with another person and seriously injures or kills either or both of them. The existing rules arose in a different age when it was judged appropriate to make allowance for assaults between males done in the heat of the moment. \u27 The obvious solution of excluding violent husbands and fathers from the family home has been beset, in Nova Scotia and some other provinces, by the problem of constitutional restrictions on Provincial Family Court Judges\u27 powers to make the necessary orders. In an attempt to overcome this difficulty, the Report of the Nova Scotia Court Structure Task Force recommended the creation of a Unified Family Court, a view recently approved by the Law Reform Commission of Nova Scotia. The Law Reform Commission\u27s recommendation shows how interlinked are the needs of children and parents in cases of family violence

Whatever Happened to Exempt Property? An Overview of the Matrimonial Property Act of Nova Scotia

As it is five years since the introduction of the Matrimonial Property Act, it may be appropriate before turning to the title of my paper to outline the general philosophy of the Act. The philosophy is to allow either spouse to apply to the court on the occurrence of one of the four triggering events (death, divorce, nullity or separation) to seek an equal division of the matrimonial assets. Where a merely equal division of matrimonial assets would be unfair or unconscionable a court may divide the matrimonial assets up unequally or have recourse to the exempt property

Adding 6 months of androgen deprivation therapy to postoperative radiotherapy for prostate cancer: a comparison of short-course versus no androgen deprivation therapy in the RADICALS-HD randomised controlled trial

Background Previous evidence indicates that adjuvant, short-course androgen deprivation therapy (ADT) improves metastasis-free survival when given with primary radiotherapy for intermediate-risk and high-risk localised prostate cancer. However, the value of ADT with postoperative radiotherapy after radical prostatectomy is unclear. Methods RADICALS-HD was an international randomised controlled trial to test the efficacy of ADT used in combination with postoperative radiotherapy for prostate cancer. Key eligibility criteria were indication for radiotherapy after radical prostatectomy for prostate cancer, prostate-specific antigen less than 5 ng/mL, absence of metastatic disease, and written consent. Participants were randomly assigned (1:1) to radiotherapy alone (no ADT) or radiotherapy with 6 months of ADT (short-course ADT), using monthly subcutaneous gonadotropin-releasing hormone analogue injections, daily oral bicalutamide monotherapy 150 mg, or monthly subcutaneous degarelix. Randomisation was done centrally through minimisation with a random element, stratified by Gleason score, positive margins, radiotherapy timing, planned radiotherapy schedule, and planned type of ADT, in a computerised system. The allocated treatment was not masked. The primary outcome measure was metastasis-free survival, defined as distant metastasis arising from prostate cancer or death from any cause. Standard survival analysis methods were used, accounting for randomisation stratification factors. The trial had 80% power with two-sided α of 5% to detect an absolute increase in 10-year metastasis-free survival from 80% to 86% (hazard ratio [HR] 0·67). Analyses followed the intention-to-treat principle. The trial is registered with the ISRCTN registry, ISRCTN40814031, and ClinicalTrials.gov, NCT00541047. Findings Between Nov 22, 2007, and June 29, 2015, 1480 patients (median age 66 years [IQR 61–69]) were randomly assigned to receive no ADT (n=737) or short-course ADT (n=743) in addition to postoperative radiotherapy at 121 centres in Canada, Denmark, Ireland, and the UK. With a median follow-up of 9·0 years (IQR 7·1–10·1), metastasis-free survival events were reported for 268 participants (142 in the no ADT group and 126 in the short-course ADT group; HR 0·886 [95% CI 0·688–1·140], p=0·35). 10-year metastasis-free survival was 79·2% (95% CI 75·4–82·5) in the no ADT group and 80·4% (76·6–83·6) in the short-course ADT group. Toxicity of grade 3 or higher was reported for 121 (17%) of 737 participants in the no ADT group and 100 (14%) of 743 in the short-course ADT group (p=0·15), with no treatment-related deaths. Interpretation Metastatic disease is uncommon following postoperative bed radiotherapy after radical prostatectomy. Adding 6 months of ADT to this radiotherapy did not improve metastasis-free survival compared with no ADT. These findings do not support the use of short-course ADT with postoperative radiotherapy in this patient population

Duration of androgen deprivation therapy with postoperative radiotherapy for prostate cancer: a comparison of long-course versus short-course androgen deprivation therapy in the RADICALS-HD randomised trial

Background Previous evidence supports androgen deprivation therapy (ADT) with primary radiotherapy as initial treatment for intermediate-risk and high-risk localised prostate cancer. However, the use and optimal duration of ADT with postoperative radiotherapy after radical prostatectomy remains uncertain. Methods RADICALS-HD was a randomised controlled trial of ADT duration within the RADICALS protocol. Here, we report on the comparison of short-course versus long-course ADT. Key eligibility criteria were indication for radiotherapy after previous radical prostatectomy for prostate cancer, prostate-specific antigen less than 5 ng/mL, absence of metastatic disease, and written consent. Participants were randomly assigned (1:1) to add 6 months of ADT (short-course ADT) or 24 months of ADT (long-course ADT) to radiotherapy, using subcutaneous gonadotrophin-releasing hormone analogue (monthly in the short-course ADT group and 3-monthly in the long-course ADT group), daily oral bicalutamide monotherapy 150 mg, or monthly subcutaneous degarelix. Randomisation was done centrally through minimisation with a random element, stratified by Gleason score, positive margins, radiotherapy timing, planned radiotherapy schedule, and planned type of ADT, in a computerised system. The allocated treatment was not masked. The primary outcome measure was metastasis-free survival, defined as metastasis arising from prostate cancer or death from any cause. The comparison had more than 80% power with two-sided α of 5% to detect an absolute increase in 10-year metastasis-free survival from 75% to 81% (hazard ratio [HR] 0·72). Standard time-to-event analyses were used. Analyses followed intention-to-treat principle. The trial is registered with the ISRCTN registry, ISRCTN40814031, and ClinicalTrials.gov , NCT00541047 . Findings Between Jan 30, 2008, and July 7, 2015, 1523 patients (median age 65 years, IQR 60–69) were randomly assigned to receive short-course ADT (n=761) or long-course ADT (n=762) in addition to postoperative radiotherapy at 138 centres in Canada, Denmark, Ireland, and the UK. With a median follow-up of 8·9 years (7·0–10·0), 313 metastasis-free survival events were reported overall (174 in the short-course ADT group and 139 in the long-course ADT group; HR 0·773 [95% CI 0·612–0·975]; p=0·029). 10-year metastasis-free survival was 71·9% (95% CI 67·6–75·7) in the short-course ADT group and 78·1% (74·2–81·5) in the long-course ADT group. Toxicity of grade 3 or higher was reported for 105 (14%) of 753 participants in the short-course ADT group and 142 (19%) of 757 participants in the long-course ADT group (p=0·025), with no treatment-related deaths. Interpretation Compared with adding 6 months of ADT, adding 24 months of ADT improved metastasis-free survival in people receiving postoperative radiotherapy. For individuals who can accept the additional duration of adverse effects, long-course ADT should be offered with postoperative radiotherapy. Funding Cancer Research UK, UK Research and Innovation (formerly Medical Research Council), and Canadian Cancer Society

Custody Disputes - Evaluation and Intervention

Mediation of custody disputes has become a buzz word of late. The duty of lawyers to discuss with clients the possibility of mediation is referred to in the new Divorce Act However, little research is available and this book is therefore a valuable contribution to the Canadian literature on dealing with custody disputes

Whatever Happened to Exempt Property? An Overview of the Matrimonial Property Act of Nova Scotia

As it is five years since the introduction of the Matrimonial Property Act, it may be appropriate before turning to the title of my paper to outline the general philosophy of the Act. The philosophy is to allow either spouse to apply to the court on the occurrence of one of the four triggering events (death, divorce, nullity or separation) to seek an equal division of the matrimonial assets. Where a merely equal division of matrimonial assets would be unfair or unconscionable a court may divide the matrimonial assets up unequally or have recourse to the exempt property

Personal Injuries in Canadian Motor Vehicle Insurance Policies and the Conflict of Laws: An Introductory Foray

At one time the personal injuries aspects of a motor vehicle insurance policy were relatively simple. The insurer agreed to meet the cost of personal injuries caused to a third party by the fault of the insured. These are normally referred to as Section A benefits. In time, however, the coverage of the policy could be increased by the payment of additional sums so as to permit: i) the insured persons to recover against their own insurer for injuries or loss caused by an uninsured or under-insured driver in circumstances in which liability existed at common law; ii) recovery by the owner or driver regardless of proof of fault for injury or loss arising out of the use or operation of a car; iii) persons other than the driver or owner of a car (who came within the extended definition of insured person) to recover defined amounts from the insurer in circumstances (i) and (ii). The so-called Section B or no-fault benefits usually benefitted the owner or driver of a car (first-party claims) and members of his family or others riding in the insured\u27s car but could cover other passengers. The inclusion of some no-fault benefits has become mandatory in motor insurance policies. This increase in coverage runs into actual or potential conflict with common law or statutory defences such as those restricting or preventing actions between spouses or gratuitous passengers and the driver who volunteered to drive them

Family Violence-Investigating child abuse and learning from British Mistakes

It seems appropriate at the onset to set out something of what the disciplines of law, medicine and social work know about family violence and when, during recent years, this knowledge came to the attention of professionals, the public and legislature. We can then, perhaps, judge whether our existing laws, rules of evidence and procedure take this information adequately into account in dealing with cases of violence within the family. Whilst solving these problems takes time, and law often lags behind the behavioural sciences, the question arises whether the lag is too long and whether differences between experts in the behavioural sciences have become an excuse for inactivity. Moreover, many ostensibly neutral legal rules have differential impact on the family members. For example, in the field of spousal violence if the existing criminal law rules on self defence and provocation, with their emphasis on imminent danger, reasonable force, the dignity to retreat and immediacy of response, do not provide women with as useful a defence to a woman who commits an assault following repeated assaults by her partners as they do a man who finds his partner having sexual relations with another person and seriously injures or kills either or both of them. The existing rules arose in a different age when it was judged appropriate to make allowance for assaults between males done in the heat of the moment. \u27 The obvious solution of excluding violent husbands and fathers from the family home has been beset, in Nova Scotia and some other provinces, by the problem of constitutional restrictions on Provincial Family Court Judges\u27 powers to make the necessary orders. In an attempt to overcome this difficulty, the Report of the Nova Scotia Court Structure Task Force recommended the creation of a Unified Family Court, a view recently approved by the Law Reform Commission of Nova Scotia. The Law Reform Commission\u27s recommendation shows how interlinked are the needs of children and parents in cases of family violence