Transcript presentation - Canadian Public Health Association

Overview and Critique of
Public Health Emergency
Laws in Canada
Elaine Gibson
Associate Director, Health Law Institute
Dalhousie University
[email protected]
CPHA Conference - June 2008
Funded by Canadian Institutes of Health
Research
“The danger of immediate death to
ourselves took away all bowels of love, all
concern for one another. I speak in
general, for there were many instances of
immovable affection, pity, and duty…”
Daniel Defoe
Journal of the Plague Year 1721
“Neither a man nor a crowd nor a nation can
be trusted to act humanely or to think
sanely under the influence of a great
fear.”
Bertrand Russell
Role of Law
Protect
 Constrain/restrict
 Liberate
 Equalize
 Inherently collective
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Constitution Act, 1867 – Division of
Powers
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Federal
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Criminal law
Peace, order and good government
Quarantine
Marine hospitals
Provincial
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Hospitals
Property and civil rights
Matters of a local or private nature
Challenges in Public Health
Laws
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Split jurisdiction – mostly provincial
Lack of co-operation/co-ordination
Differences in laws
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“The lack of federal-provincial cooperation
was a serious problem during SARS…
It is clearly incumbent on both levels of
government to ensure that the breakdown
that occurred during SARS does not
happen again.”
Campbell Commission
Interim Report
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“What exists now are separate systems
within each of the provinces and
territories, as well as a federal system that
operates primarily at Canada’s
international borders.”
Naylor Report
Differences in Laws
Duty on self
 Quarantine
 Mandatory treatment
 Contact notification
 Public notices/posting
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Case Study: Reporting infectious
disease cases to federal
government
“In the final analysis, the entire disease
surveillance and control system is only as
strong as its weakest link.”
Kirby Report
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“The bottom line is that the lack of clarity
around the flow of communication and the
reporting structure…provided an
environment in which the crucial elements
of the fight against SARS were
disconnected from each other.”
Campbell Commission Interim
Report
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“The inherent tensions between the federal and
provincial governments must be overcome by a
spirit of cooperation around infectious disease
surveillance and coupled with the necessary
machinery to ensure in advance that the vital
information will flow without delay.”
Campbell Commission
Interim Report
Auditor-General Report 2008
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“Fundamental weaknesses…The federal
government has not figured out how to
effectively detect and monitor the spread of
deadly diseases.
Of primary concern is the fact that information
about potential outbreaks is not routinely shared
by the provinces.”
Globe and Mail May 7, 2008
Variation - Resulting Problems
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Unevenness in highly interventionist laws
Confusion
Diseases don’t stop at borders
Needs
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Clarity in laws
Clarity in goals (ethics)
Harmonization
Intergovernmental agreements (in
progress)
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“Neither a man nor a crowd nor a nation
can be trusted to act humanely or to think
sanely under the influence of a great
fear.”
Bertrand Russell