Abstract
This commentary addresses some of the key legal challenges associated with establishing a national public health agency in Canada. These include issues related to privacy and confidentiality of personal health information in the public health context, constraints on the jurisdiction and powers of a national agency, the need to respect individual rights and freedoms in an outbreak situation, and international cooperation in infectious disease control.
The authors are part of a research initiative, comprised of experts in law, public health policy and medicine, that is currently analyzing legal considerations that may influence the mandate of a national public health agency in regard to infectious disease activities. This article discusses critical issues raised at a meeting in August 2004 that brought the research team together with key federal and provincial policy-makers and members of the public health community.
The commentary emphasizes that law sets the foundation for public health activities, and the promise of a national public health agency will only be realized if significant legal issues are examined early on to ensure the agency is built on a robust legal and policy framework.
MeSH terms: Jurisprudence, communicable disease control, organization and administration
Résumé
Ce commentaire porte sur certains des principaux défis juridiques associés à la création d’une agence nationale de santé publique au Canada: la protection des renseignements personnels et de la confidentialité des dossiers médicaux dans un contexte de santé publique, les contraintes liées aux compétences et aux pouvoirs d’une agence nationale, la nécessité de respecter les droits et libertés individuels en cas d’épidémie, et la coopération internationale dans la lutte contre les maladies infectieuses.
Les auteurs sont membres d’une équipe de recherche composée de spécialistes du droit, des politiques de santé publique et de la médecine, chargée d’analyser les aspects juridiques pouvant influer sur le mandat d’une agence nationale de santé publique dans sa lutte contre les maladies infectieuses. Le présent article examine les questions névralgiques qui ont été posées lors d’une réunion, en août 2004, entre les membres de l’équipe de recherche, des décideurs clés aux paliers fédéral et provincial et des intervenants en santé publique.
Le commentaire souligne que les activités de santé publique sont assujetties au cadre juridique, et qu’une agence nationale de santé publique ne peut donner sa pleine mesure que si l’on examine à l’avance les questions de droit importantes pour s’assurer que l’agence a des assises juridiques et politiques solides.
Footnotes
Acknowledgements: We acknowledge funding support from the Canadian Institutes of Health Research and thank all participants at the First Collaborators’ Meeting in August 2004 for their insight and suggestions. Special thanks to Geoff Moysa for preparing a report of the proceedings.
Research Team: Timothy Caulfield, Canada Research Chair in Health Law & Policy; Professor, Faculty of Law and Faculty of Medicine & Dentistry, University of Alberta; Research Director, University of Alberta Health Law Institute
Nola M. Ries, Research Associate, University of Alberta Health Law Institute
Elaine Gibson, Associate Director, Dalhousie Health Law Institute, Associate Professor, Faculty of Law
Bartha Maria Knoppers, Professor, Faculty of Law, University of Montreal; Canada Research Chair in Law & Medicine; Senior Researcher, Centre de recherche en droit public
Mireille Lacroix, Research Associate, Centre de recherche en droit public, University of Montreal
Kumanan Wilson, Assistant Professor, Departments of Medicine and Health Policy, Management and Evaluation, University of Toronto; Research Associate, Institute of Intergovernmental Relations, Queen’s University
Rosario Isasi, Research Associate, Centre de recherche en droit public
References
- 1.The National Advisory Committee on SARSPublic Health. Learning from SARS: Renewal of Public Health in Canada. Ottawa: Health Canada; 2003. [Google Scholar]
- 2004.Available: https://doi.org/www.health.gov.on.ca/english/public/pub/ministry_reports/walker04/ walker04_mn.html.
- 2.Schabas R. Public health: What is to be done? CMAJ. 2002;166:1282–83. [PMC free article] [PubMed] [Google Scholar]
- 3.Canadian AIDS Society v. Ontario, [1995] 25 O.R. (3d) 388 (Gen. Div.), para. 133.
- 4.See e.g., Canadian Medical Association. Canadians highly value the privacy and confidentiality of their health information. 1999. [Google Scholar]
- 5.For c s eg, Jackman M. Constitutional Jurisdiction Over Health in Canada. Health Law Journal. 2000;8:95. [PubMed] [Google Scholar]
- 6.Gostin LO. Public Health Law in a New Century. JAMA. 2000;283:2979–84. doi: 10.1001/jama.283.22.2979. [DOI] [PubMed] [Google Scholar]
- 7.Schneider v. R. [1982] 2 S.C.R. 112 at 142.
- 8.There h b s l l a o t p i t C c i c w t s a t i g i t US S eg, Misrahi JJ, et al. et al. Legal authorities for interventions during public health emergencies. In: Goodman RA, et al.et al., editors. Law in Public Health Practice. New York, NY: Oxford University Press; 2003. [Google Scholar]
- 9.The Honourable Carolyn Bennett. Hansard, 12 May 2004. https://doi.org/www.parl.gc.ca/37/3/parlbus/chambus/house/debates/055_2004-05-14/han055_1250-E.htm.
- 10.Canadian Charter of Rights and Freedoms, Part I of the Constitution Act 1982, being Schedule B to the Canada Act, 1867 (U.K.), 1982, c. 11. Relevant rights protected under the Charter include: freedom of association (s. 2); liberty and personal security (s. 7); unreasonable search and seizure (s. 8); arbitrary detention (s. 9); cruel and unusual treatment (s. 12); and discrimination (s. 15).
- 11.Gostin LO, editor. Public Health Law and Ethics: A Reader. Berkeley, CA: University of California Press; 2002. p. 415. [Google Scholar]
- 12.Gostin LO. International Infectious Disease Law: Revision of the World Health Organization’s International Health Regulations. JAMA. 2004;291(21):2623–27. doi: 10.1001/jama.291.21.2623. [DOI] [PubMed] [Google Scholar]
- 13.See eg, Fidler DP. Emerging trends in international law concerning global infectious disease control. Emerg Infect Dis. 2003;9(3):285–90. doi: 10.3201/eid0903.020336. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 14.For a s r t T T s, Frank J, Di Ruggiero E, Moloughney B. Proceedings of the “Think Tank on the Future of Public Health in Canada”. Can J Public Health. 2004;95(1):6–11. doi: 10.1007/BF03403625. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 15.Matthews GW, Benjamin G, Mills SP, Parmet W, Misrahi JJ. Legal preparedness for bioterrorism. J Law Med Ethics. 2002;30(3):52–56. [PubMed] [Google Scholar]