Charting A Course: Legal and Ethical Issues Relating to Complementary and Alternative Health Care - Guide to Related Reports

Prepared for Health Canada by
The Health Law Institute
Faculty of Law
University of Alberta
Edmonton, Alberta

March 2003

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Charting a Course: Legal and Ethical Issues Relating to CAHC - Guide to Related Reports

The issues outlined for each of the following resources do not in all cases cover every issue touched upon in the source but indicate the main issues which the resource focussed upon.

Andrews, L.B.,"The Shadow Health Care System: Regulation of Alternative Health Care Providers" [1996] 32 Hous. L. Rev. 1274.

• regulation of practitioners

Beauchamp T.L.& Childress, J.F., Principles of Biomedical Ethics, 4^th ed. (New York: Oxford University Press, 1994).

• ethical principles of autonomy, beneficence, non-maleficence, justice

Bissonette v. Canada, [2002] T.C.J. No. 94 T.C.C.

• income tax treatment of CAHC expenses

Boozang., K.M., "Western Medicine Opens the Door to Alternative Medicine"(1998) 24:2/3 185.

• standard of care
• informed consent

Bukse L., "Looking for an Alternative" (1999) 161:4 CMAJ 363.

• informed consent
• public health insurance
• private health insurance

Canada, Health Canada. "The Need for Guidelines: Ethical Issues in the Use of Complementary and Alternative Care in Canada Today" in Perspectives on Complementary and Alternative Health Care (Ottawa: Publications Health Canada 2001).

• regulation of CAHC practitioners
• standard of care
• informed consent
• ethical issues and CAHC practice
• ethical issues and CAHC research
• ethical issues and health policy

Canada Health Canada. "The Regulation of Complementary and Alternative Health Care Practitioners: Policy Considerations" by James Casey & Frances Picharack in Perspectives on Complementary and Alternative Health Care (Ottawa: Publications Health Canada 2001).

• regulation of NHP industry
• regulation of CAHC practitioners

Canada, Report of the Standing Committee on Health, Natural Health Products: A New Vision, (Ottawa: Public Works and Government Services Canada, 1998). (Chair: Joseph Volpe).

• regulation of NHP industry
• legal enforcement of regulatory framework
• regulation of practitioners
• informed consent
• ethical issues of autonomy/choice, respect for cultural diversity, cost, plant conservation

Casey J.T., Status Report and Analysis of Health Professional Regulations in Canada, (Edmonton: Federal/Provincial/Territorial Advisory Committee on Health Human Resources, March 1999).

• regulation of practitioners

Crouch R., Elliott R., Lemmens T. & Charland L. Canadian Strategy on HIV/AIDS, Complementary/Alternative Health Care and HIV/AIDS: Legal, Ethical & Policy Issues in Regulation by (Toronto: Canadian HIV/AIDS Legal Network, 2001).

• regulation of NHP industry
• international trade agreements
• regulation of practitioners
• negligence
• standard of care
• informed consent
• ethical principles of autonomy, beneficence, non-maleficence, justice

Capen, K.,"Courts, Licensing Bodies Turning Their Attention to Alternative Therapies" (1997) 156:9 CMAJ 1307.

• regulation of practitioners
• negligence
• standard of care

Caulfield T. & Feasby C., "Potions, Promises and Paradoxes: Complementary Medicine and Alternative Medicine and Malpractice Law in Canada" (2001) 9 Health L.J. 183.

• standard of care
• informed consent

Clark, P.A. "The Ethics of Alternative Medicine Therapies," (2000) 21:4 J. Pub. Health Plcy. 447.

• ethical issues of autonomy, beneficence, justice, NHPs, CAHC practice, research,

Cohen, M.H., Complementary & Alternative Medicine, Baltimore: The Johns Hopkins University Press, (1998).

• regulation of practitioners
• negligence
• standard of care
• informed consent
• private health insurance

de Bruyn, T., "Health Law and Ethics in Relation to the Use of Complementary and Alternative Health Care and Natural Health Products" Report prepared for an Invitational Roundtable, Toronto, January 2002 [unpublished].

• regulation of NHPs
• regulation of practitioners
• informed consent
• ethical issues of autonomy, beneficence, NHPs, CAHC practice, research

Demont v. Canada, [2002] T.C.J. No. 562 T.C.C.

• income tax treatment of CAHC expenses

Doyle, A., "Alternative Medicine and Medical Malpractice: emerging issues" (2001) 22 J. Legal Med. 533.

• regulation of practitioners
• negligence
• standard of care
• informed consent

Feasby, C., "Determining Standard of Care in Alternative Contexts" (1997) 5 Health L.J. 45.

• standard of care
• informed consent

Gilmour, J.M. Natural Health Products: The Product/Practitioner Interface (March 2002) [unpublished] archived at Health Canada.

• regulation of NHPs
• regulation of practitioners
• standard of care
• conflict of interest

Gilmour, J.M., Regulation of Complementary and Alternative Health Care: Goals, Legal Frameworks, Implementation (October 2001) [unpublished] archived at Natural Health Products Directorate, Health Canada.

• regulation of practitioners
• negligence
• informed consent
• criminal liability
• consumer protection legislation
• public health insurance
• ethical issues of autonomy/consumer choice

Gilmour, J.M., Kelner, M. & Wellman B., "Opening the Door to Complementary an Alternative Medicine: Self-Regulation in Ontario" (2002) 24:2 L. & Polcy. 149.

• regulation of practitioners

Grandinetti, D. "Will Alternative-Medicine Referrals Get you Sued?" (1999) 76:10 Med. Econ. 38.

• standard of care - referrals

Gray, C., "Huge Court Fight May be in Offing as Ontario College Considers Penalty for Maverick MD" (1999) 160:6 CMAJ 877.

• regulation of practitioners
• standard of care

Gray, C., "Dr. Krop Gets Knuckles Rapped, But Vows to Fight College's 'Inquisition'" (1999) 161:11 CMAJ 1431.

• regulation of practitioners

Haigh, R.A., "Reconstructing Paradise: Canada's Health Care system, Alternative Medicine and the Charter of Rights," (1999) 7 Health L.J. 141.

• regulation of practitioners
• public health insurance

Haig, R.D., "Role of Non-Physician Providers in Primary Health," (1997) 18:2 Health L. in Canada 49.

• regulation of practitioners

Hanvey, L. Reflections on Health Law and Ethics in Complementary and Alternative Health Care (March 2002) [unpublished], Commissioned by Health Canada. Online: Health Canada Natural Products Directorate.

• regulation of NHP industry
• labelling and informed choice
• regulation of practitioners
• ethical issues and CAHC research
• ethical issues and CAHC policy

Health Canada, Natural Health Products Directorate, online: http://www.hc-sc.gc.ca/hpfb-dgpsa/nhpd-dpsn/faq_e.html.

• regulation of NHPs

Hoffer, L.J., "Complementary or Alternative Medicine: the Need for Plausibility" (2003) 168:2 JAMC 180.

• ethics of research

Ketchen v. Canada, [2003] T.C.J. No. 42 T.C.C.

• income tax treatment of CAHC expenses

Krop v. College of Physicians and Surgeons of Ontario, [2002] O.J. No. 308 S.C.J.

• regulation of practitioners

Krop v. College of Physicians and Surgeons of Ontario, [2002] S..C..C. 382.

• regulation of practitioners

Litman, M.L., "Fiduciary Law and For-Profit and Not-For-Profit" in Timothy Caulfield and Barbara von Tigerstrom, eds. Health Care Reform & the Law in Canada (Edmonton: The University of Alberta Press, 2002) 85.

• standard of care

Mackay, B., "Changing Face of Canada is Changing the Face of Medicine" (2003) 168:5 CMAJ 599.

• ethical issue of respect for cultural diversity

McNamara, L., Nelson E. & Windwick B., "Regulation of Health Care Professionals" in Downie, Caulfield & Flood, eds. Canadian Health Law and Policy (Toronto: Butterworths, 2002) 84.

• regulation of practitioners

Melnychuk v. Canada, [2002] T.C.J. No. 94 T.C.C.

• income tax treatment of CAHC expenses

Natural Health Products, C. Gaz. 2001. I. 4912.

• regulation of NHPs

Picard E.& Robertson, G.B., Legal Liability of Doctors and Hospitals in Canada, 2^nd ed. (Toronto: Carwsell, 1996) 246.

• regulation of practitioners
• civil liability
• negligence
• standard of care
• consent
• informed consent

Seney v. Crooks [1998] A.J. No. 1060 C.A.

• informed consent

Silversides, A., "More Provinces Protecting MDs who Practise Alternative Medicine" (2002) 166:3 CMAJ 367.

• regulation of practitioners

Somerville, M., The Ethical Canary: Science, Society and the Human Spirit, (New York: Viking, 2000) 175.

• Consent
• Capacity
• Informed consent
• Ethical issues of autonomy, beneficence, non-maleficence

Stone, J. "Ethical Issues in Complementary and Alternative Medicine" (2000) 8 Comp. Therapies in Med. 207.

• ethical issues of autonomy, CAHC practice, CAHC research

Stone, J. An Ethical Framework for Complementary and Alternative Therapists, (New York: Routledge, 2002).

Stone, J. & Matthews, J., Complementary Medicine and the Law, (Oxford: Oxford University Press, 1996).

• regulation of NHPs
• regulation of practitioners
• civil liability
• negligence
• standard of care
• informed consent
• criminal liability
• ethical issues of autonomy, beneficence, non-maleficence, justice, CAHC practice,

Studdart D.M., et al. "Medical Malpractice Implications of Alternative Medicine" (1998) 280:18 JAMA 1610.

• negligence
• standard of care

Sugarman J. & Burk L., "Physicians' Ethical Obligations Regarding Alternative Medicine" (1998) 280:18 JAMA 1623.

• ethical issues of autonomy, beneficence, non-maleficence, justice, respect for cultural diversity

Thorne, S. et al. "Ethical Dimensions in the Borderland Between Conventional and Complementary/Alternative Medicine" (2002) 8:6 J. Alt & Comp. Med. 907.

• regulation of CAHC practitioners
• standard of care
• informed consent
• ethical issues and CAHC practice
• ethical issues and CAHC research
• ethical issues and health policy

York University Centre for Health Studies, Complementary and Alternative Health Practices and Therapies - A Canadian Overview. (Toronto, York University: Strategies and Systems for Health Directorate Health Promotion and Programs Branch, 1999).

• regulation of NHP industry
• regulation of practitioners
• standard of care
• capacity
• informed consent
• income tax treatment of expenses associated with CAHC
• public health insurance
• private health insurance
• ethical issues including autonomy, respect for cultural diversity, justice and cost