The application process for "Santéships" 2021–22 is now open! Santéships are opportunities for first-year students enrolled at the University of Ottawa Faculty of Law to be mentored as a research assistant under a professor in the Centre for Health Law, Policy and Ethics in the winter semester of 2022. Successful applicants receive a bursary of $1,000 and engage in a research project within the professor's broader research program (60 hours total).
Digital technologies are briskly transforming how the law is administered. The eco-system in which courts operate has shifted sharply and precipitously during the pandemic, which dramatically hastened "judicial digitization" on a scale and at a pace that our court system would never have contemplated previously. This has culminated, for example, in court proceedings transpiring on Zoom, Teams and the like. This de facto marriage of convenience may in a word best be characterized as an unstructured partnership prematurely born out of necessity… Karen Eltis writes in the Federmann Cyber Security Research Centre's Cyberlaw Blogospace
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When vaccine passports or certificates launched in Ontario it was a development welcomed by some and strongly opposed by others. The launch raised a myriad of legal, ethical, privacy, and policy issues as jurisdictions around the world grapple with the continued global pandemic and the unusual requirements of demonstrating vaccination in order to enter some public or private spaces. On September 27 CHLPE's Colleen Flood, Bryan Thomas, and Kumanan Wilson were joined by Vivek Krishnamurthy, Director of uOttawa's Canadian Internet Policy and Public Interest Clinic (CIPPIC), as well as Marie-Eve Sylvestre, Dean of Civil Law. Catch up on the full video of the webinar and discussion here.
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Also hear Colleen Flood on the Law Bytes Podcast, hosted by Professor Michael Geist.
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CHLPE’s Patrick Fafard was interviewed by Markham Hislop on the role of Science Advisory Groups and scientific evidence and advice in general in how governments manage the pandemic.
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AI in healthcare has the potential to improve clinical outcomes, healthcare quality, and objectivity in clinical decision-making. However, it also has the potential to perpetuate or exacerbate discrimination in healthcare by producing outputs on the basis of arbitrary traits such as race, sex, and sexual orientation taken in ways that are not clinically relevant. Such discrimination may arise from any combination of algorithmic bias (bias in coding or the machine learning implementation) or data bias (the use of non-representative training data, including data masking systemic discrimination). If these problems are not mitigated, the benefits of AI in healthcare AI are likely be realized at the expense of marginalized groups. This is a complex problem that requires concerted responses from government as well as private actors...
Bradley Henderson, Colleen M. Flood, and Teresa Scassa write in preprint, hosted on SSRN.
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Find out more about the Machine M.D. research project >
Canada’s federal election results had barely been counted when the Premiers resumed making their well-worn demands for more federal health care money. Instead of thanking Ottawa for the billions it has already provided for fighting COVID-19, or asking for short-term pandemic-related funding, the ritual chorus seeks ever-increasing amounts of money for decades to come. Granted, the need for more money certainly feels urgent right now. A number of provinces are having difficulty even staffing their hospitals, after almost two years of burnout-inducing working conditions for front-line health care workers. However, the premiers’ multibillion-dollar asks have been for unconditional long-term funding, well beyond the scope of the current crisis. It is entirely reasonable to ask them to explain how the money will be used—especially since spending more on health care does not automatically mean better health outcomes. CHLPE's Michael Wolfson writes.
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Ontario's health care system has been battered by COVID-19, medical staff have been pushed to their limits, and there's a massive backlog of diagnostic and surgical procedures built up due to shutdowns. Has the time come for private health care to help fill the gaps? CHLPE Director Colleen M. Flood appeared in a panel on TVO's The Agenda.
Chair of CHLPE's Advisory Board, Professor David Sweanor, as well as CHLPE member Patrick Fafard were among 100 signatories of an open letter to the 182 parties (countries) to the Framework Convention on Tobacco Control to take a more positive stance on tobacco harm reduction. The letter pushes back against WHO’s drive for prohibition or excessive regulation and taxation of vaping products, heated and smokeless tobacco products, and novel oral nicotine products: "Cigarettes and other smoked tobacco products are responsible for the vast majority of the deaths caused by tobacco use globally. Smoke-free nicotine products offer a promising route to reducing the harms arising from smoking. There is compelling evidence that smoke-free products are much less harmful than cigarettes and that they can displace smoking for individuals and at the population level."
CHLPE's Michael Wolfson is Principal Investigator on WellCare, a CIHR-funded project investigating the future of elder care. WellCare is part of a broader international endeavour headed by the EU under the banner Better Lives, Better Years.
An increasing proportion of the population at higher ages combined with increasing life expectancies and declining birth rates could generate major tensions for meeting Canada's elder care needs by 2050. Such needs are approached by some combination of informal care provided by family members and formal care either privately purchased or from publicly funded government programs. The WellCare project will compare the many ways formal and informal care is provided across four countries—Spain, Austria, the U.K., and Canada. With this analysis, complemented by computer modelling, the project will illuminate alternative approaches to meeting caring responsibilities. A central aspect of the analysis will be inter-generational equity. The results will include new insights and actionable policy ideas for Canada. If you would like to learn more, please get in touch at healthlaw@uottawa.ca.
CHLPE's Colleen M. Flood and Bryan Thomas are public health sub-editors for Lex-Atlas: COVID-19 (LAC19). With nearly 200 jurists participating, this large-scale international project builds a report and analysis of national legal responses to COVID-19 around the world. National responses have varied considerably. Epidemiological performance is but one measure, and a difficult one to judge when transparency is doubtful. Countries have employed emergency powers differently, but understanding them requires attention to the broader constitutional structure in which they are situated. It is hoped LAC19 will assist policy makers in future pandemic preparedness, to fashion ongoing responses to COVID-19, and to assist scholars and historians to come to evaluative judgments of state responses. The project is also a great source for original news and analysis articles, blog posts, and more.
Read Editorial (part I): Mandatory vaccination and the law (Bryan Thomas, co-author) >
Read Editorial (part II): Conditional policies and vaccine passports (Bryan Thomas, co-author) >
While the world’s wealthiest countries are paying hesitant citizens to get vaccinated against COVID-19 and stockpiling vaccine supply for potential booster shots, the developing world is struggling to get even a first vaccine into the arms of its citizens. The fact that some of this supply is about to reach its expiration date just adds insult to injury. Adam Houston writes in BioSpace...
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CHLPE's first Summer Institute in Health Law ran in August, focussing on issues of COVID-19. The Institute was comprised of 11 morning/afternoon sessions helmed by 14 professors. 33 attendees including students, nurses, physicians, lawyers, policymakers, researchers, and more completed the program. We had hundreds of applications for a very limited number of spots. But this was only the first in an annual series of Summer Institutes, so we look forward to welcoming a new cohort next year. Congrats to our first round of alumni!
Michael Da Silva, Post-Doctoral Fellow at CHLPE and Lead Research Associate on the AI + Society Initiative, has been appointed to a Health Canada external reference group to tackle how to regulate "adaptive machine learning" artificial intelligence (AI) in medical devices. Such AI changes its operation in response to data acquired over time, with the aim of improving its performance. For example, a device for diabetes management could adapt based on how a patient’s body responds to treatment. This is an exciting advance but it also prevents us from fully know how a device's risks will evolve with use. By current Health Canada regulations, this effectively bars such devices from the Canadian market. The reference group will advise on ways to evolve our regulations to open the door to adaptive AI without unduly compromising safety standards.
As the COVID-19 pandemic took hold in 2020, Chief Medical Officers (CMOs) entered the public spotlight like never before. Amidst this increased visibility, the role is deeply contested. Much of the disagreement concerns whether CMOs should act independently of the government: while some argue CMOs should act as independent voices who work to shape government policy to protect public health, others stress that CMOs are civil servants whose job is to support the government. Such debates about the CMO role can be explained by its inherently contradictory nature, which requires incumbents to balance their commitments as physicians with their mandates as civil servants...
Margaret Macaulay, Patrick Fafard and Adèle Cassola write in the Globe and Mail as well as a deeper take in the Journal of Epidemiology & Community Health.
Canada’s response to the COVID-19 pandemic has been plagued by many of the same challenges that have affected its response to public health threats over the past two decades. These challenges largely relate to how the federal, provincial and territorial governments work together in a federal system in which responsibility for public health duties is provincial, territorial or local, but in which pan-Canadian coordination is critical. Creating a Canadian Immunization Services using the model for the Canadian Blood Services could address historical challenges related to variability in immunization practices and sharing of data across Canada. Kumanan Wilson, Graham Sher & Jane Philpott write in CMAJ.
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The University of Ottawa has been awarded four new Canada Research Chairs (CRC), one of which is CHLPE's Emmanuelle Bernheim. Emmanuelle's research looks at improving access to the justice system for diverse groups, particularly those living with mental health issues. Read in Droit Inc. about Professor Bernheim's new Social Rights Interdisciplinary Clinic, aiming to help persons with mental health issues and in conditions of homelessness in the Ottawa area.
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Professor Marie-Eve Sylvestre is co-author of Red Zones: Criminal Law and the Territorial Governance of Marginalized People, which recently won the 2021 W. Wesley Pue Prize. Congratulations Marie-Eve! In Red Zones, Marie-Eve Sylvestre, Nicholas Blomley, and Céline Bellot examine the court-imposed territorial restrictions and other bail and sentencing conditions that are increasingly issued in the context of criminal proceedings. Drawing on extensive fieldwork with legal actors in the criminal justice system, as well as those who have been subjected to court surveillance, the authors demonstrate the devastating impact these restrictions have on the marginalized populations—the homeless, drug users, sex workers and protesters—who depend on public spaces. On a broader level, the authors show how red zones, unlike better publicized forms of spatial regulation such as legislation or policing strategies, create a form of legal territorialization that threatens to invert traditional expectations of justice and reshape our understanding of criminal law and punishment.
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Five authors including CHLPE's Bryan Thomas, Colleen Flood, and Kumanan Wilson examine vaccine passports in the context of Charter rights, privacy rights, and implementation in this C.D. Howe Institute report. The report concludes that a well-designed vaccine passport regime, backed by an equitable vaccine distribution scheme, will likely withstand a Charter challenge. And that privacy issues raised by vaccine passports can be adequately addressed through careful design and regulation. The report suggests some broad principles for the design of a vaccine passport regime, including that passport gating should be limited to non-essential services and that wherever feasible, unvaccinated persons should be accommodated with rapid testing.
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See also COVID-19 Vaccine Certificates: Key Considerations for the Ontario Context by the Ontario COVID-19 Science Advisory Table (Colleen Flood, Kumanan Wilson members).
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And Ottawa Board of Trade Supports Vaccination Passports as a Boon for Businesses in the Ottawa Citizen, interviewing Kumanan Wilson.
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As the COVID-19 pandemic continues, the World Health Organization (WHO), the International Health Regulations (IHR) and countries’ adherence to IHR guidance are coming under scrutiny and review. The IHR require states parties to designate or establish national "focal points" to facilitate information sharing about disease events with WHO. Focal points are responsible for timely notification to WHO of relevant health events, responding to WHO Secretariat requests for event-related information, and ensuring that messages and advice from WHO are disseminated to the relevant sectors within the country. At the request of WHO, a team led by CHLPE's Dr. Kumanan Wilson evaluated the ability of focal points to carry out their functions through in-depth interviews and quantitative surveys.
Read summary findings and recommendations >
Indigenous patients who have had surgery are nearly a third more likely to die after their procedures than other populations in Canada and face higher risks of complications, new research suggests. The Canadian Medical Association Journal published a systematic review consisting of 28 separate studies. The research involved roughly 1.9 million participants, about 10 per cent of whom identified as Indigenous, to assess the surgical outcomes for Indigenous patients in Canada across a range of procedures. CHLPE's Jason Nickerson is co-author.
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Breast cancer risk has conventionally been assessed using family history and rare high/moderate penetrance pathogenic variants (PVs). In addition to these PVs, it is now possible to use increasingly predictive polygenic risk scores (PRS) as well. PRS information would be the most important advance in enabling effective risk stratification for population-wide breast cancer screening. CHLPE's Michael Wolfson is first author in Genetics in Medicine...
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Canadian leadership on vaccine equity was an early casualty of COVID-19. A year into the pandemic, Canada's international image is that of a country who secured over ten doses of scarce vaccine per capita. Weeks after its vaccine portfolio made headlines worldwide, Canada remained silent on what would happen to its extra few hundred million projected doses; Prime Minister Justin Trudeau finally made a vague commitment to share surplus, not in an official policy but in a television interview. Little has happened since... Adam Houston writes in The Lancet (open access).
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The global initiative COVAX was meant to ensure poorer countries weren't left behind as COVID-19 vaccines rolled out. But wealthy countries struck their own agreements to jump to the head of the line, says CHLPE's Jason Nickerson, the humanitarian representative to Canada for Doctors Without Borders. Jason discusses Canada's role in how COVAX fell short on CBC's The Current for June 23.
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CHLPE's Professor Jennifer Chandler was invited to deliver a keynote lecture in the III International Colloquium on the Philosophy of Neuroscience, organized by the ANPOF Working Group on the Philosophy of Neuroscience. Her presentation addressed legal challenges arising at the cutting edge of neurological therapies: The Tyrannical or Vulnerable Self: Should Ulysses Agreements Be Used to Address Significant Personality and Behavioural Change in Capable Patients Receiving Deep Brain Stimulation?
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Key Policy Issues in Organ Donation & Transplantation took place June 17–18 2021, with 200 attendees and 30 speakers spread over 9 panels. The conference was chaired by CHLPE Interim Director Professor Jennifer Chandler, with panels chaired by various CHLPE members as well as members of the Canadian Donation and Transplantation Research Program (CDTRP). Full videos of all panels are available to stream at www.ottawahealthlaw.ca/odtconference. See also www.ottawahealthlaw.ca/pastevents for videos of all our other recent events.
