News Archive
LATEST CIFAR REPORT ON AI AND HEALTHCARE
Artificial intelligence (AI) will transform and democratize health care systems. Yet at the same time it presents clear risks and implementation issues, such as those connected to discrimination, informed consent, safety/quality (and liability for harm), and privacy. This report from a group of experts across AI, law, ethics, policy, and medicine, addresses the core question: How can Canada maximize the potential benefits of the use of AI in health care while minimizing potential dangers?
CANIMMUNIZE MAKES WAVES IN NOVA SCOTIA
A made-in-Ottawa vaccine booking system is winning praise in Nova Scotia, where it is being used for the COVID-19 vaccine rollout, and drawing unfavourable comparisons to Ontario where booking a vaccine has become the source of widespread frustration. The Ottawa company CANImmunize built Nova Scotia’s COVID-19 vaccine booking system. The company grew out of an app created by CHLPE's Dr. Kumanan Wilson, a physician and senior researcher at the Ottawa Hospital Research Institute, alongside engineer and now chief technology officer Cameron Bell. They created it almost a decade ago after a woman at a playground complained about the paper-based system of keeping track of vaccines using yellow cards. She suggested Wilson create an app to help people do so...
OCCUPATIONAL HEALTH AND SAFETY
Professor Katherine Lippel is the Canada Research Chair in Occupational Health and Safety Law, leading research to inform policies and legislation that improve worker health and protection. Here we spotlight a couple of her recent open access publications (in French):
Retour au travail après une lésion professionnelle : étude de cas sur les effets du droit sur l’expérience des justiciables
This article reports on findings from a Quebec study investigating the experiences of precariously employed or mobile workers (a fly-in / fly-out health care worker and two employees of temporary employment agencies) who attempt to return to work after a work injury. It illustrates the unexpected effects of legal regulations and their associated economic incentives on the return-to-work process. And it examines mechanisms by which the regulatory framework that governs workers’ compensation, occupational health and safety, and the right to equality lead to less than satisfactory outcomes in disability prevention.
L’indemnisation des travailleurs précaires en Ontario : résistance des employeurs et droit de parole limité pour les victimes de lésions professionnelles
The policies and practices of workers’ compensation have barely kept pace with the changing worker and employer needs created by the growth of precarious forms of employment. This study focused on how well workers’ compensation and return to work policies in Ontario fit the needs of precariously employed workers. Three domains where return to work policies fit uneasily with the precariously employed workers were identified, including knowledge and power contrasts between well informed employers and vulnerable workers, injury attribution challenges, and worker fear of speaking out about accidents.
VACCINE CERTIFICATES SHOULD NOT COME AT EXPENSE OF OTHER COVID PRIORITIES
While there’s mounting pressure to create a vaccine certificate system, it risks diverting focus and funds from other work to combat COVID-19. One example is tackling persisting vaccine nationalism, which now constitutes an obstacle to aggressive vaccination to achieve global herd immunity. Another important competing priority is the intensification of research on second-generation vaccines, or even a universal SARS CoV-2 vaccine to account for emergent variants, which are now threatening to torpedo progress on vaccine development. Then there is the focus on tackling the extremely disruptive effects of COVID-19 itself. Professor Chidi Oguamanam writes in Policy Options...
PRIVACY CONCERNS COMPLICATE VACCINE PASSPORTS
Vaccine passports are a form of documentation that prove people have been inoculated against specific diseases. Countries around the world are developing them to allow people who are vaccinated against COVID to be able to bypass certain pandemic restrictions to once again begin travelling or attending places like restaurants, clubs, bars or gyms. The federal government has a number of privacy considerations to make as it looks into developing a COVID vaccine passport system, according to experts. Karen Eltis contributes in this piece in iPolitics.
VACCINE PASSPORTS DONE EQUITABLY
Around the world, governments and other organizations are developing COVID-19 vaccine passports—documentation to allow vaccinated people greater mobility and access to other services. But vaccine passports are controversial: sources of opposition include scientific questions—for example, whether vaccinated people can still transmit the virus—and concerns about privacy, especially in connection with digital passports. Each of these are likely to be solvable problems. Evidence of vaccine effectiveness continues to accumulate, and privacy concerns could be mostly addressed by adopting passport alternatives that satisfactorily protect an individual’s information.
A deeper and more intractable concern is that any system of vaccine passports risks being discriminatory and inequitable. Consider the inequities we see already in the distribution of COVID-19 vaccines: supplies and distribution have predictably favored richer countries. Marginalized groups are less likely to be vaccinated—often because of worse access, but also because of vaccine hesitancy based on intelligible mistrust of government and historical experiences of medical abuse. For people who are unable to be vaccinated because of their health status or religion, a vaccine passport regime could unfairly frustrate their return to normal life...
Read the full text of the article by Ryan Tanner & Colleen M. Flood in JAMA >
Also check out other recent articles by Professor Colleen Flood and Dr. Kumanan Wilson's team on immunity passports:
Mandatory vaccination for health care workers: an analysis of law and policy
CALL TO ACTION FOR BETTER PLANNING AND BETTER CARE THROUGH BETTER DATA
Safe, high-quality care for patients is tied to safe, high-quality work for health workers. Although COVID-19 has heightened our concerns, many health workforce planning issues predate the pandemic. Without essential health workforce data, we will continue to make decisions in the dark, with incomplete, misleading and non-standardized information that is disconnected from the real-world experience of those at the point of care. The result is inadequate planning for population needs, inefficient deployment of health workers, persistent maldistribution of services, and a perpetuation of current inequities.
Join the call on the Government of Canada to support health workers by making significant and immediate investments to enhance the data infrastructure that provinces, territories, regions and training programs need to better plan for and support the health workforce.
WHAT’S PREVENTING CANADA FROM CREATING A ROBUST HEALTH DATA INFRASTRUCTURE?
High-quality scientific evidence, and the data and analysis on which it is based, is essential to inform the immediate needs of COVID-19 policy and effective health policy more generally. In the current emergency pandemic context, it could have saved lives and reduced serious illness. This situation is not new. Canada’s health information has been sub-standard for decades. The pandemic has only served to make the problems more visible. It’s time the federal government provided much stronger leadership so Canada can finally have an effective health data infrastructure. Professor Michael Wolfson writes in Policy Options...
Full text >
See also Professor Wolfson's recent op-ed in the Ottawa Citizen:
Full text >
"IT’S A MINEFIELD": HOW PUBLIC TRUST IN CANADA'S TOP DOCTORS IS UNDERMINED BY POLITICS AMID THE COVID-19 PANDEMIC
From a federal level with Dr. Theresa Tam, to Ontario’s Dr. David Williams and Alberta’s Dr. Deena Hinshaw, Canada's top doctors have been in the spotlight since COVID-19 was declared a pandemic in March 2020. We've seen in the past year how it's been increasingly difficult for chief medical officers of health (CMOHs) to generate public trust in a government's COVID-19 response while maintaining their own professional integrity amid a health crisis. Professor Patrick Fafard (Public and International Affairs) contributes.
CANADA’S LONG ROAD TO A VACCINE INJURY COMPENSATION PROGRAM
Work is underway on a new pan-Canadian no-fault vaccine injury compensation program, but it may be months before the scheme is operational. Dr. Kumanan Wilson appears in CMAJ News.
UNEXPECTED LESSONS FROM COVID-19: A U.K. DOCTOR'S PERSPECTIVE
Heidi Paine was a resident physician in one of the hardest hit hospitals in London, England during the early days of the COVID pandemic. She is currently a visiting researcher at CHLPE, where she brings her experiences to bear in thinking about the many facets of COVID's impact on the healthcare system. Read her blog post here...
CANADA'S HEALTH WORKFORCE DIGITAL RESEARCH INFRASTRUCTURE
Health workers are the foundation of all health systems. They account for more than 10% of all employed Canadians and over 2/3 of all health care spending, not including the personal and public cost to their training. That amounts to $175 billion in 2019, or nearly 8% of Canada’s GDP. Nonetheless, health workforce research secures less than 3% of health services and policy research funds, and investments in necessary data infrastructure from governments have not materialized. Canada lags behind comparable OECD countries including the U.K., Australia and the U.S. in terms of health workforce data and digital analytics. The gaps in our knowledge about the health workforce have especially been exposed during the COVID-19 pandemic. The consequences of poor health workforce data and science range from sub-optimal health workforce utilization to poor population health outcomes...
Professor Ivy Bourgeault writes in this white paper submitted to the New Digital Research Infrastructure Organization.
Full text >
See also a related op-ed by Professor Bourgeault in the Hill Times.
Full text >
THE COVID-19 PANDEMIC PRESENTS AN OPPORTUNITY TO DEVELOP MORE SUSTAINABLE HEALTH WORKFORCES
This commentary addresses the critically important role of health workers in their countries’ more immediate responses to COVID-19 outbreaks, and provides policy recommendations for more sustainable health workforces. Paradoxically, pandemic response plans in country after country often fail to explicitly address health workforce requirements and considerations...
Professor Ivy Bourgeault is first author on this new open-access publication in Human Resources for Health.
WHY SCHEDULING AND TRACKING ARE ESSENTIAL TO THE COVID VACCINE ROLLOUT
Dr. Kumanan Wilson appeared on the Hill Times Hot Room podcast to discuss how the technologies used to schedule and track the rollout are essential to ensuring that the largest healthcare intervention in human history runs smoothly.
MANDATORY CHILDHOOD IMMUNIZATION PROGRAMS: A ROLE FOR RELIGIOUS AND CONSCIENCE BELIEF EXEMPTIONS?
Mariette Brennan along with CHLPE members Kumanan Wilson and Vanessa Gruben are authors of this new paper, available freely on SSRN. Childhood immunization programs are vital for public health. This paper analyzes the constitutionality of religious and conscience belief exemptions in vaccination programs in terms of both routine childhood immunizations and in the case of a COVID-19 vaccine. The paper proposes ways to restructure religious and conscience belief exemptions and provides guidance on how to move childhood immunization programs forward in the COVID-19 era.
TWO $15K LL.M. BURSARIES IN BIOMEDICAL LAW
Professor Jennifer Chandler is looking for two excellent researchers interested in doing their Masters in Law under her supervision at the University of Ottawa’s Faculty of Law. A research bursary of $15,000 is available for one student to participate in each of:
- Legal Definition of Death in an Age of Techno-Scientific Change
- Presumed Consent (Opt-Out) Systems for Organ Donation
CONFERENCE ON ORGAN DONATION & TRANSPLANTATION – REGISTRATION NOW OPEN
Registration is now open for Key Policy Issues in Organ Donation & Transplantation, an online conference coming June 17–18. Spanning nine panels over two days with speakers from medicine, law, policy, ethics, and patient partners. We hope to see you there!
ANNUAL REPORT 2019–20
CHLPE is excited to release our annual report for 2019–20! Find out what we've been up to in this black swan of a year.
MAJOR NEW PUBLICATION IN NEJM ON SPONTANEOUS RESUMPTION OF CARDIAC ACTIVITY
Bertram Loeb Research Chair and CHLPE member Jennifer Chandler was part of the international multi-disciplinary team conducting this study under the leadership of Dr. Sonny Dhanani, CHEO. Professor Chandler contributed ethical, legal and social scientific expertise to the project. This work is key to the practice of organ donation after cardiac death, where speculation about the possibility of auto-resuscitation (spontaneous resumption of heartbeat) has led to ethical and legal questions about how long to wait following cardiac arrest before removal of organs for transplantation. Professor Chandler is presently involved in a follow-on study examining neurological activity during the dying process.
THE STRANGE THING THAT IS THE REVIEW BOARD
Guillaume Ouellet and Emmanuelle Bernheim write in response to recent columns by Patrick Lagacé on the follow-up of persons found not criminally responsible by reason of mental disorder.
PETER LIU NAMED TO ORDER OF ONTARIO
CHLPE Advisory Committee member Dr. Peter Liu has been appointed to the 2020 Order of Ontario, the province’s highest honour. Dr. Liu is credited for having raised the international profile of Canadian cardiovascular research through his leadership at top national institutions. Congratulation Dr. Liu!
THE DANGERS OF PLAYING POLITICS WITH COVID-19 CURES
As treatments for COVID-19 are sought, there also needs to be a stronger stance against promoting unproven medicines. Faculty of Law Ph.D. Candidate Adam Houston writes in African Arguments.
WHEN ARE YOU ACTUALLY ALLOWED TO TRAVEL AND HOW WILL THE GOVERNMENT CHECK?
Everyone knows international trips during the COVID-19 pandemic are highly discouraged. But what are Canadians legally allowed—and not allowed—to do when it comes to travelling abroad? The answer is more complicated than you might think. CHLPE's Martha Jackman (Law) contributes (Global News).
WHAT DOES OUR FUTURE AFTER THE PANDEMIC LOOK LIKE?
In the weeks and months ahead, politicians, public policy experts, academics, businesses, non-profit organizations and the general public will have important choices to make in rebuilding our lives, our societies and the international order. Vanessa MacDonnell, Sophie Thériault, and Sridhar Venkatapuram write in La Presse.
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