Authors' objectives:

This paper is part of a series of Health Technology Assessment Initiatives to support Regional Health Authorities in the use of evidence in decision-making

This paper provides information on contemporary legal considerations for decision-making in health care systems. The methodology is an analytical mix of case law, legislation and secondary sources.

Authors' recommendations: With increased public awareness of emerging and evolving technology, higher expectations, consumerism, and the focus on quality, those empowered to make decisions and to deliver health care services will face increased scrutiny and legal responsibility. Public expectations of health care will continue to exert tremendous pressure on decision-makers. Canadians want to know that health care services will be there when they need them and that the services they receive are of a high quality. Technological advances in genetics and treatments, as well as targeted advertising and consumerism, contribute to expectations and demands which may exceed available resources. Health research, based on valid methodology with generalizable results to the local context, will continue to play a valuable role in evidence-based decision-making. Creating organizational cultures that foster research and innovative practices in a research model, at all levels of the organization, will contribute to quality of services that are cost-ef. cient and achieve expected results or outcomes. Health care providers will continue to be held to a high standard of care and there is potential that the standard of care will be a higher standard than what may be generally accepted practice. The onus will be on health care providers to be aware of evolving technologies and differentiate between those which are effective and ineffective. Clinical practice guidelines based on sound evidence will provide a measure of comfort. Informed consent should include patient awareness of wait times, associated risks, and alternatives. In the past, decision-makers were immune from the effects of policy decisions, where the decisions were made in good faith and with due diligence. Increased accountability, the potential amendment of the Criminal Code under Bill C-284 to increase liability where staff or the public are at risk, a legislated Patient Charter of Rights, mandatory reporting of adverse events in some provinces, and the call for tort reform will have an impact on liability. Liability for decision-makers is an evolving area of the law and will need to be monitored closely. However, a process based on the value of improving the quality of care, and a decision-making framework based on evidence-based outcomes that is accountable and transparent and follows the principles of fundamental justice, will reduce both the risk of legal challenges and the success of challenges that will undoubtedly be raised.

Project Status: Completed

Year Published: 2003

URL for published report: https://www.ihe.ca/advanced-search?type=1020

English language abstract: An English language summary is available

Publication Type: Not Assigned

Country: Canada

Organisation Name: Institute of Health Economics

Contact Address: 1200, 10405 Jasper Avenue, Edmonton, Alberta, Canada, T5J 3N4. Tel: +1 780 448 4881; Fax: +1 780 448 0018;

Contact Name: djuzwishin@ihe.ca

Contact Email: djuzwishin@ihe.ca

Copyright: <p>Alberta Heritage Foundation for Medical Research (AHFMR)</p>