Biomedical subjects
Publications and source records attributed to K Capen.
Lawyer Karen Capen looks at the implications of a recent Alberta court case involving chronic fatigue syndrome. She thinks Canada's physicians should pay close attention to this precedent-setting case.
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Although coverage of the recent release of the Krever commission's findings concentrated almost solely on recommendations concerning the safety of the blood-supply system, lawyer Karen Capen says physicians can take many lessons from this exhaustive report that extend far beyond blood. She describes it as "must reading" for physicians and says their organizations should use it as a teaching tool.
Cases involving child abuse have received wide coverage lately, as has a case involving possible risk to a fetus because of a mother's addiction to solvents. Lawyer Karen Capen discusses the legal issues facing doctors over the reporting of child abuse and outlines their obligations and responsibilities.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Sexual and other forms of harassment are common in the medical work environment. Physicians who are employers and medical educators as well as clinicians should be aware they may be held responsible for the harassing conduct of colleagues, employees and others unless measures are in place in the workplace that show reasonable efforts have been made to prevent the behaviour and deal with it appropriately when it occurs. This article uses a US case to illustrate the evolution of a sexual-harassment complaint over several years.
The growing interest in alternative medicine has come to the attention of both Canadian licensing bodies and the courts. Two recent cases, a disciplinary hearing and a medical-malpractice action, illustrate that physicians need to understand the range and complexity of issues surrounding nonconventional therapies and their clinical use.
PHYSICIANS SHOULD EXERCISE GREAT CAUTION and probably seek legal counsel if they decide to place specific limits on the work they will do or patients they will see, lawyer Karen Capen warns. The BC Human Rights Council recently ruled that a physician had violated the province's Human Rights Act when he declined to provide artificial insemination for a lesbian couple. The physician argued unsuccessfully that increased risks of litigation constituted a bona fide and reasonable justification for denying the service.
Lawyer Karen Capen says funding cutbacks that have affected the services physicians can provide may cause legal problems for Canada's doctors. If cutbacks affect the care that is being provided, they should be discussed with the patient and noted on the chart. She says physicians have "good reason to be concerned" about increasing pressures that create an imbalance between health care resources and the demand and need for services. For some doctors, these have resulted in court cases.
Negligence is sometimes established on the basis of lapses in communication and patient care management that, in hindsight, could have been avoided. A recent BC court case concerned a patient who died because of a ruptured aneurysm. A Supreme Court judge found that some of the physicians involved had failed in their duty to diagnose the patient's condition properly, or failed to communicate to one another significant signs of the patient's illness, and failed to refer him in time to the medical specialists who could have diagnosed and treated his condition promptly.
Most of the legal cases that follow the informed-consent standard set in recent court cases have involved surgical procedures. However, issues concerning a pregnant British Columbia mother who contracted chicken pox and whose child was subsequently born with severe medical complications demonstrate the complexity of medical decision making and the inadequacy of established legal requirements, especially when consent has dimensions beyond technical considerations usually associated with medical procedures. The problem physicians face, says lawyer Karen Capen, is to find a way to balance a range of professional responsibilities and the overriding fiduciary obligation to patients in matters associated with informed decision making and consent.
Recent fee increases announced to the Canadian Medical Protective Association (CMPA) and the Ontario government's plan to stop its CMPA rebate program for the province's physicians have put the spotlight on medical liability insurance. In this examination of the role played by the CMPA, Ottawa lawyer Karen Capen notes that quality service and attention to physician-patient communication will in most cases ensure a litigation-free professional life.
Ottawa lawyer Karen Capen examines the case of five Ontario physicians who faced charges of professional misconduct after a patient they cared for died in 1988. The investigation, which focused on the concept of "most responsible physician," serves as a cautionary tale for all doctors who share the care of a patient with colleagues.
Lawyer Karen Capen discusses the legal aspects of documents such as living wills, advance directives and "proxies for personal care." Most provinces are enacting legislation to govern such directives, and physicians should keep abreast of new legislation and regulations in their jurisdiction.
Physicians' now routine use of fax machines has drawn attention to the need for office policies and procedures to protect the confidentiality of medical records. The growing popularity of faxed prescriptions has also raised questions about prescribing violations. Lawyer Karen Capen outlines some of the legal concerns about the faxing of medical information, and suggests some precautions physicians can take to avoid problems.