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CMA PolicyBase

Policies that advocate for the medical profession and Canadians


28 records – page 1 of 3.

Assisted reproduction (Update 2001)

https://policybase.cma.ca/en/permalink/policy197
Last Reviewed
2018-03-03
Date
2001-05-28
Topics
Ethics and medical professionalism
  1 document  
Policy Type
Policy document
Last Reviewed
2018-03-03
Date
2001-05-28
Topics
Ethics and medical professionalism
Text
Like all scientific and medical procedures, assisted human reproduction has the potential for both benefit and harm. It is in the interests of individual Canadians and Canadian society in general that these practices be regulated so as to maximize their benefits and minimize their harms. To help achieve this goal, the Canadian Medical Association (CMA) has developed this policy on regulating these practices. It replaces previous CMA policy on assisted reproduction. Objectives The objectives of any Canadian regulatory regime for assisted reproduction should include the following: (a) to protect the health and safety of Canadians in the use of human reproductive materials for assisted reproduction, other medical procedures and medical research; (b) to ensure the appropriate treatment of human reproductive materials outside the body in recognition of their potential to form human life; and (c) to protect the dignity of all persons, in particular children and women, in relation to uses of human reproductive materials. Principles When a Canadian regulatory regime for assisted reproduction is developed, it should incorporate the following principles: For the regulation of assisted reproduction, existing organizations such as medical licensing authorities, accreditation bodies and specialist societies should be involved to the greatest extent possible. If the legislation establishing the regulatory regime is to include prohibitions as well as regulation, the prohibition of specific medical and scientific acts must be justified on explicit scientific and/or ethical grounds. If criminal sanctions are to be invoked, they should apply only in cases of deliberate contravention of the directives of the regulatory agency and not to specific medical and scientific acts. Whatever regulatory agency is created should include significant membership of scientists and clinicians working in the area of assisted reproduction. Elements of a Regulatory Regime The regulation of assisted reproduction in Canada should include the following elements: Legislation to create a national regulatory body with appropriate responsibilities and accountability for coordinating the activities of organizations that are working in the area of assisted reproduction and for carrying out functions that other organizations cannot perform. The development and monitoring of national standards for research related to human subjects including genetics and reproduction. The regulatory body would work closely with the Canadian Institutes of Health Research, other federal and provincial research granting councils, the National Council on Ethics in Human Research and other such organizations. The development and monitoring of national standards for training and certifying physicians in those reproductive technologies deemed acceptable. As is the case for all post-graduate medical training in Canada, this is appropriately done through bodies such as the Royal College of Physicians and Surgeons of Canada and the College of Family Physicians of Canada. The licensing and monitoring of individual physicians. This task is the responsibility of the provincial and territorial medical licensing authorities which could regulate physician behaviour in respect to the reproductive technologies, just as they do for other areas of medical practice. The development of guidelines for medical procedures. This should be done by medical specialty societies such as the Society of Obstetricians and Gynaecologists of Canada (SOGC) and the Canadian Fertility and Andrology Society (CFAS). The accreditation of facilities where assisted reproduction is practised. There is already in Canada a well functioning accreditation system, run by the Canadian Council on Health Services Accreditation, which may be suitable for assisted reproduction facitilies. Whatever regulatory body is established to deal with assisted reproduction should utilize, not duplicate, the work of these organizations. In order to maximize the effectiveness of these organizations, the regulatory body could provide them with additional resources and delegated powers. Criminalization The CMA is opposed to the criminalization of scientific and medical procedures. Criminalization represents an unjustified intrusion of government into the patient-physician relationship. Previous attempts to criminalize medical procedures (for example, abortion) were ultimately self-defeating. If the federal government wishes to use its criminal law power to regulate assisted reproduction, criminal sanctions should apply only in cases of deliberate contravention of the directives of the regulatory agency and not to specific medical and scientific acts.
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Bicycle helmets

https://policybase.cma.ca/en/permalink/policy738
Last Reviewed
2017-03-04
Date
1992-08-19
Topics
Population health/ health equity/ public health
Resolution
GC92-41
a) That the Canadian Medical Association require the use of bicycle helmets at all activities that it sponsors or supports involving the use of bicycles, b) That the Canadian Medical Association recommend to its divisions that they require the use of bicycle helmets at all activities that they sponsor or support involving the use of bicycles.
Policy Type
Policy resolution
Last Reviewed
2017-03-04
Date
1992-08-19
Topics
Population health/ health equity/ public health
Resolution
GC92-41
a) That the Canadian Medical Association require the use of bicycle helmets at all activities that it sponsors or supports involving the use of bicycles, b) That the Canadian Medical Association recommend to its divisions that they require the use of bicycle helmets at all activities that they sponsor or support involving the use of bicycles.
Text
a) That the Canadian Medical Association require the use of bicycle helmets at all activities that it sponsors or supports involving the use of bicycles, b) That the Canadian Medical Association recommend to its divisions that they require the use of bicycle helmets at all activities that they sponsor or support involving the use of bicycles.
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Boxing (Update 2001)

https://policybase.cma.ca/en/permalink/policy192
Last Reviewed
2018-03-03
Date
2001-05-28
Topics
Population health/ health equity/ public health
  1 document  
Policy Type
Policy document
Last Reviewed
2018-03-03
Date
2001-05-28
Replaces
Boxing (1986)
Topics
Population health/ health equity/ public health
Text
The CMA recommends to the appropriate government authorities that all boxing be banned in Canada. Until such time, strategies to prevent injury should be pursued. Background The CMA considers boxing a dangerous sport. While most sports involve risk of injury, boxing is distinct in that the basic intent of the boxer is to harm and incapacitate his or her opponent. Boxers are at significant risk of injuries resulting in brain damage. Boxers are susceptible not only to acute life-threatening brain trauma, but also to the chronic and debilitating effects of gradual cerebral atrophy. Studies demonstrate a correlation between the number of bouts fought and the presence of cerebral abnormalities in boxers. There is also a risk of eye injury including long-term damage such as retinal tears and detachments. Recommendations: - CMA supports a ban on professional and amateur boxing in Canada. - Until boxing is banned in this country, the following preventive strategies should be pursued to reduce brain and eye injuries in boxers: - Head blows should be prohibited. CMA encourages universal use of protective garb such as headgear and thumbless, impact-absorbing gloves - The World Boxing Council, World Boxing Association and other regulatory bodies should develop and enforce objective brain injury risk assessment tools to exclude individual boxers from sparring or fighting. - The World Boxing Council, World Boxing Association and other regulatory bodies should develop and enforce standard criteria for referees, ringside officials and ringside physicians to halt sparring or boxing bouts when a boxer has experienced blows that place him or her at imminent risk of serious injury. - The World Boxing Council, World Boxing Association and other regulatory bodies should encourage implementation of measures advocated by the World Medical Boxing Congress to reduce the incidence of brain and eye injuries. - CMA believes that the professional responsibility of the physician who serves in a medical capacity in a boxing contest is to protect the health and safety of the contestants. The desire of spectators, promoters of the event, or even injured athletes that they not be removed from the contest should not influence the physician’s medical judgment. - Further long term outcome data should be obtained from boxers in order to more accurately establish successful preventive interventions. CMA encourages ongoing research into the causes and treatments of boxing-related injuries, and into the effects of preventive strategies.
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Breastfeeding and HIV

https://policybase.cma.ca/en/permalink/policy737
Last Reviewed
2017-03-04
Date
1992-08-19
Topics
Population health/ health equity/ public health
Health care and patient safety
Resolution
GC92-34
Where safe alternatives exist, breast feeding should be avoided by mothers at high risk for HIV [human immunodeficiency virus] infection and by those known to be infected.
Policy Type
Policy resolution
Last Reviewed
2017-03-04
Date
1992-08-19
Topics
Population health/ health equity/ public health
Health care and patient safety
Resolution
GC92-34
Where safe alternatives exist, breast feeding should be avoided by mothers at high risk for HIV [human immunodeficiency virus] infection and by those known to be infected.
Text
Where safe alternatives exist, breast feeding should be avoided by mothers at high risk for HIV [human immunodeficiency virus] infection and by those known to be infected.
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Canada Health Act

https://policybase.cma.ca/en/permalink/policy621
Last Reviewed
2017-03-04
Date
1992-08-19
Topics
Health systems, system funding and performance
Resolution
GC92-22
That the Canadian Medical Association continue to lobby the federal government with respect to its obligations under Section 12.2 of the Canada Health Act.
Policy Type
Policy resolution
Last Reviewed
2017-03-04
Date
1992-08-19
Topics
Health systems, system funding and performance
Resolution
GC92-22
That the Canadian Medical Association continue to lobby the federal government with respect to its obligations under Section 12.2 of the Canada Health Act.
Text
That the Canadian Medical Association continue to lobby the federal government with respect to its obligations under Section 12.2 of the Canada Health Act.
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Cell phones and driving

https://policybase.cma.ca/en/permalink/policy433
Last Reviewed
2020-02-29
Date
2001-08-15
Topics
Population health/ health equity/ public health
Resolution
GC01-54
That Canadian Medical Association supports legislation prohibiting the use of phones when driving a motor vehicle
Policy Type
Policy resolution
Last Reviewed
2020-02-29
Date
2001-08-15
Topics
Population health/ health equity/ public health
Resolution
GC01-54
That Canadian Medical Association supports legislation prohibiting the use of phones when driving a motor vehicle
Text
That Canadian Medical Association supports legislation prohibiting the use of phones when driving a motor vehicle
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Comprehensive school health

https://policybase.cma.ca/en/permalink/policy748
Last Reviewed
2017-03-04
Date
1992-03-02
Topics
Population health/ health equity/ public health
Resolution
BD92-05-192
That the Canadian Association of School Health (CASH) statement on comprehensive school health be endorsed by the Canadian Medical Association.
Policy Type
Policy resolution
Last Reviewed
2017-03-04
Date
1992-03-02
Topics
Population health/ health equity/ public health
Resolution
BD92-05-192
That the Canadian Association of School Health (CASH) statement on comprehensive school health be endorsed by the Canadian Medical Association.
Text
That the Canadian Association of School Health (CASH) statement on comprehensive school health be endorsed by the Canadian Medical Association.
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Decentralization of health care planning and management

https://policybase.cma.ca/en/permalink/policy622
Last Reviewed
2017-03-04
Date
1992-08-19
Topics
Health systems, system funding and performance
Resolution
GC92-26
That the Canadian Medical Association continue to document decentralization of health planning/management initiatives and to provide the information necessary for members and divisions to have effective input into the development of decentralization policies and system management processes
Policy Type
Policy resolution
Last Reviewed
2017-03-04
Date
1992-08-19
Topics
Health systems, system funding and performance
Resolution
GC92-26
That the Canadian Medical Association continue to document decentralization of health planning/management initiatives and to provide the information necessary for members and divisions to have effective input into the development of decentralization policies and system management processes
Text
That the Canadian Medical Association continue to document decentralization of health planning/management initiatives and to provide the information necessary for members and divisions to have effective input into the development of decentralization policies and system management processes
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Diets of less than 900 Kcal

https://policybase.cma.ca/en/permalink/policy740
Last Reviewed
2017-03-04
Date
1992-08-19
Topics
Population health/ health equity/ public health
Resolution
GC92-44
That the Canadian Medical Association recommend that, since diets of less than 900 Kcal are rarely indicated, a) physicians prescribing such diets ensure that they are aware of their indications, contraindications, appropriate management protocols and risks, and b) physicians advise patients of potential complications and that an informed consent form be signed by prospective patients before prescribing such a diet.
Policy Type
Policy resolution
Last Reviewed
2017-03-04
Date
1992-08-19
Topics
Population health/ health equity/ public health
Resolution
GC92-44
That the Canadian Medical Association recommend that, since diets of less than 900 Kcal are rarely indicated, a) physicians prescribing such diets ensure that they are aware of their indications, contraindications, appropriate management protocols and risks, and b) physicians advise patients of potential complications and that an informed consent form be signed by prospective patients before prescribing such a diet.
Text
That the Canadian Medical Association recommend that, since diets of less than 900 Kcal are rarely indicated, a) physicians prescribing such diets ensure that they are aware of their indications, contraindications, appropriate management protocols and risks, and b) physicians advise patients of potential complications and that an informed consent form be signed by prospective patients before prescribing such a diet.
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Drug testing in the workplace (Update 2001)

https://policybase.cma.ca/en/permalink/policy194
Last Reviewed
2018-03-03
Date
2001-05-28
Topics
Ethics and medical professionalism
Pharmaceuticals/ prescribing/ cannabis/ marijuana/ drugs
  1 document  
Policy Type
Policy document
Last Reviewed
2018-03-03
Date
2001-05-28
Replaces
Drug testing in the workplace (1992)
Topics
Ethics and medical professionalism
Pharmaceuticals/ prescribing/ cannabis/ marijuana/ drugs
Text
Health and safety in the workplace continue to be areas of concern to the CMA. The CMA recommends that educational programs on the risks of drug-related impairment to health and safety in the workplace be directed toward labour, management and the public in general. Occupations for which impairment resulting from drug use may constitute a serious hazard should be identified and designated as such. The association recommends that supervisors be trained to refer a worker in a safety-sensitive job for a health assessment if the supervisor has reasonable grounds to suspect impairment of the worker. Workers holding safety-sensitive jobs should be educated to report any departure from their usual state of health as well as any drugs (prescribed or otherwise) being taken to the occupational health physician or, in the absence of such, to the physician of the worker's choice. The CMA is opposed to routine pre-employment drug testing. It recommends that random drug testing among employees be restricted to safety-sensitive positions and undertaken only when measures of performance and effective peer or supervisory observation are unavailable. Drug testing should always be conducted in such a way as to protect confidentiality and should be undertaken with the subject's informed consent (except when otherwise required by law). The idea of drug testing among workers has developed from society's concern over the relation between drug use and impairment, with resultant risks to the worker, fellow workers and the public. Education: Since prevention is the principal and ultimate objective the association recommends that educational programs on the risks of impairment to health and safety in the workplace be directed toward labour, management and the public in general. Illicit drugs are not the only ones that may cause impairment. Certain prescription drugs and even some over-the-counter medications may affect a person's ability to carry out professional functions safely; such effects may vary considerably from one person to another. Alcohol is by far the most common impairing drug implicated in accidents; in addition, the scientific literature contains a growing body of information on impairment and dangers resulting from the use and misuse of various therapeutic medications. Far less is documented or known about the role of illicit drugs in work-related accidents. Safety-sensitive occupations: In most workplaces there are occupations for which impairment may constitute a serious hazard. Such occupations should be identified and designated as such. Workers who hold such safety-sensitive jobs must accept the fact that other workers and the public need to be protected from the hazards of impairment, whether from physical or psychologic ill health or from the use of drugs (over-the-counter, prescription or illicit). Performance assessment of safety-sensitive occupations: The CMA recommends that supervisors be trained to refer a worker in a safety-sensitive job for a health assessment if the supervisor has reasonable grounds (e.g., unsatisfactory performance or observed unusual behaviour) to suspect impairment of the worker. The examining physician may recommend that some tests (including tests for the presence of certain drugs) be carried out under pre-agreed protocols. Workers holding safety-sensitive jobs must be educated to report any departure from their usual state of health as well as any drugs (prescribed or otherwise) they may be taking to the occupational health physician or, in the absence of such, to the physician of the worker's choice. Testing: Any discussion of drug testing must take the following into account: If a quantitative test is to be used to determine impairment a limit must be established beyond which a person is deemed to be impaired. However, since the threshold of impairment varies from one person to another this variation should be taken into account when a worker is being assessed. The tests must be valid and reliable. They must be performed only in laboratories accredited for drug testing. The tests must provide results rapidly enough to be useful in deciding whether the person should continue to work. If different testing procedures are available and the differences between the validity and reliability are not significant the least intrusive alternative should be chosen. The test should be conducted in such a way as to ensure confidentiality and should be undertaken with the subject's informed consent (except when otherwise required by law). Pre-employment testing: The CMA opposes routine pre-employment drug testing for the following reasons: Routine pre-employment drug screening may not objectively identify those people who constitute a risk to society. The mass, low-cost screening tests may not be reliable or valid. The circumstances may not justify possible human rights violations. Random testing: The CMA believes that random drug testing among employees has a limited role, if any, in the workplace. Such testing should be restricted to employees in safety-sensitive positions and undertaken only when measures of performance and effective peer or supervisory observation are unavailable. Role of occupational health services: Occupational health physicians must not be involved in a policing or disciplinary role with respect to employee testing. CMA recommends that employers provide a safe environment for all workers. With the help of experts such as those from national and provincial agencies dedicated to dealing with substance abuse occupational health departments should develop lists of drugs known to cause short-term or long-term impairment, including alcohol. These lists should be posted prominently in the workplace, and workers should be advised that in the event of obvious impairment those involved in safety-sensitive occupations will be asked to undergo medical assessment. If testing for drugs is indicated refusal to submit to testing may result in a presumption of noncompliance with the health requirements of the job. Alcohol impairment should not be tolerated, and legislation should be considered that would set a legal blood alcohol level for safety-sensitive occupations. Breathalyzers or other detection methods could be used if alcohol impairment is suspected in a person holding safety-sensitive occupation. As stated previously, refusal to submit to testing may result in a presumption of noncompliance with the health requirements of the job. These measures should be discussed with labour and management. Labour should be expected to recognize drug-related impairment as a serious health and safety issue, and management should demonstrate its concern by ensuring access to treatment, prevention and educational programs such as employee assistance programs.
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28 records – page 1 of 3.