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Acquired immunodeficiency syndrome (Update 2000)

https://policybase.cma.ca/en/permalink/policy165
Last Reviewed
2020-02-29
Date
2000-12-09
Topics
Health care and patient safety
  1 document  
Policy Type
Policy document
Last Reviewed
2020-02-29
Date
2000-12-09
Replaces
Acquired immunodeficiency syndrome (1989)
Topics
Health care and patient safety
Text
Acquired immunodeficiency syndrome (UPDATE 2000) The Canadian Medical Association has developed the following general principles to serve as guidelines for various bodies, health care professionals and the general public. Specific aspects of infection with human immunodeficiency virus (HIV) and acquired immunodeficency syndrome (AIDS) that relate to physicians' ethical responsibilities as well as society's moral obligations are discussed. Such matters include: the need for education, research and treatment resources; the patient's right to investigation and treatment and to refuse either; the need to obtain the patient's informed consent; the right to privacy and confidentiality; the importance of infection control; and the right to financial compensation in the case of occupational exposure to HIV. Education Physicians should keep their knowledge of AIDS and HIV infection up to date. Physicians should educate patients and the general public in the prevention of AIDS by informing them of means available to protect against the risk of HIV infection and to avoid further transmission of the virus. Health authorities should maintain an active public education program on AIDS that includes the school population and such initiatives as public service announcements by the media. Resources All levels of government should provide resources for adequate information and education of health care professionals and the public on HIV-related diseases; research into the prevention and treatment of HIV infection and AIDS; and the availability and accessibility of proper diagnosis and care for all patients with HIV infection. HIV antibody testing Physicians have an ethical responsibility to recommend appropriate testing for HIV antibody and to care for their patients with AIDS or refer them to where treatment is available. Physicians should provide counselling to patients before and after HIV antibody testing. Because of the potential psychologic, social and economic consequences attached to a positive HIV test result, informed consent must, with rare exceptions, be obtained from a patient before testing. However, the CMA endorses informed mandatory testing for HIV infection in cases involving the donation of blood, body fluids or organs. The CMA recognizes that people who have doubts about their serologic status may avoid being tested for fear of indiscretion and therefore supports voluntary non-nominal testing of potential HIV carriers on request. The CMA supports the Canadian Blood Service and Hema-Québec in their programs of testing and screening blood donations and blood products. Confidentiality in reporting and contact tracing The CMA supports the position that cases of HIV infection should be reported non-nominally with enough information to be epidemiologically useful. In addition, each confirmed case of AIDS should be reported non-nominally to a designated authority for epidemiologic purposes. The CMA encourages attending physicians to assist public health authorities to trace and counsel confidentially all contacts of patients with HIV infection. Contact tracing should be carried out with the cooperation and participation of the patient to provide maximum flexibility and effectiveness in alerting and counselling as many potentially infected people as possible. In some jurisdictions physicians may be compelled to provide detailed information to public health authorities. In such circumstances, the CMA urges those involved to maintain confidentiality to the greatest extent possible and to take all reasonable steps to inform the patient that their information is being disclosed. The CMA Code of Ethics (article 22) advises physicians that disclosure of a patient’s HIV status to a spouse or current sexual partner may not be unethical and, indeed, may be indicated when physicians are confronted with an HIV-infected patient who is unwilling to inform the person at risk. Such disclosure may be justified when all of the following conditions are met: the partner is at risk of infection with HIV and has no other reasonable means of knowing of the risk; the patient has refused to inform his or her sexual partner; the patient has refused an offer of assistance by the physician to do so on the patient's behalf; and the physician has informed the patient of his or her intention to disclose the information to the partner. The CMA stresses the need to respect the confidentiality of patients with HIV infection and consequently recommends that legal and regulatory safeguards to protect such confidentiality be established and maintained. Infection control Health care institutions and professionals should ensure that adequate infection-control measures in the handling of blood and body fluids are in place and that the rights of professionals directly involved in patient care to be informed of and protected from the risks of HIV infection are safeguarded. The CMA does not recommend routine testing of hospitalized patients. The CMA urges appropriate funding agencies to assess the explicit and implicit costs of infection control measures and to ensure that additional funds are provided to cover these extraordinary costs. Occupational exposure and the health care professional Health care workers should receive adequate financial compensation in the case of HIV infection acquired as a result of accidental occupational exposure. Physicians and other health care providers with HIV infection have the same rights as others to be protected from wrongful discrimination in the workplace and to be eligible for financial compensation for work-related infection. Physicians with HIV infection should consult appropriate colleagues to determine the nature and extent of the risk related to their continued involvement in the care of patients.
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The future of medicine

https://policybase.cma.ca/en/permalink/policy209
Last Reviewed
2017-03-04
Date
2000-08-12
Topics
Health systems, system funding and performance
Ethics and medical professionalism
  1 document  
Policy Type
Policy document
Last Reviewed
2017-03-04
Date
2000-08-12
Topics
Health systems, system funding and performance
Ethics and medical professionalism
Text
The future of medicine In 1997 the Canadian Medical Association (CMA) embarked on a study of the future of medicine. Two premises guided this activity: (1) the pace of change in the practice of medicine that physicians experienced in the last quarter of the 20th century is bound to increase in the 21st century; and (2) it is essential that the medical profession position itself to influence future developments in medical practice. In order to prepare the profession to anticipate and meet the challenges of the future, the CMA is engaged in a medium- to long-term (5–20 years) planning exercise. This policy statement summarizes the results of the first part of this exercise: working definitions of health, health care and medicine; a vision for the future of the medical profession; and the implications of this vision for the roles of physicians. This work was conducted by an expert project advisory group, which developed background papers on these topics and prepared this statement for approval by the CMA Board of Directors. Definitions Health: is a state of physical, mental, emotional and spiritual well-being. It is characterized in part by an absence of illness (a subjective experience) and disease (a pathological abnormality) that enables one to pursue major life goals and to function in personal, social and work contexts. Health care: is any activity that has as its primary objective the improvement, maintenance or support of physical, mental, emotional and spiritual well-being, as characterized by the absence of illness and disease. Medicine: is the art and science of healing. It is based on a body of knowledge, skills and practices concerned with the health and pathology of individuals and populations. The practice of medicine encompasses those health care activities that are performed by or under the direction of physicians in the service of patients, including health promotion, disease prevention, diagnosis, treatment, rehabilitation, palliation, education and research. A vision for the future of the medical profession Medicine will continue to be a healing profession dedicated to serving humanity. Its cornerstone will continue to be the relationship of trust between the patient and the physician. It will uphold with integrity the values of respect for persons, compassion, beneficence and justice. It will strive for excellence and incorporate progress in its art and science. It will maintain high standards of ethics, clinical practice, education and research in order to serve patients. It will encourage the development of healthy communities and of practices and policies that promote the well-being of the public. It will demonstrate its capacity for societal responsibility through self-regulation and accountability. It will actively participate in decision-making regarding health and health care policy. It will guard against forces and events that may compromise its primary commitment to the well-being of patients. The roles of physicians in the future1 Although the vision and values of medicine are enduring and will remain stable, the practice environment of physicians will change as the medical profession responds to health system and societal influences. This in turn will have implications for the roles of physicians. The traditional role of physicians has been medical expert and healer. This has involved diagnosing and treating disease and other forms of illness, comforting those who cannot be cured and preventing illness through patient counselling and public-health measures. While this role will remain at the core of medical practice, the evolving context of health care requires physicians to assume additional roles to support their primary role. The CMA proposes the following roles as essential to the future practice of medicine (cf. Fig. 1 for their interrelationship). Although no physician will function in all roles simultaneously, they should all have the fundamental competencies to participate in each of these roles. -Medical expert and healer: Physicians have always been recognized for their role as medical expert and healer; it is the defining nature of their practice and derives from the broad knowledge base of medicine and its application through a combination of art and science. This is the foundation for continued physician leadership in the provision of medical and health care in the future. -Professional: There must be renewed efforts to reaffirm the principles of the medical profession, including upholding its unique body of knowledge and skills; maintenance of high standards of practice; and commitment to the underlying values of caring, service and compassion. The medical profession of the future must continue to develop standards of care with ongoing opportunities for continued assessment of competency in order to remain a credible, self-regulated discipline worthy of public respect and trust. -Communicator: Increasing emphasis will be placed upon the ability to gather and communicate medical information in a compassionate and caring fashion, to enter into a partnership with patients when organizing care plans and to provide important information through counselling and the promotion of health. As always, the patient–physician relationship will remain paramount, with its essential features of compassion, confidentiality, honesty and respect. -Scholar: Scholarship involves the creation of new knowledge (research), its uniform application (clinical practice) and its transfer to others (education). It is this strong association with the science of medicine and physicians’ willingness to embrace the scholarship of their practice that is closely linked to their roles of medical experts and professionals. -Collaborator: Health care services will increasingly be provided by interdisciplinary teams throughout the continuum of care from health promotion activities to the management of acute life-threatening disorders to the delivery of palliative care. In the role of collaborator, physicians recognize the essential functions of other health care workers and respect unique provider contributions in patient-centred health care delivery. -Advocate: As the health sector becomes increasingly complex and interdependent with other sectors of society, it will be essential for physicians to play a greater role as health advocates. This may pertain to advocacy for individual and family health promotion in the practice environment; it may also relate to the promotion of improved health at the broader community level. -Manager: In order to provide quality care, physicians of the future must be effective resource managers at the individual practice level, at the health care facility level and as part of the wider health care system. In order to fulfil these roles and participate in communities as integral members of society, physicians need to lead balanced lives. Physicians may sometimes experience conflicts among these roles. The CMA Code of Ethics specifies the basic principles of professional ethics for dealing with such conflicts. Conclusion The CMA has developed this vision for the future of medicine and the future roles of physicians to assist individual physicians and medical organizations to anticipate and prepare for the challenges of the next 20 years. The vision provides the profession with criteria for evaluating proposed changes in how medicine is practised and reaffirms the core values of medicine that must be upheld in whatever system emerges. The CMA invites other organizations, nonmedical as well as medical, to comment on the contents of this statement and its implications for health and health care. The CMA welcomes opportunities to dialogue with others on how the health care system can be improved for the benefit of future patients and society in general. 1The section is indebted to the work of the Educating Future Physicians for Ontario (EFPO) project supported by the Associated Medical Services group, the Ontario faculties of medicine and the Ontario Ministry of Health, and the Canadian Medical Education Directions for Specialists 2000 (CanMEDs 2000) project of the Royal College of Physicians and Surgeons of Canada.
Documents
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Principles for the development, use and evaluation of health care databases

https://policybase.cma.ca/en/permalink/policy579
Last Reviewed
2017-03-04
Date
1997-08-20
Topics
Health information and e-health
Ethics and medical professionalism
Resolution
GC97-26
That physicians, through the Canadian Medical Association, its Divisions and affiliates, should be involved in delineating principles to guide the development, use and evaluation of databases that provide linkages between health care utilization, socioeconomic status and other determinants of health and health status.
Policy Type
Policy resolution
Last Reviewed
2017-03-04
Date
1997-08-20
Topics
Health information and e-health
Ethics and medical professionalism
Resolution
GC97-26
That physicians, through the Canadian Medical Association, its Divisions and affiliates, should be involved in delineating principles to guide the development, use and evaluation of databases that provide linkages between health care utilization, socioeconomic status and other determinants of health and health status.
Text
That physicians, through the Canadian Medical Association, its Divisions and affiliates, should be involved in delineating principles to guide the development, use and evaluation of databases that provide linkages between health care utilization, socioeconomic status and other determinants of health and health status.
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Evidence and stakeholder involvement in the development of health policy

https://policybase.cma.ca/en/permalink/policy580
Last Reviewed
2017-03-04
Date
1997-08-20
Topics
Ethics and medical professionalism
Resolution
GC97-27
That evidence-based approaches and wide stakeholder involvement are essential in the development and implementation of public policies designed to improve the health of the population both collectively and individually.
Policy Type
Policy resolution
Last Reviewed
2017-03-04
Date
1997-08-20
Topics
Ethics and medical professionalism
Resolution
GC97-27
That evidence-based approaches and wide stakeholder involvement are essential in the development and implementation of public policies designed to improve the health of the population both collectively and individually.
Text
That evidence-based approaches and wide stakeholder involvement are essential in the development and implementation of public policies designed to improve the health of the population both collectively and individually.
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Evolving patient-physician relationship

https://policybase.cma.ca/en/permalink/policy581
Last Reviewed
2017-03-04
Date
1997-08-20
Topics
Population health/ health equity/ public health
Health systems, system funding and performance
Ethics and medical professionalism
Resolution
GC97-28
That the Canadian Medical Association explore the changing relationships of physicians with their patients and communities related to the expanding role of patients in decision-making and self-care.
Policy Type
Policy resolution
Last Reviewed
2017-03-04
Date
1997-08-20
Topics
Population health/ health equity/ public health
Health systems, system funding and performance
Ethics and medical professionalism
Resolution
GC97-28
That the Canadian Medical Association explore the changing relationships of physicians with their patients and communities related to the expanding role of patients in decision-making and self-care.
Text
That the Canadian Medical Association explore the changing relationships of physicians with their patients and communities related to the expanding role of patients in decision-making and self-care.
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Evidence-based health-impact analysis and policy development

https://policybase.cma.ca/en/permalink/policy582
Last Reviewed
2017-03-04
Date
1997-08-20
Topics
Health systems, system funding and performance
Ethics and medical professionalism
Resolution
GC97-31
That the Canadian Medical Association and its Divisions urge government to establish a framework to ensure that the development and implementation of public policy is guided by evidence-based health-impact analysis.
Policy Type
Policy resolution
Last Reviewed
2017-03-04
Date
1997-08-20
Topics
Health systems, system funding and performance
Ethics and medical professionalism
Resolution
GC97-31
That the Canadian Medical Association and its Divisions urge government to establish a framework to ensure that the development and implementation of public policy is guided by evidence-based health-impact analysis.
Text
That the Canadian Medical Association and its Divisions urge government to establish a framework to ensure that the development and implementation of public policy is guided by evidence-based health-impact analysis.
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Patient accountability and responsibility

https://policybase.cma.ca/en/permalink/policy587
Last Reviewed
2017-03-04
Date
1997-08-20
Topics
Health systems, system funding and performance
Ethics and medical professionalism
Resolution
GC97-44
That the Canadian Medical Association study ways in which the role of patient accountability and responsibility can be incorporated into models of health care.
Policy Type
Policy resolution
Last Reviewed
2017-03-04
Date
1997-08-20
Topics
Health systems, system funding and performance
Ethics and medical professionalism
Resolution
GC97-44
That the Canadian Medical Association study ways in which the role of patient accountability and responsibility can be incorporated into models of health care.
Text
That the Canadian Medical Association study ways in which the role of patient accountability and responsibility can be incorporated into models of health care.
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Training and licensing operators of powered watercraft

https://policybase.cma.ca/en/permalink/policy763
Last Reviewed
2017-03-04
Date
1997-08-20
Topics
Health care and patient safety
Resolution
GC97-62
That the Canadian Medical Association urge provincial, territorial and federal governments and their involved agencies to require training and licensing of operators of powered watercraft.
Policy Type
Policy resolution
Last Reviewed
2017-03-04
Date
1997-08-20
Topics
Health care and patient safety
Resolution
GC97-62
That the Canadian Medical Association urge provincial, territorial and federal governments and their involved agencies to require training and licensing of operators of powered watercraft.
Text
That the Canadian Medical Association urge provincial, territorial and federal governments and their involved agencies to require training and licensing of operators of powered watercraft.
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Training and licensing operators of powered snow craft

https://policybase.cma.ca/en/permalink/policy766
Last Reviewed
2017-03-04
Date
1997-08-20
Topics
Health care and patient safety
Resolution
GC97-69
That the Canadian Medical Association urge the federal provincial and territorial governments and their agencies to require education, training and licensing of operators of powered snow craft.
Policy Type
Policy resolution
Last Reviewed
2017-03-04
Date
1997-08-20
Topics
Health care and patient safety
Resolution
GC97-69
That the Canadian Medical Association urge the federal provincial and territorial governments and their agencies to require education, training and licensing of operators of powered snow craft.
Text
That the Canadian Medical Association urge the federal provincial and territorial governments and their agencies to require education, training and licensing of operators of powered snow craft.
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Access to health care services for language minorities

https://policybase.cma.ca/en/permalink/policy767
Last Reviewed
2017-03-04
Date
1997-08-20
Topics
Health care and patient safety
Resolution
GC97-70
The Canadian Medical Association, in conjunction with provincial/ territorial medical associations, encourages all levels of government to ensure that public health care facilities provide language minorities with reasonable community access to health care services in their first language.
Policy Type
Policy resolution
Last Reviewed
2017-03-04
Date
1997-08-20
Topics
Health care and patient safety
Resolution
GC97-70
The Canadian Medical Association, in conjunction with provincial/ territorial medical associations, encourages all levels of government to ensure that public health care facilities provide language minorities with reasonable community access to health care services in their first language.
Text
The Canadian Medical Association, in conjunction with provincial/ territorial medical associations, encourages all levels of government to ensure that public health care facilities provide language minorities with reasonable community access to health care services in their first language.
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Quality End-of-Life Care report

https://policybase.cma.ca/en/permalink/policy388
Last Reviewed
2014-03-01
Date
2000-08-16
Topics
Ethics and medical professionalism
Resolution
GC00-19
That the Canadian Medical Association advise the Federal Minister of Health that it supports the recommendations of the Senate Standing Committee of the Senate "Quality End-of-Life Care" of June 2000, as appended to the Reports to General Council, and urge the government to work with provincial and territorial governments towards rapid implementation of the recommendations.
Policy Type
Policy resolution
Last Reviewed
2014-03-01
Date
2000-08-16
Topics
Ethics and medical professionalism
Resolution
GC00-19
That the Canadian Medical Association advise the Federal Minister of Health that it supports the recommendations of the Senate Standing Committee of the Senate "Quality End-of-Life Care" of June 2000, as appended to the Reports to General Council, and urge the government to work with provincial and territorial governments towards rapid implementation of the recommendations.
Text
That the Canadian Medical Association advise the Federal Minister of Health that it supports the recommendations of the Senate Standing Committee of the Senate "Quality End-of-Life Care" of June 2000, as appended to the Reports to General Council, and urge the government to work with provincial and territorial governments towards rapid implementation of the recommendations.
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Allocation of health care resources

https://policybase.cma.ca/en/permalink/policy389
Last Reviewed
2014-03-01
Date
2000-08-16
Topics
Health systems, system funding and performance
Ethics and medical professionalism
Resolution
GC00-186
That the Canadian Medical Association work with its divisions and affiliates to determine and proclaim the values that should influence health care priority setting and allocation of health care resources in Canada.
Policy Type
Policy resolution
Last Reviewed
2014-03-01
Date
2000-08-16
Topics
Health systems, system funding and performance
Ethics and medical professionalism
Resolution
GC00-186
That the Canadian Medical Association work with its divisions and affiliates to determine and proclaim the values that should influence health care priority setting and allocation of health care resources in Canada.
Text
That the Canadian Medical Association work with its divisions and affiliates to determine and proclaim the values that should influence health care priority setting and allocation of health care resources in Canada.
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