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CMA PolicyBase

Policies that advocate for the medical profession and Canadians


11 records – page 1 of 2.

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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Child poverty in Canada

https://policybase.cma.ca/en/permalink/policy8525
Last Reviewed
2013-03-02
Date
2006-08-23
Topics
Health care and patient safety
Population health/ health equity/ public health
Resolution
GC06-21
The Canadian Medical Association requests that the federal government adopt a rigorous strategy to eradicate child poverty in Canada.
Policy Type
Policy resolution
Last Reviewed
2013-03-02
Date
2006-08-23
Topics
Health care and patient safety
Population health/ health equity/ public health
Resolution
GC06-21
The Canadian Medical Association requests that the federal government adopt a rigorous strategy to eradicate child poverty in Canada.
Text
The Canadian Medical Association requests that the federal government adopt a rigorous strategy to eradicate child poverty in Canada.
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Community housing for the mentally ill

https://policybase.cma.ca/en/permalink/policy50
Last Reviewed
2016-05-20
Date
2002-08-21
Topics
Health care and patient safety
Health systems, system funding and performance
Resolution
GC02-63
That Canadian Medical Association call on the federal, provincial and territorial governments to adopt strategies to deal with the current absence of an adequate network of community housing for the chronically mentally ill, including adequate resources, coordination and appropriate supervision of standards.
  1 document  
Policy Type
Policy resolution
Last Reviewed
2016-05-20
Date
2002-08-21
Topics
Health care and patient safety
Health systems, system funding and performance
Resolution
GC02-63
That Canadian Medical Association call on the federal, provincial and territorial governments to adopt strategies to deal with the current absence of an adequate network of community housing for the chronically mentally ill, including adequate resources, coordination and appropriate supervision of standards.
Text
That Canadian Medical Association call on the federal, provincial and territorial governments to adopt strategies to deal with the current absence of an adequate network of community housing for the chronically mentally ill, including adequate resources, coordination and appropriate supervision of standards.
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Health care services for children

https://policybase.cma.ca/en/permalink/policy8523
Last Reviewed
2020-02-29
Date
2006-08-23
Topics
Population health/ health equity/ public health
Health care and patient safety
Resolution
GC06-19
The Canadian Medical Association calls on governments to work closely with health stakeholders to provide seamless delivery of a comprehensive basket of mental and developmental health care services for children.
Policy Type
Policy resolution
Last Reviewed
2020-02-29
Date
2006-08-23
Topics
Population health/ health equity/ public health
Health care and patient safety
Resolution
GC06-19
The Canadian Medical Association calls on governments to work closely with health stakeholders to provide seamless delivery of a comprehensive basket of mental and developmental health care services for children.
Text
The Canadian Medical Association calls on governments to work closely with health stakeholders to provide seamless delivery of a comprehensive basket of mental and developmental health care services for children.
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The health status of Aboriginal children

https://policybase.cma.ca/en/permalink/policy8503
Last Reviewed
2013-03-02
Date
2006-08-23
Topics
Population health/ health equity/ public health
Health care and patient safety
Resolution
GC06-11
The Canadian Medical Association calls on the Minister of Health to work with other federal departments, the CMA and others to address the failure of previous federal efforts to raise the health status of Aboriginal children to the national level by developing a differentiated children's health strategy, creating safe environments, developing equitable educational opportunities and creating effective programs to deal with obesity, diabetes, substance abuse and other issues.
Policy Type
Policy resolution
Last Reviewed
2013-03-02
Date
2006-08-23
Topics
Population health/ health equity/ public health
Health care and patient safety
Resolution
GC06-11
The Canadian Medical Association calls on the Minister of Health to work with other federal departments, the CMA and others to address the failure of previous federal efforts to raise the health status of Aboriginal children to the national level by developing a differentiated children's health strategy, creating safe environments, developing equitable educational opportunities and creating effective programs to deal with obesity, diabetes, substance abuse and other issues.
Text
The Canadian Medical Association calls on the Minister of Health to work with other federal departments, the CMA and others to address the failure of previous federal efforts to raise the health status of Aboriginal children to the national level by developing a differentiated children's health strategy, creating safe environments, developing equitable educational opportunities and creating effective programs to deal with obesity, diabetes, substance abuse and other issues.
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Motorized dirt bikes, all-terrain vehicles (ATVs) and snowmobiles.

https://policybase.cma.ca/en/permalink/policy8681
Last Reviewed
2013-03-02
Date
2006-12-03
Topics
Health care and patient safety
Resolution
BD07-03-58
The Canadian Medical Association calls on governments to prohibit anyone under age 16 from operating motorized dirt bikes, all-terrain vehicles (ATVs) and snowmobiles.
Policy Type
Policy resolution
Last Reviewed
2013-03-02
Date
2006-12-03
Topics
Health care and patient safety
Resolution
BD07-03-58
The Canadian Medical Association calls on governments to prohibit anyone under age 16 from operating motorized dirt bikes, all-terrain vehicles (ATVs) and snowmobiles.
Text
The Canadian Medical Association calls on governments to prohibit anyone under age 16 from operating motorized dirt bikes, all-terrain vehicles (ATVs) and snowmobiles.
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A national action plan for mental illness and mental health : a call for action

https://policybase.cma.ca/en/permalink/policy171
Last Reviewed
2019-03-03
Date
2002-12-07
Topics
Health care and patient safety
  1 document  
Policy Type
Policy endorsement
Last Reviewed
2019-03-03
Date
2002-12-07
Topics
Health care and patient safety
Text
A National Action Plan for Mental Illness and Mental Health : A Call for Action This consensus statement was drafted at the National Summit on Mental Illness and Mental Health held on October 3, 4, 2002. The consensus statement was ratified subsequently by each of the signatory organizations. VISION We envision a country where all Canadians enjoy good mental health. Canadians with mental illnesses*, their families and care providers must have access to the care, support and respect to which they are entitled and in parity with other health conditions. PRINCIPLES We are committed to a National Action Plan that upholds the following principles: 1. Mental illness and mental health issues must be considered within the framework of the determinants of health and recognizes the important linkages among mental, neurological and physiological health. 2. Given the impact of mental health issues and mental illness (i.e. on the suffering of Canadians, on mortality, especially from suicide, on the economy, on social services such as health, education and criminal justice), Canadian governments and health planners must address mental health issues commensurate with the level of their burden on society. 3. Mental health promotion and the treatment of mental illnesses must be timely, continuous, inter-disciplinary, culturally appropriate, and integrated across the full life cycle and the continuum of care (i.e. physical and mental health; social supports and tertiary care to home/community care). KEY ELEMENTS OF A NATIONAL ACTION PLAN 1. National Mental Health Goals. These goals would provide a framework to, for example, evaluate both processes and outcomes, set minimum standards, and assess systemic change. 2. A Policy Framework. The framework must provide for a comprehensive health promotion and service delivery plan, an enhanced research program, a surveillance and national data/information system, a public education strategy, a health human resources plan, and an innovations fund that embraces both mental illness and mental health promotion as well as the principles of recovery and citizenship. 3. Dedicated, Sustained and Adequate Resources tied to the National Mental Health Goals and specific outcomes. 4. An Accountability Mechanism, such as annual reporting on, for example, access, mental health status, systemic change and the application of best practices. * NOTE: The use of the term "mental illness" in this "Call for Action" includes diseases, disorders, conditions or problems. It also includes the spectrum of addictions. A CALL FOR LEADERSHIP AND ACTION We, the undersigned, urge the federal, provincial and territorial governments to work together with federal leadership to recognize and act upon the compelling moral, social and economic case for mental health promotion and mental illness care. SIGNATORY ORGANIZATIONS Canadian Medical Association Canadian Psychiatric Association NATIONAL ORGANIZATIONS REPRESENTED AT THE OCTOBER 2002 SUMMIT Autism Society of Canada Canadian Academy of Child Psychiatry Canadian Alliance on Mental Illness & Mental Health Canadian Association for Suicide Prevention Canadian Association of Occupational Therapists Canadian Association of Social Workers Canadian Coalition for Seniors Mental Health Canadian Council of Professional Psychology Programs Canadian Federation of Mental Health Nurses Canadian Health Care Association Canadian Medical Association Canadian Mental Health Association Canadian Psychiatric Association Canadian Psychiatric Research Foundation Canadian Psychological Association College of Family Physicians of Canada Mood Disorders Society of Canada National Network for Mental Health Native Mental Health Association of Canada Schizophrenia Society 1
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Nicotine-based drinks

https://policybase.cma.ca/en/permalink/policy8541
Last Reviewed
2020-02-29
Date
2006-08-23
Topics
Health care and patient safety
Population health/ health equity/ public health
Resolution
GC06-71
The Canadian Medical Association calls on the Federal Minister of Health to ban the sale or distribution of nicotine-based drinks in Canada.
Policy Type
Policy resolution
Last Reviewed
2020-02-29
Date
2006-08-23
Topics
Health care and patient safety
Population health/ health equity/ public health
Resolution
GC06-71
The Canadian Medical Association calls on the Federal Minister of Health to ban the sale or distribution of nicotine-based drinks in Canada.
Text
The Canadian Medical Association calls on the Federal Minister of Health to ban the sale or distribution of nicotine-based drinks in Canada.
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Pharmacists who are given independent prescribing authority

https://policybase.cma.ca/en/permalink/policy8557
Last Reviewed
2020-02-29
Date
2006-08-23
Topics
Population health/ health equity/ public health
Pharmaceuticals/ prescribing/ cannabis/ marijuana/ drugs
Health care and patient safety
Resolution
GC06-67
The Canadian Medical Association, in conjunction with its divisions and affiliates, without endorsing pharmacist independent prescribing strongly urges the Government of Alberta to require pharmacists who are given independent prescribing authority to: a) require explicit, informed consent from a patient; b) maintain a patient's record; c) provide 24-hour availability to the patient; d) carry appropriate coverage for legal liability; e) disclose any potential conflict of interest as both a prescriber and dispenser of medication; and, f) if the pharmacist changes a physician's prescription, advise the physician of the change(s).
Policy Type
Policy resolution
Last Reviewed
2020-02-29
Date
2006-08-23
Topics
Population health/ health equity/ public health
Pharmaceuticals/ prescribing/ cannabis/ marijuana/ drugs
Health care and patient safety
Resolution
GC06-67
The Canadian Medical Association, in conjunction with its divisions and affiliates, without endorsing pharmacist independent prescribing strongly urges the Government of Alberta to require pharmacists who are given independent prescribing authority to: a) require explicit, informed consent from a patient; b) maintain a patient's record; c) provide 24-hour availability to the patient; d) carry appropriate coverage for legal liability; e) disclose any potential conflict of interest as both a prescriber and dispenser of medication; and, f) if the pharmacist changes a physician's prescription, advise the physician of the change(s).
Text
The Canadian Medical Association, in conjunction with its divisions and affiliates, without endorsing pharmacist independent prescribing strongly urges the Government of Alberta to require pharmacists who are given independent prescribing authority to: a) require explicit, informed consent from a patient; b) maintain a patient's record; c) provide 24-hour availability to the patient; d) carry appropriate coverage for legal liability; e) disclose any potential conflict of interest as both a prescriber and dispenser of medication; and, f) if the pharmacist changes a physician's prescription, advise the physician of the change(s).
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Review of the Personal Information Protection and Electronic Documents Act (PIPEDA) : CMA's Presentation to the House of Commons Standing Committee on Access to Information, Privacy and Ethics - December 13, 2006

https://policybase.cma.ca/en/permalink/policy8668
Last Reviewed
2019-03-03
Date
2006-12-13
Topics
Health care and patient safety
Health information and e-health
Ethics and medical professionalism
  1 document  
Policy Type
Parliamentary submission
Last Reviewed
2019-03-03
Date
2006-12-13
Topics
Health care and patient safety
Health information and e-health
Ethics and medical professionalism
Text
The Canadian Medical Association (CMA) is pleased to be here today to participate in your review of the Personal Information Protection and Electronic Documents Act, or PIPEDA. The CMA has had a long-standing interest in privacy-related matters, including enhancing measures to protect and promote the privacy of health information. We welcome the opportunity to share our policies and thoughts on these vital matters. As a pediatric oncologist from Winnipeg and Chair of the CMA's Committee on Ethics, I come here today with one bottom line: Physicians have always- and continue to - take their patients' privacy very seriously. This is the cornerstone of the special bond between patients and their doctor and has been thus since the time of Hippocrates. In recognition of the importance of privacy, the CMA has produced such documents as the CMA Code of Ethics and the CMA Health Information Privacy Code to guide our more than 64,000 members across the country. These documents existed before the federal government introduced PIPEDA. It is out of our concern for protecting and ensuring the privacy of medical information that we speak to you today. There are three specific areas which we would like to raise: 1) Recognition in law of the unique nature of health care; 2) Physician information as "work product"; and 3) Emerging Privacy and Health information issues. 1. Recognition in law of the unique nature of health care I would like to highlight the importance of recognizing in law the special circumstances of protecting health information. In fact, when PIPEDA was first being debated, CMA posed questions about the scope of the Act and was told that the legislation, originally designed for commerce and the private sector, would not capture health information. We were also told that even if it did, PIPEDA wouldn't change how we practiced medicine. The passing of PIPEDA generated enough concern and uncertainty that government agreed to delay its application to health for 3 years. For example, PIPEDA failed to clarify the issue of implied consent for the sharing of patient information between health professionals providing care. For example, when the family physicians says to a patient "I'm going to send you to see an oncologist to run some tests" and the patient agrees and follows that course of action, then clearly there is "consent" to the sharing of their health information with others. As an oncologist I assume there is consent to send the test results to other specialists that I may need to consult in order to advance the patient's care in a timely fashion. This, however, needed to be addressed before PIPEDA was applied to health care. The delayed application allowed the federal government and health care community to work together and develop a set of guidelines for how PIPEDA would be applied. The resulting PIPEDA Awareness Raising Tools, known as PARTs, contain a series of questions and answers that make up guidelines for health care providers. They answered many of our concerns, provided necessary definitions and allowed for the implied consent model to continue to be used within the circle of care. The CMA applauds the government for this collaborative effort and the resulting guidelines have been used by health care providers ever since. However, we remain concerned that the PARTs guidelines have no legal status. This limitation creates a degree of uncertainty that the CMA would like this legislative review to see addressed by ensuring the PARTs series of questions and answers are referenced in PIPEDA. In addition to participating in the PARTS initiative, since PIPEDA's implementation, the CMA has designed practical tools for physicians and patients: * adopted the CMA policy Principles Concerning Physician Information to address the importance of protecting the privacy of physician information; * produced Privacy in Practice: a handbook for Canadian physicians to help physicians maintain best practices in the protection of patient health information; and * created the PRIVACYWIZARD(tm) designed to help physicians record their current privacy practices, communicate these to patients and identify possible areas for enhancement. 2. Physician Practice Information as "Work Product" I referred earlier to CMA's Policy document on physician information. The CMA strongly believes that physicians have legitimate privacy concerns about the use by third parties of information - such as prescribing and other practice data for commercial purposes. Currently deemed "work product" this information can be collected, used and disclosed without consent. We feel PIPEDA inadequately protects this information. We recognize that it is information generated out of the patient-physician relationship. We disagreed with findings of the previous Privacy Commissioner that physician prescribing information is not subject to PIPEDA's privacy protection provisions for "personal information". The CMA has consistently advocated that physician prescribing data and other practice information is personal information and appeared as an intervener in a Federal Court review of this issue that was ultimately settled by the main parties. Also, insufficient regard for the privacy of prescribing and other physician data could have a negative impact on the sanctity of the physician-patient relationship. Patients confide highly sensitive information to physicians with the expectation this information will be kept in the strictest confidence. This expectation exists because they know that physicians are under ethical and regulatory dictates to safeguard their information and that physicians take this responsibilities very seriously. The perceived and indeed actual loss of control by physicians over information created in the patient encounter, such as prescribing data, could undermine the confidence and faith of our patients that we are able to safeguard their health information. This concern is not hypothetical. For physicians, so called "work product" information also encompasses practice patterns such as discharge rates, referral rates, billing patterns, hospital length of stays, complaints, peer review results, mortality and re-admittance rates. With the advent of electronic medical records and growth in pay-for-performance and outcome-based incentive programs for physicians, there is an enormous potential for the resulting physician "performance" data or "work product" to be "mined" by other parties and used to influence performance review (traditionally the purview of the medical licensing authorities) as well as decisions around treatment funding and system planning. The lack of transparency in the sale and compilation of physicians' prescribing and other performance data means that physicians might find themselves to be the unwitting subject and targets of marketing research. We believe practice decisions must be made in the best interest of patients and not the bottom-line interests of businesses and marketers. CMA therefore recommends a legislative change to include physician information as personal information under PIPEDA. Legislation in Quebec provides an example that is consistent with CMA's approach since it requires regulatory oversight and gives individuals the right to opt out of the collection, use and disclosure of "professional" information. 3. Emerging Privacy and Health information issues With budgetary and demographic pressures, our health care system is under strain and physicians are striving to deliver timely, quality care to patients, often with competing and multiple demands. Physicians are therefore seeking assurances from law makers that any amendments to PIPEDA will take into account the potential impact on them and their patients. Therefore, we seek assurances that: * health care is recognized as unique when it comes to the disclosure of personal information before the transfer of a business (one physician transferring his/her practice to another) because it is regulated at the provincial level through the appropriate licensing body. As a general rule, physicians must give notice to the public, whether via a newspaper ad or a notice in the office about the change in practice. * the federal government will consider the impact of the trans-border flow of personal information on telehealth and Electronic Health Record activities. Communications between patients and physicians via electronic means are likely to increase and to move across geographic boundaries with increasing frequency; and * the federal government will study the issue of international cross border data flows, particularly among Canadian researchers who receive funding from US drug companies. These arrangements should be governed by Canadian law (PIPEDA) not American (HIPAA or the US Patriot Act). In closing, the privacy protection of personal health information is a responsibility that my colleagues and I do not take lightly. It is a key pillar of our relationship with Canadians, they not only expect it-they deserve it. I look forward to taking questions from Committee members. Canadian Medical Association Ottawa, December 13, 2006
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11 records – page 1 of 2.