Statement to the Canadian panel on violence against women Ottawa -September, 1992

https://policybase.cma.ca/en/permalink/policy11956
Last Reviewed
2019-03-03
Date
1992-09-15
Topics
Health care and patient safety
Ethics and medical professionalism
  1 document  
Policy Type
Parliamentary submission
Last Reviewed
2019-03-03
Date
1992-09-15
Topics
Health care and patient safety
Ethics and medical professionalism
Text
The CMA is pleased to have this opportunity to address the Canadian Panel on Violence Against Women. As a professional organization with a leadership role in societal issues affecting health, it is both appropriate and important for the CMA to be actively involved in addressing the problems associated with violence. The extremely high incidence of abuse, the associated severe physical, mental and psychological health problems and the significant role played by physicians in recognizing and caring for victims make this a priority for organized medicine. The CMA has significant experience and expertise in this field. In 1984, the CMA General Council passed a resolution stating: "That Health and Welfare Canada and the Provincial Ministries of Health and Education alert the Canadian public to the existence of family violence, including wife assault, child abuse, and elder abuse, and to the services available which respond to these problems, and that organized medicine (through such vehicles as professional journals, newsletters, conferences and formal medical education) alert the physicians of Canada to the problem and that all physicians learn to recognize the signs of family violence in their daily contact with patients and undertake the care and management of victims using available community resources." (Resolution #84-47) The CMA calls the Panel's attention to four major areas of concern: Recognition and Treatment, Education and Training, Protocol Development and Research. 1. Recognition and Treatment: Recognition includes acknowledging the existence and prevalence of abuse and identifying victims of violence. Violence against women is clearly a health issue and one that should be given a very high priority. Statistics indicate that nearly one in eight Canadian women will be subject to spousal violence in her lifetime and that one in five will be a victim of sexual assault. Violence against women is a major determinant of both short -and long-term health problems including traumatic injury, physical and psychological illnesses, alcohol/drug addiction and death. Furthermore, although it is critically important to recognize that abuse crosses all racial and socio-economic boundaries, there are strong indications that certain groups are particularly vulnerable to abusive acts (e.g., pregnant, disabled and elderly women). Recognition includes acknowledging and understanding the social context within which violence occurs. Violence is not an isolated phenomenon, but is part of the much broader issue of societal abuse of women. Physicians are often the first point of contact for patients who have been abused physically, sexually, mentally and/or psychologically. They have a vital role to play in identifying victims and providing treatment and supportive intervention including appropriate referral. Abuse is not always readily apparent, however, and may go undetected for extended periods of time. Numerous studies have shown that both physicians and patients often fail to identify abuse as an underlying cause of symptoms. Such delays can result in devastating and sometimes fatal consequences for patients. Even in those cases where abuse is apparent, both physicians and patients often feel uncomfortable talking openly about the abuse and the circumstances surrounding it. It is the physician's role and responsibility to create a safe and supportive environment for the disclosure and discussion of abuse. Furthermore, the lack of resources for support services or the lack of awareness of what services are available to provide immediate and follow-up care to patients in need may discourage physicians from acknowledging the existence of abuse and identifying victims. It is clear that improvement in the ability and the degree to which victims of abuse are recognized and given appropriate assistance by physicians and other caring professionals in a non-threatening environment is urgently required. Individuals who are abused usually approach the health care system through primary contact with emergency departments or other primary care centres. The care available in such settings is acute, fragmented and episodic. Such settings are not appropriate for the victims of violence. The challenge that we, as physicians, recognize is to be able to provide access in a coordinated way to medical, social, legal and other support services that are essential for the victim of violence. This integration of services is essential at the point of initial recognition and contact. The CMA has been involved with eight other organizations in the Interdisciplinary Project on Domestic Violence (IPVD), the primary goal of which is to promote interdisciplinary co-operation in the recognition and management of domestic violence. 2. Education and Training: The spectrum of abuse is complex; the victims are diverse; expertise in the field is developing. The current system of medical education neither provides health care personnel with the knowledge or skills nor does it foster the attitude to deal adequately with this issue. Some of CMA's divisions have played an active role in this area. For instance, the Ontario Medical Association has developed curriculum guidelines and medical management of wife abuse for undergraduate medical students. It is ,important that there be more involvement by relevant medical groups in developing educational and training programs and more commitment from medical educators to integrate these programs and resources into the curriculum. Programs must be developed and instituted at all levels of medical education in order that physicians can gain the requisite knowledge and skills and be sensitive to the diversity of victims of violence. The CMA believes that the educational programs must result in: 1) understanding of the health consequences of violence; 2) development of effective communication skills; and, 3) understanding of the social context in which violence occurs. Understanding of the social context in which violence occurs will require an examination of the values and attitudes that persist in our society, including a close consideration of the concepts of gender role socialization, sexuality and power. This is required in order to dispel the pervasive societal misconceptions held by physicians and others which act as barriers to an effective and supportive medical response to patients suffering the effects of violence. 3. Development of Protocols: The CMA recognizes the need for more effective management and treatment of the spectrum of problems associated with violence against women. Health care facilities, professional organizations and other relevant groups are challenged to formulate educational and policy protocols for integrated and collaborative approaches to dealing with prevention of abuse and the management of victims of violence. The CMA and a number of its divisions have been active in this area:
In 1985, the CMA prepared and published Family Violence: Guidelines for Recognition and Management (Ghent, W.R., Da Sylva, N.P., Farren, M.E.), which dealt with the signs and symptoms, assessment and management, referral assistance and medical records with respect to wife battering, child abuse and abuse of the elderly;
The Ontario Medical Association published Repons on Wife Assault in January 1991. This document, endorsed by the CMA, examines the problem of wife assault from a medical perspective and outlines approaches to treatment of the male batterer and his family;
The Medical Society of Nova Scotia has developed a handbook entitled Wife Abuse: A Handbook for Physicians, advising on the identification and management of cases involving the battering of women;
The New Brunswick Medical Society has produced a series of discussion papers on violence and in conjunction with that province's Advisory Council on the Status of Women, has produced a graphic poster depicting physical assault on pregnant women as a way of urging physicians to be alert for signs of violence against women; The Medical Society of Prince Edward Island has worked cooperatively with the provincial Department of Health and Social Services and the Interministerial Committee on Family Violence to produce a document entitled Domestic Violence: A Handbook for Physicians. The CMA encourages continued involvement by the medical profession in the development of initiatives such as these and welcomes the opportunity to work in collaboration with other professionals involved in this area. 4. Research The CMA has identified violence against women as a priority health issue. Like rriany other areas in women's health, there is a need for research focusing on all aspects of violence and the associated problems. More specifically, the CMA maintains that there should be more research on the incidence of abuse (particularly as it relates to particular groups), on ways to facilitate the disclosure by victims of abuse and on the effectiveness of educational and prevention programs. The CMA recognizes that the medical profession must show a greater commitment to ending abuse of women and providing more appropriate care and support services to those who are victims of violence. The CMA possesses unique skills and expertise in this area and welcomes the opportunity to work with the Panel on this challenging social and health problem.
Documents
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License of the Medical Council of Canada (LMCC)

https://policybase.cma.ca/en/permalink/policy516
Last Reviewed
2017-03-04
Date
1992-08-19
Topics
Physician practice/ compensation/ forms
Resolution
GC92-09
That the Canadian Medical Association, while recognizing that the provincial/territorial licensing authorities have the ultimate authority regarding licensure requirements in their respective jurisdictions, wishes to reaffirm the principle that any rights and privileges that will be accorded to holders of the revised License of the Medical Council of Canada (LMCC) should be conferred on all physicians who completed their LMCC prior to the new requirements, including portability of eligibility for licensure.
Policy Type
Policy resolution
Last Reviewed
2017-03-04
Date
1992-08-19
Topics
Physician practice/ compensation/ forms
Resolution
GC92-09
That the Canadian Medical Association, while recognizing that the provincial/territorial licensing authorities have the ultimate authority regarding licensure requirements in their respective jurisdictions, wishes to reaffirm the principle that any rights and privileges that will be accorded to holders of the revised License of the Medical Council of Canada (LMCC) should be conferred on all physicians who completed their LMCC prior to the new requirements, including portability of eligibility for licensure.
Text
That the Canadian Medical Association, while recognizing that the provincial/territorial licensing authorities have the ultimate authority regarding licensure requirements in their respective jurisdictions, wishes to reaffirm the principle that any rights and privileges that will be accorded to holders of the revised License of the Medical Council of Canada (LMCC) should be conferred on all physicians who completed their LMCC prior to the new requirements, including portability of eligibility for licensure.
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Sensitivity to Canada's pluralistic society

https://policybase.cma.ca/en/permalink/policy523
Last Reviewed
2017-03-04
Date
1992-03-02
Topics
Population health/ health equity/ public health
Resolution
BD92-05-155
That the Canadian Medical Association reflect sensitivity to Canada's pluralistic society in its communication and publication activities.
Policy Type
Policy resolution
Last Reviewed
2017-03-04
Date
1992-03-02
Topics
Population health/ health equity/ public health
Resolution
BD92-05-155
That the Canadian Medical Association reflect sensitivity to Canada's pluralistic society in its communication and publication activities.
Text
That the Canadian Medical Association reflect sensitivity to Canada's pluralistic society in its communication and publication activities.
Less detail

United Nations Convention on the Rights of the Child

https://policybase.cma.ca/en/permalink/policy591
Last Reviewed
2017-03-04
Date
1992-05-09
Topics
Ethics and medical professionalism
Resolution
BD92-06-251
That the Canadian Medical Association adopt as Canadian Medical Association policy the United Nations Convention on the Rights of the Child.
Policy Type
Policy resolution
Last Reviewed
2017-03-04
Date
1992-05-09
Topics
Ethics and medical professionalism
Resolution
BD92-06-251
That the Canadian Medical Association adopt as Canadian Medical Association policy the United Nations Convention on the Rights of the Child.
Text
That the Canadian Medical Association adopt as Canadian Medical Association policy the United Nations Convention on the Rights of the Child.
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Violence against women

https://policybase.cma.ca/en/permalink/policy592
Last Reviewed
2017-03-04
Date
1992-10-17
Topics
Ethics and medical professionalism
Resolution
BD93-02-57
That the statement to the Advisory Panel on Violence against Women be approved.
Policy Type
Policy resolution
Last Reviewed
2017-03-04
Date
1992-10-17
Topics
Ethics and medical professionalism
Resolution
BD93-02-57
That the statement to the Advisory Panel on Violence against Women be approved.
Text
That the statement to the Advisory Panel on Violence against Women be approved.
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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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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
Less detail

Support services for sick and disabled members

https://policybase.cma.ca/en/permalink/policy635
Last Reviewed
2017-03-04
Date
1992-05-09
Topics
Population health/ health equity/ public health
Resolution
BD92-06-250
That the Canadian Medical Association work with the divisions in exploring options for financial and other support services for members whose employment status is affected as a result of disease and uninsurable as the result of disease or disability.
Policy Type
Policy resolution
Last Reviewed
2017-03-04
Date
1992-05-09
Topics
Population health/ health equity/ public health
Resolution
BD92-06-250
That the Canadian Medical Association work with the divisions in exploring options for financial and other support services for members whose employment status is affected as a result of disease and uninsurable as the result of disease or disability.
Text
That the Canadian Medical Association work with the divisions in exploring options for financial and other support services for members whose employment status is affected as a result of disease and uninsurable as the result of disease or disability.
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Physician manpower

https://policybase.cma.ca/en/permalink/policy702
Last Reviewed
2017-03-04
Date
1977-06-22
Topics
Health human resources
Resolution
GC77-2
Whereas the subject of physician manpower is one of major concern and importance to the profession and the governments in Canada, and Whereas it is essential that the profession have major input to the policies developed in this regard Therefore be it resolved that the Board of Directors ensure that the appropriate body in the Canadian Medical Association continues to examine this subject of physician manpower, develops expertise in it, and provides advice to the board of directors in relation to it, on an ongoing basis.
Policy Type
Policy resolution
Last Reviewed
2017-03-04
Date
1977-06-22
Topics
Health human resources
Resolution
GC77-2
Whereas the subject of physician manpower is one of major concern and importance to the profession and the governments in Canada, and Whereas it is essential that the profession have major input to the policies developed in this regard Therefore be it resolved that the Board of Directors ensure that the appropriate body in the Canadian Medical Association continues to examine this subject of physician manpower, develops expertise in it, and provides advice to the board of directors in relation to it, on an ongoing basis.
Text
Whereas the subject of physician manpower is one of major concern and importance to the profession and the governments in Canada, and Whereas it is essential that the profession have major input to the policies developed in this regard Therefore be it resolved that the Board of Directors ensure that the appropriate body in the Canadian Medical Association continues to examine this subject of physician manpower, develops expertise in it, and provides advice to the board of directors in relation to it, on an ongoing basis.
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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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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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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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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.
Less detail
Last Reviewed
2017-03-04
Date
1977-06-22
Topics
Population health/ health equity/ public health
Resolution
GC77-27
That the Canadian Medical Association encourage programs to promote fluoridation of communal water supplies.
Policy Type
Policy resolution
Last Reviewed
2017-03-04
Date
1977-06-22
Topics
Population health/ health equity/ public health
Resolution
GC77-27
That the Canadian Medical Association encourage programs to promote fluoridation of communal water supplies.
Text
That the Canadian Medical Association encourage programs to promote fluoridation of communal water supplies.
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Goods and Services Tax (GST)

https://policybase.cma.ca/en/permalink/policy619
Last Reviewed
2016-05-20
Date
1992-08-19
Topics
Physician practice/ compensation/ forms
Resolution
GC92-19
That the Canadian Medical Association, on behalf of its members and divisions and on the basis of its recent review of evidence on the impact of the Goods and Services Tax on Canadian physicians, continue its efforts to negotiate a tax rebate or such other arrangements so as to afford physicians the same fair treatment as is received by municipalities, universities, schools and hospitals.
Policy Type
Policy resolution
Last Reviewed
2016-05-20
Date
1992-08-19
Topics
Physician practice/ compensation/ forms
Resolution
GC92-19
That the Canadian Medical Association, on behalf of its members and divisions and on the basis of its recent review of evidence on the impact of the Goods and Services Tax on Canadian physicians, continue its efforts to negotiate a tax rebate or such other arrangements so as to afford physicians the same fair treatment as is received by municipalities, universities, schools and hospitals.
Text
That the Canadian Medical Association, on behalf of its members and divisions and on the basis of its recent review of evidence on the impact of the Goods and Services Tax on Canadian physicians, continue its efforts to negotiate a tax rebate or such other arrangements so as to afford physicians the same fair treatment as is received by municipalities, universities, schools and hospitals.
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