Courts and health policy: judicial policy making and publicly funded health care in Canada

The 1982 Canadian Charter of Rights and Freedoms provided political actors with the opportunity to make rights-based challenges to public policy decisions. Two challenges launched by providers and consumers of health care illuminate the impact of judicial review on health care policy and the institutional capacity of courts to formulate policy in this field. The significant impact of rights-based claims on cross-jurisdictional policy differences in a federal regime is noted.     

Re Lavigne and Ontario Public Service Employees Union: public administration and remedial decree litigation under the Charter of Rights and Freedoms

Abstract: Analysts studying the political impact of the Charter of Rights and Freedoms have tended to focus on the role of the Supreme Court of Canada and on the formulation of remedies for Charter violations under s. 52(1) of the Constitution Act, 1982 (judicial nullification) and s. 24(2) of the Charter (exclusion of evidence). Without denying the importance of the Supreme Court, or the impact of nullification and exclusion of evidence, it is important to recognize that s. 24(1) of the Charter provides a remedial alternative whose implementation is likely to occur primarily within lower courts, and whose potential policy consequences are vast. What makes s. 24(1) so potentially important is that it provides courts the opportunity to shape and administer social policy directly through positive and prospective remedies. This article offers a preliminary exploration of this phenomenon by utilizing a model of remedial decree litigation developed in the United States to examine the most interesting s. 24(1) case yet considered by lower courts: Re Lavigne and Ontario Public Service Employees Union. The aim of the article is to explore the extent to which Canadian courts are restructuring their decision-making processes to undertake the institutional obligations imposed on them by remedial decree litigation under the Charter. Sommaire: Les analystes qui étudient l'impact politique de la Charte des droits et Iibertés axent leurs travaux sur le rôle de la Cour suprême du Canada et sur la formulation des sanctions pour violation de la Charte en vertu de l'art. 52(1) de la Loi constitutionnelle de 1982 (invalidation judiciaire) et de l'art. 24(2) de la Charte (exclusion de preuve). Sans nier ni l'importance de la Cour suprême, ni celle de l'impact de l'invalidation ou de l'exclusion de preuve, il est important de reconnaître que l'art 24(1) de la Charte fournit un mode de sanctions dont l'application est plus susceptible de se produire de-vant les tribunaux inférieurs et dont les conséquences politiques éventuelles sont nom-breuses. L'importance de l'art 24(1) tient à ce qu'il donne aux tribunaux la possibilité de formuler et d'appliquer directement des politiques sociales par le biais de sanctions positives et prospectives. Cet article étudie ce phénomène en utilisant un modéle de jugement réparateur élaboré aux États-Unis pour examiner au titre de l'art. 24(1) un tribunal inférieur: Re Lavigne et le Syndicat des employés de Infection publiyue de l'Ontorio. L'objet de cet article est d'étudier dans quelle mesure les tribunaux canadiens restructuring leurs procédures de prise de décisions pour mettre en oeuvre les obligations institutionalism qui leur sont attribuées par les recours réparateurs qu'autorise la Charte.     

Assessment of the Capacity to Express Informed Consent for Organ Donation in Patients with Schizophrenia

Abstract: In Italy, the “silent‐consent” principle of donor’s willingness regulates organ donation for postmortem transplantation, but civil incompetence excludes it. We investigated decisional capacity for organ donation for transplantation of 30 controls and 30 nonincompetent patients with schizophrenia as related to clinical symptoms, cognition, and functioning. Assessments were carried out through the Competence for Donation Assessment Scale (CDAS), Brief Psychiatric Rating Scale (BPRS), Scale for the Assessment of Positive Symptoms (SAPS), Scale for the Assessment of Negative Symptoms, Life Skills Profile (LSP), Raven’s Colored Progressive Matrices (RCPM), Wisconsin Card Sorting Test, Rey RI, Rey RD, and Visual Search. Patients and controls differed on the CDAS Understanding and Choice Expression areas. Patients showed significant inverse bivariate correlations between CDAS Understanding and scores on total BPRS, LSP self‐care scale, and RCPM cognitive test. Our results show that decisional capacity for participating in research does not predict decisional capacity for postmortem organ donation in patients with schizophrenic or schizoaffective psychosis; hence, before judging consent for donation, patients must be provided with enhanced information to better understand this delicate issue.     

科学发展与社会和谐良性互动:开创改革开放新局面的关键着力点

科学发展和社会和谐是内在统一的,都是发展中国特色社会主义的基本要求,这种内在统一决定了在发展中国特色社会主义的过程中,科学发展和社会和谐能够而且必须做到良性互动.改革开放作为建设和发展中国特色社会主义的伟大实践,只有深刻体现和着力实现这种内在统一和良性互动,才能使改革开放伟大事业不断达到一种新的境界,才能更好地为发展中国特色社会主义提供强大动力.因此,在新的历史起点上,继续坚定不移地推进和深化改革开放,不断开创改革开放新局面,进而不断开创中国特色社会主义事业新局面,必须将实现科学发展与社会和谐良性互动作为关键着力点.