Proposed Disposition of 2015 General Council Resolutions 148 th Annual Meeting of the Canadian Medical Association

Transcription

1 Reference Resolution Disposition Proposed Seniors' Care Strategy 1. SS SS SS SS SS SS SS SS SS7-8 supports improved training, resource allocation and incentives to help primary care physicians develop robust, aroundthe-clock services for frail and elderly Canadians living in the community. supports the adoption of fracture-liaison programs at facilities involved with postfracture care. supports the development of a coordinated national approach to reduce polypharmacy in the elderly. will ensure that its national seniors' strategy specifically addresses the needs of seniors in rural and northern areas. supports the inclusion of adequate, evidence-based support for family caregivers in a national seniors strategy. recognizes the participation, roles and valuable contributions of seniors in our society. supports the development of guidelines and standards for the use of telemonitoring technology. recommends that a national seniors strategy includes evidence-based hospital practices that better meet seniors' physical, cognitive and psychosocial needs. supports the development of innovative and alternative models/partnerships that can provide services and resources for patients seamless transition through the continuum of care in a national seniors' strategy. Work with the College of Family Physicians of Canada; incorporate into CMA s work on the National Seniors Strategy and policy database. Produce a letter synthesizing this and other resolutions relating to medical education and continuing professional development for the information of the Association of Faculties of Medicine of Canada, Committee on Accreditation of Canadian Medical Schools, Committee on Accreditation of Continuing Medical Education, Canadian Federation of Medical Students, College of Family Physicians of Canada and Royal College of Physicians and Surgeons of Canada. Work with Canadian Orthopaedic Association to disseminate policy and add to policy database. The policy A Prescription for Optimal Prescribing will be updated to reflect this resolution. Polypharmacy in the elderly is also addressed in the policy on Medication Use and Seniors. This resolution will be incorporated into CMA s work on the National Seniors Strategy. This resolution will be incorporated into CMA s work on the National Seniors Strategy. This resolution will be incorporated into CMA s work on the National Seniors Strategy. CMA s 2015 pre-budget brief calls for increased support for Canada s family caregivers and recommends that the federal government amend the Caregiver and Family Caregiver Tax Credits to make them refundable. This resolution will be incorporated into CMA s work on the National Seniors Strategy. CMA will develop guidelines using the same process used to produce guiding principles for the recommendation of mobile health apps to patients, consult with former members of the GP Forum and the ehealth Action Group and incorporate policies of the American Telemedicine Association. CMA will advocate as stated in this resolution as part of its National Seniors Strategy. CMA will advocate as stated in this resolution as part of its National Seniors Strategy. 1

2 10. SS7-10 recommends that tax incentives and/or other financial supports for caregivers be available for all family members, without a requirement for co-habitation. Delegates Motions End-of-life Care 11. DM DM EI DM DM DM DM DM SP 0-13 encourages increased education and training in end-of-life care for community health care workers. recognizes that the practice of assisted death as defined by the Supreme Court of Canada is distinct from the practice of palliative care. calls for the unconditional public release of the Final Report of the External Panel on Options for a Legislative Response to Carter v. Canada upon its completion. supports consultation with the Canadian Society of Palliative Care Physicians and other relevant physician societies when policies, regulations and guidelines are developed on physician-assisted dying. supports the development and application of accredited standards for the integration of a palliative care approach into the management of lifelimiting chronic disease. will develop guidelines for physician assessment of patients who request physician-assisted death. supports the development of pan- Canadian guidelines for physicians on the terminology to be used when completing medical certification of death forms in cases involving physicianassisted death. will advocate that discussion of and access to a high-quality palliative approach to care be available to all Canadians, including those with life-limiting illnesses who are considering assisted death. will advocate for the adoption of a framework for physician participation in medical aid in dying that is based on the principles of respect for patient autonomy, equity, respect for physician values, consent and capacity, clarity, CMA will write to the Minister of National Revenue and incorporate this resolution in its work on a National Seniors Strategy. The resolution will be included in the CMA policy database and reflected in CMA s end-of-life strategy. CMA will write a letter to the Panel to encourage the release of the final report, if it appears it will not be made public. CMA will consult with affiliates as required. 2

3 dignity of life, protection of patients, accountability, solidarity and mutual respect. Delegates Motions Emerging Issues 20. EI EI EI0-4 insists that provincial/territorial governments should fund all necessary growth in health care. stands against governments undertaking unilateral action in lieu of a negotiated agreement with physicians. supports the Ontario Medical Association s request for the inclusion of a binding dispute resolution mechanism in its contract negotiations with the Government of Ontario. Delegates Motions Medical professionalism 23. DM DM DM DM5-7 supports mandatory training on organ donation for medical students and residents at all Canadian medical schools. supports the development of a national multidisciplinary knowledge-sharing network for precision medicine research. encourages the expansion of continuing professional development opportunities that result in measurable improvement outcomes for patient care. will advocate for incorporation of a systems-thinking approach across all stages of the medical career life cycle. In 2014 the Canadian population grew by 1.1% and provincial/territorial government health spending grew by just 1.9% leaving a shortfall by the time you account for population aging and utilization. This resolution ties in well with CMA s advocacy for a National Seniors Strategy and can be factored in specifically to advocacy for the demographic top-up fund that is proposed in CMA s 2016 pre-budget submission. CMA has previously written to Health Minister Leona Agglukaq urging the federal government to enforce Section 12(2) of the Canada Health Act and received a response saying that the Act does not prescribe how the provinces should negotiate. This issue will be discussed at the 2015 National Health Policy and Negotiations Conference as the provincial/territorial medical associations may have some novel suggestions. CMA will also raise this issue as one element in its political engagement strategy. Pursuant to consultation with the Ontario Medical Association, CMA will convey this resolution to the Ontario Premier and provincial health minister and will raise the possibility of a joint letter from all provincial/territorial medical association presidents. CMA will share this resolution with the Canadian Medical Protective Association, who is branching out into analytics. CMA will also discuss with the Committee of Ethics the possibility of developing a CMA policy on genetic testing. The resolution will be added to the policy database. (It should be noted that this is already included in CACME standards.) The NewCo Physician Advisory Group will review potential professional development opportunities for physicians. 3

4 27. DM DM DM DM DM DM DM DM5-13 supports physicians who choose a gradual transition toward retirement. will promote the development of resources to foster academic writing and editing among practicing physicians and physicians-in-training. supports the inclusion of training in the handover of patient care as part of the accreditation standards for Canadian medical schools. will provide information and tools to physicians to promote the medical profession s critical role in supporting immunization. will advocate for a generalist approach across the medical career life cycle. will promote the development of clinical tools to assist physicians and physicians-in-training improve their understanding of the specific health care needs of individuals who identify themselves as lesbian, gay, bisexual, transgender and/or queer. supports in principle the right of Canadian medical students and medical residents to vote in the election of their medical association representatives. affirms its support for the continued use of the arm s-length, anonymous pre-accreditation survey as an integral component of the national system of accreditation for postgraduate medical education. CMA will refer this issue to the Canadian Physician Health Institute s advisory committee for consideration, and incorporate this resolution into the business plan on physician health to be delivered to the CMA Board in Q NewCo to investigate potential opportunities to develop resources to support physicians in developing skills for writing and editing for CMAJ and other medical journals. CMA will reach out to former members of the GP Forum to explore their interest in producing the proposed discussion paper. CMA will propose this as an item for discussion at an upcoming Presidents Forum. 4

5 Delegates Motions Physician Health 35. DM5-14 encourages medical schools to incorporate student wellness education in the medical school curriculum. 36. DM5-48 will explore options for developing grief resources and peer-support networks for physicians dealing with bereavement. Delegates Motions National voice for profession 37. DM5-66 will conduct a campaign to urge governments to restore and increase public health budgets. 38. DM5-15 urges the pan-canadian Pharmaceutical Alliance to invite the federal government and private health insurance industry to participate in its price negotiations for prescription drugs. 39. DM5-16 endorses the concept of a basic income guarantee. 40. DM5-17 supports the development and implementation of a national strategy on the use of naloxone. 41. DM5-18 supports the development of an equitable and comprehensive national pharmacare program. 42. DM5-20 supports the organization, centralization and management of cradle-to-grave health records for patients living in Canada. 43. DM5-21 will promote the health benefits of a strong, predictable price on carbon 44. DM DM5-23 emissions. will develop workplace guidelines for physicians who have or develop disabilities or disease. calls on the federal government to amend the Criminal Code by making it a specific criminal offence to assault health care providers performing their duties. Committee on Accreditation of Canadian Medical Schools (CACMS), Committee on Accreditation of Continuing Medical Education, Canadian Federation of Medical Students, College of Family Physicians of Canada and Royal (Note that this is already incorporated into CACMS standards.) CMA will refer this issue to the Canadian Physician Health Institute s advisory committee for consideration, and will incorporate this resolution into the business plan on physician health to be delivered to the CMA Board in Q CMA will continue to work with its public health partners to advocate for an increase in public health budgets, including the Canadian Coalition for Public Health in the 21st Century, Chronic Disease Prevention Alliance of Canada and the Canadian Public Health Association. CMA has conveyed this recommendation to the Premier co-chairs of the Health Care Innovation Working Group and will incorporate it in any advocacy engagement related to pharmacare. CMA will also consider incorporating this resolution into future advocacy initiatives/briefs. This resolution will be included in the CMA policy database. Key messages supporting a national strategy on naloxone use will be incorporated into CMA advocacy on pharmaceutical policy. CMA s 2015 pre-budget brief recommends that the federal government establish a new funding program for catastrophic coverage of prescription medicine. The wording of this resolution can be incorporated into future briefs to government. CMA will initiate research into the health benefits of a strong predictable price on carbon emissions. In addition, given the interest in climate change for next year s General Council, additional resources may be required to address the environment resolutions this year. CMA will explore options to collaborate with the Canadian Physician Health Institute and Canadian Association of Physicians with Disabilities. CMA will write a letter proposing language for the Criminal Code while adapting the language already existing about making it a specific criminal offence to assault peace officers while performing their duties. 5

6 46. DM DM LM10-1 Proposed Disposition of 2015 General Council Resolutions will promote practical advocacy strategies to support the health and well-being of First Nations, Métis and Inuit communities in Canada. will work with the Royal College of Physicians and Surgeons of Canada and College of Family Physicians of Canada to provide a unified voice when advocating on issues of common interest. urges the federal government to prevent torture around the world by allowing third party investigators, including medical professionals, to examine and review detention centres. CMA will consult with the Royal College of Physicians and Surgeons of Canada on its Indigenous health initiative. CMA will also engage its First Nations, Inuit and Métis partners. Work is underway in this area, including ongoing consultations at the CEO level. CMA will review potential options and tactics and write a letter urging the Government of Canada to ratify policy or legislation to prevent torture around the world by allowing third party investigators, including medical professionals, to examine and review detention centres. Delegates Motions Healthy population/world-class health care 49. DM DM DM DM DM DM DM5-42 supports consistent immunization policies, health and safety requirements and standardized reporting for all medical schools in Canada. supports the development of a national skin cancer awareness and prevention campaign. urges the federal government to accelerate the development and implementation of a national immunization registry. urges the federal government to enact legislation prohibiting all forms of discrimination based on genetic testing. asks governments to step up their commitment to promoting and raising awareness of immunization against childhood diseases. will work to reduce barriers to accessing immunization. supports the development of best practices to assist patients aged 16 to 24 transitioning from pediatric to adult health services. Note that the Canadian Dermatology Association and Canadian Cancer Society already have anti-tanning and skin cancer campaigns. CMA will discuss with the Committee of Ethics the possibility of developing a CMA policy on genetic testing. This resolution will be added to the CMA policy database. 6

7 56. DM DM DM DM DM DM DM DM DM DM5-34 supports the development of a lifespan broad national strategy for Autism Spectrum Disorder that covers research, prevention, treatment, education, support, funding and policies. supports improved access to bariatric surgery across Canada. supports the Pan-Canadian Joint Consortium for School Health. recommends the development of a structured screening program for cervical cancer that includes detection of high-risk human papillomavirus in vulnerable groups. recommends that governments authorize elementary and secondary schools to require a declaration of immunization status, to be followed by a conversation between public health officials and parents where children are shown to be inadequately immunized. recommends patient populations that fall under federal jurisdiction should have access to the same effective and appropriate care as all other Canadians. calls for regulations on the marketing of direct-to-consumer genetic testing. supports the development of a national strategy to integrate precision medicine into clinical care. calls for a review of national, provincial and territorial informedconsent and privacy legislation to reflect the challenges created by the introduction of genetic testing. recommends that primary care telemedicine investments, policies and regulations support comprehensive and continuous patient-centred care. CMA will inform the Canadian Autism Spectrum Disorders Alliance of CMA s support for a national strategy for Autism Spectrum Disorder. The notion of improving timely access to a wide range of procedures is covered in the Wait Time Alliance s 2015 report card. CMA will write a letter to the Pan-Canadian Joint Consortium for School Health indicating CMA s support for comprehensive school health. CMA will refer this resolution to the Society of Obstetricians and Gynecologists of Canada for their information. This issue will be referenced in the Wait Time Alliance s 2015 report card. CMA will discuss with the Committee of Ethics the possibility of developing a CMA policy on genetic testing. This resolution will be added to the CMA policy database. CMA will discuss with the Committee of Ethics the possibility of developing a CMA policy on genetic testing. This resolution will be added to the CMA policy database. CMA will discuss with the Committee of Ethics the possibility of developing a CMA policy on genetic testing. This resolution will be added to the CMA policy database. CMA will develop guidelines using the same process used to produce guiding principles for the recommendation of mobile health apps to patients and consult with former members of the GP Forum and the ehealth Action Group. CMA will also incorporate policies of the American Telemedicine Association. (Note that disposition of this resolution is combined with that of item #7 from this table.) 7

8 66. DM DM DM DM DM5-37 calls for immunization registries that can accept information directly from the electronic medical records of health care providers. promotes increased knowledge amongst physicians in the practice of trauma-informed care. will consult with Health Canada to discuss the effects of online gambling. will convene a national roundtable to eliminate jurisdictional barriers and establish best-care practices that acknowledge the unique circumstances of Aboriginal communities. supports the development of a national plan to address vaccine hesitancy. Health Canada officials will be consulted. CMA will consult with the Royal College of Physicians and Surgeons of Canada on its Indigenous health initiative. CMA will also engage its First Nations, Inuit and Métis partners. 71. DM5-26 Referred to the Board recognizes obesity as a chronic medical disease. Delegates Motions Strategic relationships 72. DM DM DM5-50 recommends that laboratories work collaboratively with physicians to ensure that ranges reported in connection with laboratory results are evidence based and clinically significant. will work with the insurance industry to develop guidelines for physicians who provide patients with information related to travel insurance. will create a working group to evaluate federal forms used by physicians. Delegates Motions Products and services 75. DM5-51 recommends to the Board of Directors of MD Financial Management Inc. that it establish a carbon-risk reducedinvestment option that includes investment in renewable energy initiatives. The resolution, adopted by the CMA Board in October 2015, will be added to the CMA policy database. Key messages will be prepared to support CMA elected officials on this issue. CMA will meet with the Canadian Society of Medical Laboratory Science to explore the issues and options. In the first instance CMA will request a meeting with senior officials from the Canadian Life and Health Insurance Association to discuss this issue and the ongoing issue of blanket requests by insurance companies for patient information. This can then be used to develop guidelines and advocacy vis-à-vis insurance industry regulators and/or provincial/territorial privacy commissioners. In the first instance CMA will canvas the provincial/territorial medical associations to determine the processes they use to provide input on forms requiring physician completion at the provincial/territorial level. To the degree that they have provincial/territorial committees, these could be drawn on to form time-limited working groups to prioritize and work on federal forms issues. Interest in this work could also be solicited from former members of the GP Forum, who have previously provided valuable input on forms such as the Canada Pension Plan Disability Form and the Disability Tax Credit Form. MD has engaged a market research firm to assess client interest and test product options. The study has three stages: qualitative on-line focus groups, qualitative in-person focus groups, and a final quantitative survey for final analysis. A report is expected by November 2015 to determine next steps. 8

9 76. DM5-52 will divest its reserves of investments in energy companies whose primary business relies upon fossil fuels. 77. DM5-53 will explore investment opportunities, for its reserves, in renewable energy solutions. Governance and Finance 78. AGM0-2 will clarify the terms of service for those elected at General Council 2015 with respect to the bylaws which were in place at the time of those elections. 79. BD 1-1 (CMA) approves the Canadian Society for Vascular Surgery s application for CMA affiliate status. 80. BD 1-2 (CMA) approves the Trauma Association of Canada s application for CMA affiliate status. 81. BD 1-3 (CMA) approves the Canadian Association of Thoracic Surgeons application for CMA affiliate status. 82. BD 1-4 will combine its Audit and Finance committees and the newly constituted committee will report to the Board of Directors. 83. BD 1-5 Nominees elected to Canadian Medical Association positions by General Council, with the exception of the Committee on Nominations, will hold office for a term of three years with a maximum of two consecutive terms; student and resident representatives may hold office for a term of one year with a maximum of three consecutive terms. 84. BD 1-6 adopts the current edition of Robert s Rules of Order Newly Revised as the rules of order for the association. 85. full BD 1-7 membership fee for the year 2016 will be maintained at $495. MD, as advisor to CMA for the investment of its corporate reserves, is in the process of reviewing the portfolio for its allocation to fossil fuels, with a view to divesting in an orderly fashion and providing recommendations to the CMA Board. MD, as advisor to CMA for the investment of its corporate reserves, is in the process of reviewing the portfolio for its allocation to fossil fuels, with a view to divesting in an orderly fashion. CMA will work with the Governance Committee to confirm the terms and next steps. CMA will inform the Canadian Society for Vascular Surgery and amend the bylaws accordingly CMA will inform the Trauma Association of Canada and amend the bylaws accordingly. CMA will infor the Canadian Association of Thoracic Surgeons and amend the bylaws accordingly. Terms of reference will be developed for the new committee and submitted to the Board for approval in December The Board will also be asked to appoint the financial/audit expert at that time. Terms of reference and the bylaws will be adjusted accordingly. The bylaws will be adjusted accordingly. Provincial/territorial medical associations were informed in early September. 86. AUD 3-2 will retain PricewaterhouseCoopers as auditors for the 2016 association fiscal year. CMA will inform PricewaterhouseCoopers. 9