November FINAL EXAMINATION 28, 2017 WRITE YOUR EXAM CODE: Return this exam question paper to your invigilator at the end of the exam before you leave the classroom. Your Small Group: CIRCLE: CURTIS GEE PROUD SCOW THIS EXAMiNATION CONSISTS OF 5 PAGES PLEASE ENSURE THAT YOU HAVE A COMPLETE PAPER THE UNIVERSITY OF BRITISH COLUMBIA PETER A. ALLARD SCHOOL OF LAW FINAL EXAMINATION -NOVEMBER 28, 2017 LAW 251 Public Law Professor Michael Da Silva Professor Catherine Dauvergne Professor Andrew Martin TOTAL MARKS: 50 TIME ALLOWED: 2 HOURS NOTE: ******************* 1. This is an open book examination. You may use your textbook and hardcopies of any notes or other materials that you have. Electronic devices are not permitted. Access to the internet is not permitted. 2. ANSWER ALL QUESTIONS. Page 1 of 5
Jo and Eddi have been married for a decade. In November of 2016, they were involved in a Jo would like the doctor to discontinue life support. She believes this is what Eddi would have Page 2 of 5 might be right about Eddi s wishes, but this was never a serious topic of conversation. hospital. After initially responding to treatment, Eddi s condition worsened and Eddi is now increasingly rocky. Arlun had counselled Eddi that it was time to end the relationship. working on a sheep farm. Sam claims that he and Eddi had been in regular contact, including licensed lawyer, for advice. In her view, there ought not to be any dispute here because the Dr. Jones and the Springdale Hospital where she is employed have come to you, now a newly life support would be at odds with what their late parents would have chosen. Arlun thinks Jo Jo and Eddi regularly argued about money throughout their marriage. Their arguments is distraught at the idea of discontinuing life support. She strongly believes that discontinuing is a horrible choice. communicated. Sam thinks that remaining on life support when there is no chance of recovery Sam, Eddi and Arlun s eldest brother, recently returned from three years in New Zealand to buy a home or to enjoy lavish vacations and rent small apartments. Shortly before the wanted, although they had never discussed these plans specifically. Arlun, Eddie s older sister, stemmed from a fundamental disagreement whether to save for the future in order to be able wanted to remain on life support but knows that this was never written down or formally serious car crash. Jo was in hospital for several months recovering. Eddi has remained in (November 28, 2017) on life support with no chance of recovery. accident, Eddi told Arlun that the arguments were taking a toll and that the marriage was speaking to one another on the day before the accident. Sam believes that Eddi might have recovery is possible is conclusive and that three doctors have all agreed, Dr. Jones believes that she ought to proceed without obtaining consent from anyone. patients wishes about medical care are respected. We believe that patients, and substitute care, and we remove the complicated uncertainties of the common law. The Minister of Care (Consent) and Care Facilities (Admission ) Act RSBC 1996 c. 181. When the bill was You should assume that a complete answer to these questions can be provided by the Health support if Dr. Jones follows Dr. Jones s legal duties in this case? substitute decision-maker? (2) Assuming that Dr. Jones requires the consent of a substitute What advice will you give Dr. Jones? Specifically, (1) Does Dr. Jones require the consent of a decision-maker, who should she approach and in what order? (3) Will Eddi stay on life treatment nor pain relief (because Eddi is clearly not in pain). Given that the evidence that no question of whether to withdraw life support is not a health care matter as it provides neither introduced in the legislature, the Minister of Health stated that This Act will ensure that decision-makers where necessary, should have the final say over what is done to patients in a health care setting. With this legislation we provide certainty for doctors and all those in their FiNAL EXAMINATION November 28, 2017
Definitions 16 (1) To obtain substitute consent to provide major or minor health care to an adult, Page 3 of 5 (a) a series or sequence of similar treatments or care administered to an adult over a (a) major surgery, (d) any health care designated by regulation as major health care; (b) any treatment involving a general anesthetic, (a) the adult s spouse; (b) the adult s child; period of time for a particular health problem, cosmetic or other purpose related to health, and includes health care means anything that is done for a therapeutic, preventive, palliative, diagnostic, 1 In this Act: Health Care (Consent) and Care Facilities (Admission) Act RSBC 1996 c. 181 (excerpts) commitments to patient- and family-centred care. relevant ones are included below]. 5 (1) A health care provider must not provide any health care to an adult without the (c) major diagnostic or investigative procedures, or major health care means General rule consent needed Health emphasized that the changes were necessary to be consistent with the government s adult s consent except under sections...[provisions for substituted consent, of which the and qualifies under subsection (2): FINAL EXAMINATION a health care provider must choose the first, in listed order, of the following who is available 28, 2017 November
Page 4 of 5 Guardian and Trustee. Duties of a temporary substitute decision maker must capable. (d.1) the adult s grandparent; (d.2) the adult s grandchild; (d) the adult s brother or sister; (a) be at least 19 years of age, (b) have been in contact with the adult during the preceding 12 months, (a) before giving or refusing substitute consent, consult, to the greatest extent possible, (2) To qualify to give, refuse or revoke substitute consent to health care for an adult, a person (g) a person immediately related to the adult by marriage. (f) a close friend of the adult; (e) anyone else related by birth or adoption to the adult; (d) be capable of giving, refusing or revoking substitute consent, and (e) be willing to comply with the duties in section 19. (b) comply with any instructions or wishes the adult expressed while he or she was relative or close friend of the adult who asks to assist, and dispute about who is to be chosen, the health care provider must choose a person, including a person employed in the office of the Public Guardian and Trustee, authorized by the Public authorized by the Public Guardian and Trustee, with any near (ii) if the person chosen under section 16 is a person (i) with the adult, and an adult must 19 (1) A person chosen under section 16 to give or refuse substitute consent to health care for the circumstances to comply with this section. (3) If no one listed in subsection (1) is available or qualifies under subsection (2) or if there is a (4) A health care provider is not required to do more than make the effort that is reasonable in (c) the adult s parent; (c) have no dispute with the adult, Fll TAL EXAMINATION 28, 2017 November LAW251 Public Law
Page 5 of 5 proposed health care, (3) When deciding whether it is in the adult s best interests to give, refuse or revoke (a) the adult s current wishes, and known beliefs and values, (b) whether the adult s condition or well-being is likely to be improved by the substitute consent, the person chosen under section 16 must consider FINAL EXAMINATION November 28, 2017 LAW251 Public Law (a) radiation therapy; (b) intravenous chemotherapy; (d) electroconvulsive therapy; (e) laser surgery. (c) kidney dialysis; 4 The following are designated as major health care: Health Care Consent Regulation (excerpts) as the proposed health care. (e) whether a less restrictive or less intrusive form of health care would be as beneficial greater than the risk of harm, and - (d) whether the benefit the adult is expected to obtain from the proposed health care is proposed health care, (c) whether the adult s condition or well-being is likely to improve without the decide to give or refuse consent in the adult s best interests. (2) If the adult s instructions or wishes are not known, the person chosen under section 16 must