Governmental and Institutional Tort Liability for Quality of Care in Canada

By Hardcastle, Lorian | Health Law Journal, Annual 2007 | Go to article overview

Governmental and Institutional Tort Liability for Quality of Care in Canada


Hardcastle, Lorian, Health Law Journal


The past hall century has been marked by the expansion of the law of torts and, especially, responsibility for negligence. No citation of authority is necessary to show that, in order to meet new situations in a rapidly changing society, Courts have greatly expanded the concept of the duty owed to others by persons and institutions. [T]he responsibilities of the hospital to the patient have expanded greatly in breadth and depth in this century.... Public expectations that hospitals will provide total care and make all arrangements are influencing courts in determining the responsibilities of hospitals. If the hospital is to bear more responsibility for the doctor, present systems and organization may have to be reviewed. (1)

**********

These quotations express the need of the common law to evolve and reflect societal changes in health care, the perspective of the dissenting judge, Blair J., in the seminal Canadian case on hospital liability, Yepremian v. Scarborough General Hospital. (2) However, the majority of Canadian courts do not support Blair J.'s view and have allowed health sector tort law to remain stagnant, failing to recognize major changes in the health care system. Historically, physicians were perceived as solely responsible for patient injuries, while hospitals merely provided a location for a physician to practice and nursing staff to assist the physician in this endeavour. The patient had limited legal relations with the hospital itself and consequently, the hospital owed the patient few legal obligations. The duties imposed on the hospital corresponded to its limited role in the delivery of health care--the provision of competent staff and the maintenance of an adequate facility.

But over the last 100 years, medical care has fundamentally changed, becoming more complex, technologically advanced and specialized. The hospital is no longer merely a place where a doctor treats a patient, but a sophisticated facility designed to provide a plethora of services from a wide variety of health professionals. For example, in the case of emergency services, a patient expects treatment from the hospital's emergency team--whatever combination of physicians, nurses, and other practitioners with which the hospital chooses to staff the emergency room. The patient also knows she may have contact with other practitioners and that radiologists, pathologists or pharmacists may be involved in her treatment. Given this matrix of care, it is natural for a patient not to look solely to one's own physician for care, but to the hospital itself. Hospitals and other institutions have responded to the complexity of modern medicine by taking on a greater role in organizing and managing the delivery of services, and coordinating the diverse staff and programs. Organization and management has extended to activities related to quality of care, such as forming quality-control committees and creating policies relating to patient outcomes. (3)

Similarly, the role of provincial governments in health care has undergone a significant transformation, as part of a larger trend towards state involvement in social services. (4) Historically, its primary role was public health and limited funding of health services for the destitute. (5) The transformation in the state's role began with it undertaking the financial responsibility for physician and hospital services for all citizens, and then extended to a number of other programs, such as mental health services and prescription drug costs for certain residents. (6) But as publicly funded health care became en trenched in the Canadian identity, government increased its involvement in the governance, management and administration of the system. Motivated by its enormous public investment in health care and growing public concern and expectations, (7) the state has developed an interest in issues such as quality of care and patient outcomes. Governments now take an active role in setting the overarching policies that guide the way the system operates and evolves. …

The rest of this article is only available to active members of Questia

Sign up now for a free, 1-day trial and receive full access to:

  • Questia's entire collection
  • Automatic bibliography creation
  • More helpful research tools like notes, citations, and highlights
  • Ad-free environment

Already a member? Log in now.

Notes for this article

Add a new note
If you are trying to select text to create highlights or citations, remember that you must now click or tap on the first word, and then click or tap on the last word.
One moment ...
Default project is now your active project.
Project items

Items saved from this article

This article has been saved
Highlights (0)
Some of your highlights are legacy items.

Highlights saved before July 30, 2012 will not be displayed on their respective source pages.

You can easily re-create the highlights by opening the book page or article, selecting the text, and clicking “Highlight.”

Citations (0)
Some of your citations are legacy items.

Any citation created before July 30, 2012 will labeled as a “Cited page.” New citations will be saved as cited passages, pages or articles.

We also added the ability to view new citations from your projects or the book or article where you created them.

Notes (0)
Bookmarks (0)

You have no saved items from this article

Project items include:
  • Saved book/article
  • Highlights
  • Quotes/citations
  • Notes
  • Bookmarks
Notes
Cite this article

Cited article

Style
Citations are available only to our active members.
Sign up now to cite pages or passages in MLA, APA and Chicago citation styles.

(Einhorn, 1992, p. 25)

(Einhorn 25)

1

1. Lois J. Einhorn, Abraham Lincoln, the Orator: Penetrating the Lincoln Legend (Westport, CT: Greenwood Press, 1992), 25, http://www.questia.com/read/27419298.

Cited article

Governmental and Institutional Tort Liability for Quality of Care in Canada
Settings

Settings

Typeface
Text size Smaller Larger Reset View mode
Search within

Search within this article

Look up

Look up a word

  • Dictionary
  • Thesaurus
Please submit a word or phrase above.
Print this page

Print this page

Why can't I print more than one page at a time?

Full screen

matching results for page

Cited passage

Style
Citations are available only to our active members.
Sign up now to cite pages or passages in MLA, APA and Chicago citation styles.

"Portraying himself as an honest, ordinary person helped Lincoln identify with his audiences." (Einhorn, 1992, p. 25).

"Portraying himself as an honest, ordinary person helped Lincoln identify with his audiences." (Einhorn 25)

"Portraying himself as an honest, ordinary person helped Lincoln identify with his audiences."1

1. Lois J. Einhorn, Abraham Lincoln, the Orator: Penetrating the Lincoln Legend (Westport, CT: Greenwood Press, 1992), 25, http://www.questia.com/read/27419298.

Cited passage

Welcome to the new Questia Reader

The Questia Reader has been updated to provide you with an even better online reading experience.  It is now 100% Responsive, which means you can read our books and articles on any sized device you wish.  All of your favorite tools like notes, highlights, and citations are still here, but the way you select text has been updated to be easier to use, especially on touchscreen devices.  Here's how:

1. Click or tap the first word you want to select.
2. Click or tap the last word you want to select.

OK, got it!

Thanks for trying Questia!

Please continue trying out our research tools, but please note, full functionality is available only to our active members.

Your work will be lost once you leave this Web page.

For full access in an ad-free environment, sign up now for a FREE, 1-day trial.

Already a member? Log in now.