Academic journal article McGill Law Journal

Health Care and Human Rights after Auton and Chaoulli

Academic journal article McGill Law Journal

Health Care and Human Rights after Auton and Chaoulli

Article excerpt

The judicial interpretation of the entitlement to health care under the Charter and human rights legislation has tended to swing between interventionist and non-interventinnist poles. In Eldridge, the Supreme Court of Canada held that a thilure to provide sign language interpretation where this was necessary to ensure equal access to health care was in breach of the equality provisions of the Charter. However, in a subsequent case, Auton, the Court narrowly circumscribed the limits of this approach, holding that the Canadian system of public health care was, by its very terms, a partial health plan. It followed that exclusion of particular non-core .services could not, in itself, be seen as less favourable treatment.

The Chaoulli decision marked a return to a more interventionist approach with the Court holding (by a narrow majority) that the prohibition on private health insurance provided for in Quebec law was inconsistant with section 1 of the Quebec Charter. Tbis judgment has been cited in over eighty decisions of courts and tribunals.

However, just how important has Chaoulli been in terres of the overall approach of the Canadian courts?

The author suggests that Chaoulli--despite its significance in the legislative arena--has had a somewhat limited impact to date on the case law concerning health care, and that Auton has clear[y had a greater impact to date. The author examines several examples from subsequent case law that point to the weakness of the approaches taken in both Auton and Chaoulli. The narrow approach adopted in Auton can lead to equality claims being dismissed without any proper discrimination analysis and shows the manner in which a broad use of the "benefit provided by law" requirement may weaken equality jurisprudence.

Conversely, the case law highlights the fact that the courts will have to reject much more difficult claires than those upheld in Chaoulli unless they wish to develop positive obligations under section 7 of the Charter.

L'interpretation judiciaire du droit a des soins de sante en vertu de la Charte et des instruments legislatifs protegeant les droits de la personne a tendance a osciller entre les poles interventionniste et non interventionniste.

Dans Eldridge, la Cour supreme du Canada a statue que l'omission de fournir une interpretation en langage des signes lorsque necessaire pour assurer un acces egai aux soins de sante constituait une violation des dispositions de la Charte protegeant le droit a l'egalite. Toutefois, dans une affaire subsequente, Auton, la Cour a etroitement circonscrit les limites de cette approche, en affirmant que le regime public de soins de sante canadien est foncierement un regime partiel. Consequemment, l'exclusion de services particuliers non essentiels ne peut, en elle-meme, correspondre a un traitement moins favorable.

L'affaire Chaoulli marque un retour a une approche plus interventionniste. La Cour y affirme par une courte majorite que la prohibition de souscription a nne assurance privee de soins de sante dans la loi quebecoise n'est pas compatible avec l'article premier de la Charte quebecoise. Ce jugement a par la suite ete cite dans plus de quatre-vingts decisinns de cours et de tribunaux. Toutefois, quelle est reellement l'importance de Chaoulli en ce qui concerne l'approche globale des cours canadiennes ?

L'auteur suggere que Chaoulli, malgre son importance dans la sphere legislative, a jusqu'a present eu une influence relativement limitee dans la jurisprudence concernant les soins de sante. Auton demeure clairement a ce jour une decision beaucoup plus influente. L'auteur examine plusieurs exemples de la jurisprudence subsequente qui eclairent la faiblesse des approches respectives retenues dans Auton et dans Chaoulli. D'un cote, l'approche etroite adoptee dans Auton peut mener au rejet de demandes de protection du droit a l'egalite sans veritable analyse de la discrimination alleguee, ce qui montre que l'interpretation large exigeant qu'un <> existe peut affaiblir la jurisprudence sur le droit a l'egalite. …

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