Situations Raising Ethical Questions

1. Consider whether overriding refusals of treatment by patients (e.g. Jehovah's Witness patient's refusal, on religious grounds, of a blood transfusion) constitutes a violation or an infringement of a right.Consider an opposing argument: whether or not this action would constitute medical paternalism. (See Picture Attached "Rights-Based Ethics.")

Rights-Based Ethics The language of rights permeates the law: the right to life, the right to die, the right to privacy, the right to reproduce, etc. A legal right of access to our publicly funded health system is granted to all Canadians under the Canada Health Act, R.S.C. 1985, c. C-6 [CHA]. However, legal rights and ethical rights are not necessarily the same and may conict with one another. Ethical rights may be promoted whether or not legislation supports them. The rights- based ethical theory reflects our intuition that we have certain things as a matter of right and this cannot be violated. Rights can be either negative or positive. Negative rights correlate with duties to refrain from doing something. For instance, most privacy rights are negative rights. Positive rights correlate with duties to help in some manner. For example, healthcare professionals are bound to help someone who claims a right to healthcare. Consider a "Patients Bill of Rights," a document which recognizes patients' rights of autonomy. This can be a revolutionary departure from Hippocratic benevolence because the healthcare professional is required, by claim of right, to consider patients' authority to decide for themselves. Rights, then, arejustified claims that people can make on others or on society. Legal rights arejustified by legal principles and/or rules, moral rights by moral rules. A violation of rights occurs when there is an unjustied action against a right. An infringement of rights occurs when there is a justified action which overrides a right. .41. Winnipeg Child and Family v. G. Winnipeg Child and Family Services (Northwest Area) v. G. (D.F.) In this 1997 case, a woman, five months pregnant with her fourth child, was addicted to glue sniffing. Two previous children were born permanently disabled as a result of her addiction and were permanent wards of the state. A judge of the Superior Court (the court of first instance) had ordered the woman into the custody of the Director of Child and Family Services, detained in a healthcare facility for treatment until the birth of her child. That order was appealed. The Court of Appeal overturned the decision, and said that the existing law did not support the order made and, given the difficulty and complexity entailed in extending the law to permit such an order, the task was more appropriate for legislature than the courts. There was a further appeal to the SCC by the family services department. The appeal was dismissed, with the Court ruling that an unborn child was not a person possessing rights. In effect, it could have no existence apart from the mother at that point