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Final project report: results of a CIHR-funded project examining legal issues in infectious disease response and control.

Project Overview

Following the SARS outbreak, the Canadian Institutes of Health Research (CIHR) issued a Request for Applications for research on legal and ethical lessons related to the SARS experience. Our team of legal and public health experts included the following scholars:

Timothy Caulfield

Health Law Institute, University of Alberta

Elaine Gibson

Health Law Institute, Dalhousie University

Rosario Isasi

Centre de recherche en droit public, Universite de Montreal

Bartha Maria Knoppers

Centre de recherche en droit public, Universite de Montreal

Mireille Lacroix

Centre de recherche en droit public, Universite de Montreal (now with the Public Health Agency of Canada)

Nola Ries

Health Law Institute, University of Alberta

Kumanan Wilson

Department of Medicine, University of Toronto

Key Accomplishments

From Fall 2004 to Spring 2007, our team delved into challenging and controversial legal and policy issues that arise in the public health context, including infectious disease response and control. Noteworthy achievements related to this project include:

* Broad dissemination of research results: Throughout the course of the project, we disseminated our research to a wide audience through invitational meetings and workshops, publications in legal and public health journals, presentations at events across Canada, and a webpage with links to PowerPoint presentations, articles written by team members, and updates on new public health legislation, reports and other initiatives (see http://www.law.ualberta.ca/centres/hli/project_summary.html).

Strong engagement with the Canadian and international public health community: From the inception of the project, the research team developed strong and ongoing linkages with members of the Canadian public health community, including the Public Health Agency of Canada, Health Canada, provincial public health departments and agencies, and the Canadian Public Health Association. Team members have also participated in public health law events sponsored by the United States Centers for Disease Control, the European Public Health Ethics Network, and the World Health Organization.

* Canada's first textbook on public health law: Members of the Health Law Institute, University of Alberta, invited legal experts across Canada and internationally to contribute to the first Canadian textbook on law and public health. Canadian Public Health Law and Policy (Butterworths, 2005) is an important resource for practitioners, policy makers and academics, and is used as a text in public health law and ethics courses at Canadian universities.

* Participation in Canada's first national conference on law and the public's health: Members of the research team served on the steering and planning committees for Canada's first public health law conference, held in Toronto in November 2006, and presented papers at this national event.

* Compilation of an extensive bibliography of legal literature in the public health law field: This bibliography, which will be updated periodically, is available at http://www.law.ualberta.ca/centres/hli/docs/Biblio-2007.pdf (current to January 2007).

Meetings & Workshops

First Collaborators Meeting--Montreal, August 2004

We began the project with a First Collaborators' Meeting to bring together the research team with federal and provincial policy makers and members of the public health community to identify pivotal issues for analysis as well as to establish collaborative links with key stakeholders. Participants included the Acting Chief Public Health Officer of Canada, the Chief Executive Officer of the Canadian Public Health Association, Health Canada policy and regulatory staff, and provincial public health representatives.

Research team members made the following presentations at the First Collaborators' Meeting:

* First Collaborators' Meeting: Legal Foundations for a National Public Health Agency in Canada -- Timothy Caulfield

* International Experiences in Establishing National Public Health Agencies -- Bartha Maria Knoppers

* Legal Foundations of Public Health in Canada -- Nola Ries

* The Challenges of Multi-level Governance in Public Health -- Kumanan Wilson

* Legal Issues in Public Health Surveillance and Information Sharing -- Elaine Gibson

* The Quebec Public Health Act and its Institutions: A Modem Model -- Mireille Lacroix

Conference Series, Universite de Montreal

The Centre de recherche en droit public (CRDP), Universite de Montreal organized a conference series, "Genomics and Public Health," in 2004-05 with ten invited speakers, including five from outside Canada. At a 2007 CRDP special conference series, Richard Schabas presented on "SARS, Avian Influenza and the Precautionary Principles."

Joint Invitational Workshop--Toronto, April 2006

In April 2006, we held a workshop with colleagues at the University of Toronto Joint Centre for Bioethics, titled "Three Years After SARS: What Have We Learned about Ethical and Legal Issues in Responding to Infectious Disease Threats". This workshop provided an opportunity for researchers to present their work and engage in dialogue with invited participants from the Public Health Agency of Canada, the Canadian Public Health Association, provincial public health representatives and researchers at other academic institutions.

Presentations at the Joint Workshop addressed the following topics: emerging infections and the new International Health Regulations; judicial review of the exercise of public health powers; constitutional issues in information sharing and public health surveillance; allocation of scarce health care resources; and health care workers' duty to provide care in an infectious disease outbreak.

Publications

In addition to articles in this special edition of the Health Law Review, team members have published a wide range of articles, book chapters, reports and commentaries, including a special forum in the Alberta Law Review on legal issues in infectious disease control. In an initiative related to this CIHR-funded project, members of the University of Alberta Health Law Institute co-edited Canada's first textbook on public health law, Canadian Public Health Law and Policy (Butterworths, 2005).

Key examples of publications include:

* J. Sutherland & Elaine Gibson, "Cosmopolitanism and Global Public Health" Social Philosophy Today (in press).

* A. Attaran & Kumanan Wilson, "Legal and Epidemiological Justification for Federal Authority in Public Health Emergencies" McGill Law Journal (in press).

* Nola M. Ries, "Quarantine: Lessons from Canada's Experience with SARS" in Ethics and Epidemics, vol. 9, Advances in Bioethics series (Elsevier Publications, 2006) pp. 43-67.

* Kumanan Wilson, "Pandemic threats and the need for new emergency legislation in Canada" (2006) 2 Healthcare Policy/Politiques de Sante 35-42.

* Elaine Gibson, "SARS crisis highlights gaps in regulation of privacy in health care" (2006) 26:14 Lawyers Weekly.

* Kumanan Wilson & Harvey Lazar, "From SARS to Avian Flu--Why Ottawa must lead Canada's response" (February 2006) Policy Options 31-38.

* Kumanan Wilson & Harvey Lazar, "Governance in Pandemics" in Jacalyn Duffin & Arthur Sweetman eds. SARS in Context: Memory, History and Policy (McGill-Queen's University Press, 2006) pp. 157-173.

* Nola M. Ries, "Legal Foundations of Public Health in Canada" in Tracey M. Bailey, Timothy Caulfield & Nola M. Ries, eds. Public Health Law & Policy in Canada (Scarborough: Butterworths LexisNexis, 2005) pp. 7-37.

* Kumanan Wilson, "Risk, Causation and Precaution: Understanding Policy-Making Regarding Public Health Risks" in Public Health Law & Policy in Canada (2005), pp. 59-87.

* Elaine Gibson, "Public Health Information Privacy and Confidentiality" in Public Health Law & Policy in Canada (2005), pp. 89-129.

* Timothy Caulfield, "Genetics and Public Health: Legal, Ethical and Policy Challenges" in Public Health Law & Policy in Canada (2005), pp. 477-495.

* Mireille Lacroix, "The Quebec Public Health System: A Modern Model" in Public Health Law & Policy in Canada (2005), pp. 497-518.

* Nola M. Ries & Timothy Caulfield, "Legal Foundations of a National Public Health Agency in Canada" (2005) 96 Canadian Journal of Public Health 281.

* Kumanan Wilson & Harvey Lazar, "Planning for the Next Pandemic Threat: Defining the Federal Role in Public Health Emergencies" (2005) 6:5 Policy Matters.

* Elaine Gibson, "Post--SARS: Principles for Design of a Public Health Information System." (2005) 4:4 Law and Bioethics Report 6.

* Bartha Maria Knoppers, "Of Genomics and Public Health: Building Public Goods?" (2005) 173:10 Canadian Medical Association Journal 1185.

* Kumanan Wilson & C. MacLennan, "Federalism and Public Health Law in Canada. Opportunities and Unanswered Questions" (2005) 14 Health Law Review 3-13.

* Rosario M. Isasi & Thu Minh Nguyen, "The Global Governance of Infectious Diseases: The World Health Organization and The International Health Regulations" (2005) 43 Alberta Law Review 497-510.

* Mireille Lacroix, "Quebec's Public Health Ethics Committee: A Model for the Public Health Agency of Canada?" (2005) 43 Alberta Law Review 511-528.

* Nola M. Ries, "Quarantine and the Law: The 2003 SARS Experience in Canada--A New Disease Calls on Old Public Health Tools" (2005) 43:2 Alberta Law Review 529-547.

* Timothy Caulfield, "Introduction: Infectious Disease Forum" (2005) 43:2 Alberta Law Review 495-96.

* Nola M. Ries, "Public Health Law and Ethics: Lessons from SARS and Quarantine" (2004) 13 Health Law Review 3.

* Centre de recherche en droit public, Universite de Montreal prepared two compendia for the Public Health Agency of Canada on national and international infectious diseases/public health legislation (2004-2006) Available online at: <http://www.phac-aspc.gc.ca/php-psp/publ_health_law.html.>.

Conference Presentations

In addition to presentations at workshops organized specifically for this research project, members of the research team have presented their work at a diverse range of conferences, including:

* Timothy Caulfield, Allocation, Duty of Care and Pandemic Preparedness. Ethics Forum on Pandemic Preparedness, St. Boniface General Hospital. January 30, 2007 (Winnipeg, MB)

* Elaine Gibson, Health Information Privacy and Public Health System Needs: Can They Coexist? Canadian Conference on the Public's Health and the Law. November 7, 2006 (Toronto, ON)

* Timothy Caulfield, Emerging Issues: Genetics and Public Health. Canadian Conference on the Public's Health and the Law. November 7, 2006 (Toronto, ON)

* Nola M. Ries, Legal Issues in Public Health Emergencies. Ethics & Emergencies Conference, Centre for Democracy, Queen's University. October 19, 2006 (Kingston, ON)

* Kumanan Wilson, Governance and Biosecurity. Ethics & Emergencies Conference, Centre for Democracy, Queen's University. October 19, 2006 (Kingston, ON)

* Elaine Gibson, On Citizenship: How Infectious Disease Reporting Systems are Redrafting our Sense of Nationhood. Internet Researchers Conference. September 2006 (Brisbane, Australia)

* Rosario Isasi, The World Health Organization and the International Health Regulations: A Model for the International Governance of Genomics in Public Health? Poster presentation at the 4th DNA Sampling International Conference: Genomics and Public Health. June 4-7, 2006 (Montreal, QC)

* Timothy Caulfield, Genetics and Public Health. Canadian Public Health Association Annual Conference. May 29, 2006 (Vancouver, BC)

* Kumanan Wilson, Governance and Pandemic Threats. Canadian Public Health Association Annual Conference. May 29, 2006 (Vancouver, BC)

* Nola M. Ries, The Role of Courts in Reviewing Public Health Actions. Canadian Public Health Association Annual Conference. May 28, 2006 (Vancouver, BC)

* Rosario Isasi, International Relations & Infectious Disease Control. Canadian Public Health Association Annual Conference. May 28, 2006 (Vancouver, BC)

* Kumanan Wilson, Governance and Biosecurity. Institute of Population Health, University of Ottawa. May 2, 2006 (Ottawa, ON)

* Kumanan Wilson, Planning for the Next Pandemic Threat: Defining the Federal Role in Public Health Emergencies. 4th Annual Health Policy Summit. April 27, 2006 (Toronto, ON)

* Timothy Caulfield, Legal Overview. Three Years After SARS: CIHR Joint Invitational Workshop. April 11, 2006 (Toronto, ON)

* Elaine Gibson, Information Sharing and Privacy in Public Health: Constitutional Issues? Three Years After SARS: CIHR Joint Invitational Workshop. April 11, 2006 (Toronto, ON)

* Nola M. Ries, Judicial Review of Public Health Powers. Three Years After SARS: CIHR Joint Invitational Workshop. April 11, 2006 (Toronto, ON)

* Kumanan Wilson, Planning for the Next Pandemic Threat: Defining the Federal Role in Public Health Emergencies. Conference Board of Canada, Centre for National Security. April 6, 2006 (Toronto, ON)

* Elaine Gibson, Upcoming Issues in Public Health Law: The more things change, the more they stay the same? Health Law Teachers' Curriculum Meeting. February 2006 (Halifax, NS)

* Nola M. Ries, Legal Preparedness for Health Emergencies: Lessons from Canada's SARS Outbreak, American Public Health Association Annual Meeting. December 12, 2005 (Philadelphia, PA)

* Kumanan Wilson, Planning for the Next Pandemic Threat: Defining the Federal Role in Public Health Emergencies. Institute of Public Administration of Canada National Conference. October 29, 2005 (Regina, SK)

* Elaine Gibson, Post--SARS: Principles for Design of a Public Health Information System Public Health Law Conference, June 2005 (Atlanta, Georgia)

* Nola M. Ries, Legal Issues in Health Emergency Response. Canadian Bar Association, Health Law subsection. May 30, 2005 (Vancouver, BC)

* Nola M. Ries, Legal Foundations of Public Health in Canada. Health Law Seminar Series, University of Alberta. October 8, 2004 (Edmonton, AB)

* Elaine Gibson, Privacy, Health Information and Surveillance. Public Health Law Improvement Network Meeting, September 2004 (Toronto, ON)

Training and Mentorship

Throughout this project, members of the research team have mentored students in law and other disciplines to provide them with opportunities to expand their knowledge and experience in the field of public health law. Students have provided valuable research assistance to team members, participated in project meetings, workshops, and conferences, and have pursued opportunities to publish and present their work. For example, Kari Gammon, a former research assistant for Elaine Gibson at Dalhousie's Health Law Institute published "Pandemics and Pandemonium: Constitutional Jurisdiction over Public Health" (2006) 15 Dalhousie Journal of Legal Studies 1. Jacob Shelley, a research assistant with the University of Alberta Health Law Institute, published "Deference in the Public Health Context" (2006) 15 Health Law Review 33.

As another example of student training, team member Nola Ries has used some of the research related to this project in developing and teaching a Public Health Law course at the University of Victoria Faculty of Law (January-April 2007).

Ongoing Commitment to Public Health Law Capacity in Canada

Members of the research team maintain an ongoing commitment to contribute legal expertise to public health issues in Canada through participation in the Public Health Law Improvement Network and various legal reform initiatives underway through the Public Health Agency of Canada and other federal/provincial/territorial public health departments and agencies.

Turning from the infectious disease focus of this CIHR-funded initiative, several team members are now involved in a new CIHR-funded project examining the role of law as a tool to address obesity. Researchers involved in the obesity project are: Timothy Caulfield and Nola Ries, University of Alberta, and Barbara von Tigerstrom, University of Saskatchewan.
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Title Annotation:Canadian Institutes of Health Research
Author:Ries, Nola M.
Publication:Health Law Review
Date:Dec 22, 2007
Words:2255
Previous Article:Ethics in an epidemic: ethical considerations in preparedness planning for pandemic influenza.
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