It is recognized that patients have a right to make informed decisions about their medical care. Yet somehow, when it comes to the deciding between a vaginal birth and a caesarean section, in the past it has been acceptable for a physician to refuse a patient’s request if it was not, in the doctor’s opinion, medically necessary. Lindsay McGivern reviews recent policy developments that acknowledge that a woman’s preferences should be taken into consideration.

Chronic pain is part of many personal injury, motor vehicle, and medical malpractice claims. Since chronic pain is something that can’t be seen or measured, it can be difficult for the courts to understand the severity of the pain, or the impact it can have on a plaintiff’s day-to-day functioning. Do recent advances in neuro-imaging such as functional MRI (fMRI) offer potential solutions to these challenges? In this paper, I will review developments in neuro-imaging and their applicability in negligence claims.

Will the science of genetics play a greater role in birth injury lawsuits in the future? As the science of genetics continues to advance, it is sometimes suggested that a child’s birth injury may be caused by genetic abnormalities rather than any difficulties encountered during labour. In this article, Andrea and Paul examine the current medical understanding of the role of genetics in neurodevelopmental disorders such as cerebral palsy, and how Canadian courts have approached the defence of genetic predisposition in birth injury claims.

To win a medical malpractice law suit the plaintiff must prove two things:  that the health care providers did not meet the standard of care expected of them, and that the failure to meet the standard of care is what caused the plaintiff’s injuries.  This second element is called “causation.”  Causation is often the more difficult hurdle for the plaintiff to meet.  In the following article, Lindsay McGivern provides a description of how the courts view causation in complex medical malpractice claims.

Although paper medical records still exist, more and more clinics, offices and hospitals are moving to electronic records.  These electronic records in some cases are nothing more than digitized versions of what would normally appear in a patient’s paper chart.  In other cases, information from monitors such as blood pressure monitors or heart monitors may be recorded digitally and stored centrally in a database for the institution.   The following article discusses some of the issues associated with electronic medical records, including the use of audit trails and access logs to understand who has reviewed a record, and if changes were made to the record.