Care Planning in Medical Malpractice: Making the Case for In-Home Care

Throughout this entire process, the focus must remain on the plaintiff and his or her aspirations for their life. Every effort should be made to ensure that the care plan reflects the client’s vision of what a happy, healthy, and fulfilled life looks like for them. If the client’s disability is so profound that they are unable to articulate and communicate these wishes, counsel must consult with their supported decision-making team, in a way that is respectful of the client’s inherent dignity.

1. Katherine Brown-Henry, “A Plaintiff’s Attorney’s Perspective on Life Care Planning” in Roger O. Weed and Debra E. Berens (eds), Life Care Planning and Case Management Handbook (4th edn, Routledge, 2019) at 654.
2. For a discussion on how meaningful input in a care plan can enhance subjective senses of empowerment, see Tamar Heller, Haleigh M. Scott, and Matthew P. Janicki, “Caregiving and intellectual and developmental disabilities and dementia: report on the pre-summit workgroups on caregiving and intellectual and developmental disabilities” (2017) National Task Group on Intellectual Disabilities and Dementia Practices. Available at https://pubmed.ncbi.nlm.nih.gov/30090847/.
3. Andrews v. Grand & Toy Alberta Ltd., [1978] 2 SCR 229 at 241.
4. Ibid at 245.
5. “Pandemic Perspectives on Ageing in Canada in Light of COVID-19 Findings from a National Institute on Ageing/TELUS Health National Survey” (October 2020) National institute on Ageing at 3. Available at https://static1.squarespace.com/static/5c2fa7b03917eed9b5a436d8/t/5f85fe24729f041f154f5668/1602616868871/PandemicPerspectives+oct13.pdf.
6. The Damages Trilogy is comprised of Andrews, supra endnote 3; Thornton v. Prince George School District No. 57, [1978] 2 S.C.R. 267; and Arnold v. Teno, [1978] 2 S.C.R. 287.
7. Erika Chamberlain et al, Fridman’s The Law of Torts in Canada (4th edn, Carswell, 2020) at 663; for recent applications of this principle in British Columbia, see Jurczak v. Mauro, 2013 BCCA 50 at para. 36, and Marriott v. Peterson, 2021 BCSC 1066 at para. 64.
8. Arnold, supra endnote 6at 320.
9. Andrews, supra endnote 3 at 230.
10. Ibid at 242.
11. Ibid at 242, 245.
12. Travis v. Kwon, 2009 BCSC 63 at para. 110.
13. Ho v. Ip, 2019 BCSC 2220 at para. 94.
14. Williams v. Low, 2000 BCSC 345 at para. 25; see also Milina v. Bartsch, 49 B.C.L.R. (2d) 33 at 182-184.
15. See Accessible Canada Act, S.C. 2019, c. 10.
16. See Accessible British Columbia Act, SBC 2021, c. 19; Community Living Authority Act, SBC 2004, c. 60.
17. Ruth Sullivan, Sullivan on the Construction of Statutes, 6^th ed (Markham, Ontario: LexisNexis, 2014) at 569.
18. See Ediger v. Johnston, 2009 BCSC 386 at para. 251; Brodeur v. Provincial Health Services Authority, 2016 BCSC 1968at para. 302.
19. For a discussion on why many group homes and long-term care facilities in Canada today are akin to institutionalization, see Megan Linton and Kendal David, “Institutionalization of People Labelled with Intellectual or Developmental Disabilities in Long-Term Care” Inclusion Canada. Available at https://invisibleinstitutions.com/policy-briefs.
20. See Fullerton (Guardian ad litem of) v. Delair, 2006 BCCA 339 at para. 6.
21. “What We Heard: Summary of CLBC’s Engagement with Home Sharing Providers and Home Share Providing Agencies” (June 2018) Community Living B.C. at 3. Available at https://www.communitylivingbc.ca/wp-content/uploads/HSP-Engagement-Report-Final.pdf. See also “Review of Community Living British Columbia”, Internal Audit & Advisory Services (2011) at 1. Available at https://www2.gov.bc.ca/assets/gov/british-columbians-our-governments/services-policies-for-government/internal-corporate-services/internal-audits/clbc-review.pdf.
22. For a discussion on the lack of oversight of home sharing arrangements in British Columbia, see Rachelle Hole et al, “Home Sharing and People with Intellectual Disabilities: A Qualitative Exploration” (2015) 12:4 Journal of Policy and Practice in Intellectual Disabilities 279-287 at 285.
23. R. v. Dahl, 2022 BCSC 1387; see also Kate McInnes, “Bill C-295’s blind spot? Persons with disabilities in community care” (April 11, 2023) Law360 Canada. Available at https://www.law360.ca/ca/articles/1761719/bill-c-295-s-blind-spot-persons-with-disabilities-in-community-care-kate-mcinnes.
24. 2023 ABKB 280.
25. For a discussion on the challenges with securing Jordan’s Principle programming, see Lori Chambers and Kristin Burnett, “Jordan’s Principle: The Struggle to Access On-Reserve Health Care for High-Needs Indigenous Children in Canada” (2017) 41:2 American Indian Quarterly 101-124.
26. See Brodeur, supra endnote 19, at paras. 304-313.
27. For examples of defence claims to this effect, see Cherry (Guardian) v. Borsman, [1990] B.C.J. No. 2576 (Q.L.) at para. 125; Brodeur, ibid at para. 333; Ediger, supra endnote 19, at para. 260.
28. See “Long-term care costs in Canada projected to triple to $71B in only 30 years” (October 8, 2019) National Institute on Ageing. Available at https://www.niageing.ca/commentary-posts/10/7/long-term-care-costs-in-canada-projected-to-triple-in-only-30-years.
29. See “Health care funding in Canada” (October 18, 2022) Canadian Medical Association. Available at https://www.cma.ca/latest-stories/health-care-funding-canada#:~:text=A%20recent%20report%20on%20health,funding%20is%20projected%20to%20decline.
30. Public Guardian and Trustee Act, R.S.B.C. 1996, c. 383.