Mr. Speaker, the bill proposed by the member for Fraser Valley raises a number of important issues that must be thoroughly examined. There is no question that he speaks with passion on this issue and I commend him for that.
Bill C-217 provides that a justice may issue a warrant authorizing a peace officer to require a qualified medical practitioner to take or cause to be taken by a qualified technician samples of blood from a person in order to determine whether the person carries hepatitis B virus or the hepatitis C virus or the human autoimmune deficiency virus, which is commonly known as HIV, if the justice is satisfied that there are reasonable grounds to do so. These reasonable grounds are subsequently enumerated in the proposed bill.
At first blush, the bill appeals to our desire to help those on the front lines, those individuals who in their daily work confront the possibility of putting their health at risk. We are speaking here of medical practitioners, health care professionals, firefighters and police officers to name a few.
The Minister of Health appreciates the work that has been done by emergency responders in Canada, as we all do. They are an essential component of the Canadian health care system. Health Canada has collaborated with emergency responders on many occasions, leading to the development of a national consensus on guidelines for the establishment of a post-exposure notification protocol for emergency responders.
Those who work on the front lines as emergency responders can be exposed to blood and other bodily fluids in the course of their work. Of concern in this proposed piece of legislation are those injuries that could result in exposure to blood-borne pathogens, namely HIV, hepatitis B and hepatitis C. It must be pointed out that exposure to the blood or bodily fluids of a person infected with HIV, HBV or HCV does not necessarily result in transmission of the virus.
In order to properly prevent these exposures and to respond appropriately when exposure does occur, emergency response organizations need an overall occupational health protocol that includes immunization against hepatitis B, personal protective equipment such as gloves, and safe work practices. If possible exposure does occur, emergency responders need to be educated because of the protocols on how to obtain immediate assessment and follow-up.
Bill C-217, the blood samples act, would authorize the drawing of blood samples from individuals who may have been accidentally or intentionally exposed—frontline service emergency providers or a good Samaritan—to hepatitis B, hepatitis C or HIV.
After a suspected exposure, an emergency service provider would be permitted to apply to a justice for a warrant. This warrant would authorize a medical practitioner or technician to take a blood sample from the patient in question, test for the aforementioned diseases and provide test results to the patient and to the emergency service provider.
Refusal to submit to a blood test could result in a prison term of up to six months. While we recognize that emergency service providers must act promptly to counteract the negative effects of exposure to serious diseases, it is important to note that previous requests for such testing have been rejected by the courts.
Preventive measures should be taken within hours of exposure. According to Health Canada guidelines published in the Canada communicable diseases report, the option to administer post-exposure prophylaxis should be established within a few hours. It is unlikely that the legal and medical procedures necessary to draw an authorized blood sample, to test it and distribute its results could be accomplished within this brief time frame.
While mandatory blood testing of sources in cases of genuine exposure might assist in making more informed decisions regarding the use of post-exposure medications, there would also be the potential for endangering the health, especially the mental health, of the victim by breaking the rules of patient confidentiality.
The guidelines referred to above and established by Health Canada, in conjunction with firefighters, police and ambulance workers in 1995, demonstrate the concrete actions taken to address the risks, and by consequence have already anticipated the objectives of the bill. These guidelines, which ensure that emergency responders will be notified quickly regarding exposures obtained in their line of work, have been implemented by a number of parliaments, specifically Alberta, Ontario, British Columbia, Saskatchewan and the Northwest Territories, and in other regions and hospitals in other jurisdictions.
In 1997 a second protocol outlining assessment, testing and treatment procedures to be used to promote the well-being of health care workers, including firefighters, police and ambulance workers, was released by Health Canada. By following the second protocol, emergency responders will receive up to date care directed toward reducing the effects of an exposure.
The guidelines recommended by Health Canada for emergency responders reflect the same standard of care given to all other health care workers, including nurses and physicians. The guidelines recommend testing the source in such cases but always with consent. By following Health Canada's notification protocols, emergency responders can be assured of timely, rational and effective assessment and treatment.
The issue of blood testing has been the subject of extensive study in the criminal field in the context of sexual assault. Medical experts advise that the only way a victim of sexual assault can be sure that he or she has not been infected is by undergoing hepatitis B or C or HIV antibody testing, according to recommended procedures. A random test is simply not determinative of the health of an individual.
On its face the bill does not apply solely in cases where an offence is alleged to have been committed, but rather in any case where there has been an exchange of bodily fluids. Thus a warrant to obtain a bodily sample is sought without any offence being committed. There is therefore no nexus for criminal law. This is most troubling.
The bill also raises important concerns relating to privacy, searches and seizures and human rights guaranteed by the Canadian Charter of Rights and Freedoms. The taking of bodily substances always raises significant constitutional issues and charter issues. The taking of bodily substances without any charges being laid or before conviction raises considerable constitutional questions under section 7, life, liberty and security of the person, and section 8, unreasonable search and seizure.
The issue of blood testing clearly belongs in the domain of health. The Department of Justice is actively working with other departments, in particular Health Canada, to ensure that there is more done to provide support and assistance to those who may be concerned about the risk of hepatitis B or C or HIV infection.
In conclusion, I support measures to protect our emergency workers, firefighters, police officers and good Samaritans. However, it is questionable whether Bill C-217 does this.