Mr. Speaker, the bill proposed by the member for Fraser Valley raises a number of important issues that must be thoroughly examined.
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 the hepatitis B virus, or the hepatitis C virus or human autoimmune deficiency virus if the justice is satisfied that there are reasonable grounds to do so. These reasonable grounds are subsequently enumerated.
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 medical practitioners, firefighters and police officers to name a few.
The Minister of Health, as we all do, appreciates the work that has been done by the emergency responders in Canada. They are an essential component of the Canadian health care system. Health Canada has collaborated with the 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 body fluids in the course of their work. Of concern in this proposed piece of legislation are those injuries that could result in an exposure of blood borne pathogens, namely HIV, hepatitis B and hepatitis C. It must be pointed out that exposure to the blood or blood fluids of an HIV, HBV or HCV infected person does not necessarily result in a transmission of the virus.
In order to properly prevent these exposures and to respond appropriately when an exposure occurs, emergency response organizations need an overall occupational health protocol. That includes immunization against hepatitis B and personal protective equipment such as gloves and safe work practices. If a possible exposure does occur, emergency responders need to be educated on the protocols of how to obtain immediate assessment and follow up.
Bill C-217, a blood samples act, would authorize the drawing of blood samples from individuals who may have accidentally or intentionally exposed frontline emergency providers or a good Samaritan to hepatitis B, hepatitis C or human immunodeficiency virus 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, tests for the aforementioned diseases and provide test results to the patients and to the emergency service provider. Refusal to submit 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 disease 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 to distribute its results could be accomplished within this brief timeframe.
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 of the victim, especially his or her mental health, by breaking the rules on patient confidentiality.
The guidelines referred to previously and established by Health Canada in 1995, in conjunction with firefighters, police and ambulance workers, demonstrate concrete actions taken to address the risks and consequently have already anticipated the objectives of the bill.
Guidelines that ensure emergency responders will be notified quickly regarding exposures obtained in their line of work have been implemented by the provinces of Alberta, Ontario, British Columbia, Saskatchewan and the Northwest Territories and by 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.