Health committee  We avoid, at all costs, trying to obtain consent at the time of labour and delivery. There are many reasons for that. That is the hardest time, so you always try to make sure that the request and the intention to seek sterilization have been expressed previously.

Health committee  We don't have a hard and fast rule on that, but I can tell you there is a universal understanding that this is not the time to be obtaining consent.

Health committee  Yes.

Health committee  I can't answer that, because, as I say, I had thought that this was a historical practice. You're asking me to speculate about something that....

Health committee  It's even more than what you've described. There's also the whole hormonal milieu in pregnancy. You're flooded with oxytocin. It's called the cuddle hormone. You don't have your natural safeguards working for you when you're full of oxytocin. It's an altered state of brain. It is

Health committee  Yes.

Health committee  You are responsible. If you're the operating surgeon, you are responsible.

Health committee  Depending on the circumstances, you can lose your licence to practise. There are a range of issues, but if in fact there is coercion, which is operating without consent, that is actually something that would result in disciplinary action and there are a range of actions that the

Health committee  No. Depending on where you are, family physicians may well be the ones who are able to perform a tubal.

Health committee  Yes. It starts at the local hospital level. I think almost every hospital now has an ombudsperson or someone in a quality office you would be able to speak to. Beyond that, there is the college in your province or territory. Also, at any time, you could speak with a lawyer, if yo

Health committee  The SOGC does not have any regulatory authority, so we would refer that to the local provincial college, and it would be up to the college. You'd really need to talk to the college about how they handle complaints that have a criminal element to them, but a forced sterilization w

Health committee  Yes.

Health committee  Can I just say that there is general agreement, but you don't know the circumstances. You've painted a picture in such a way that someone, in kind of a cavalier way, is saying, “While we're in there”, but you don't just “while we're in there” get to a caesarean section. Is this h

Health committee  —but you have to really understand that there are specifics in each situation that need to be really thoughtfully considered.

Health committee  We can agree that cavalier decision-making is not good decision-making and is inappropriate.