Federal legislation to limit bulk drug exports Gunshot wound by housework


									                                                           PHARMACEUTICAL INDUSTRY
                                                           Federal legislation to limit bulk drug exports
                                                           Published at www.cmaj.ca on June 30, 2005.
                                                           Health Minister Ujjal Dosanjh          Canada that a glut of American        consist of telephone calls or
                                                           will introduce legislation this fall   buyers could create shortages         email communication. Health
                                                           to amend the Food and Drugs            and force up prices.                  Canada will consult physician
                                                           Act, prohibiting the bulk export          Health Canada will establish       and pharmacist associations and
                                                           of pharmaceuticals from Canada         a national database, known as         other stakeholders before draft-
                                                           when the federal government is         the “drug supply network,” to         ing legislation.
                                                           aware of any shortages of pre-         gather information about drug             CMA President Dr. Albert
                                                           scription drugs or vaccines.           availability and shortages.           Schumacher said, “This [con-
                                                              “It wouldn’t be a permanent            Dosanjh also announced             sultation] is particularly impor-
                                                           ban, it would be a ban only when       plans to strengthen regulations       tant when it comes to defining
                                                           there is a shortage in terms of our    in the Food and Drugs Act re-         key components of this issue,
                                                           own supply,” Dosanjh told a June       garding the nature of the doc-        such as what constitutes an es-

                                                           29 news conference in Ottawa.          tor–patient relationship. He          tablished patient–practitioner
                                                              The US Congress is consid-          would not say whether that            relationship.”
                                                           ering 4 bills that would permit        means Americans seeking to save           The federal government does
                                                           the import of lower-priced pre-        money by filling prescriptions in     not intend to kill Canada’s $1-
                                                           scription drugs from Canada            Canada would have to see Cana-        billion Internet pharmacy indus-
                                                           and other countries. These bills       dian doctors in person, or            try, Dosanjh said. — Laura Eg-
                                                           have prompted concerns in              whether that relationship could       gertson, CMAJ

                                                           PRIVACY ISSUES

                                                           Gunshot wound reporting mandatory in Ontario
                                                           Ontario’s hospitals will soon as-      location of patients who present      public, and that reporting data will
                                                           sume the mantle of Neighbour-          with a gunshot wound.                 better inform strategies to pre-
                                                           hood Watch as the province fol-            However, there’s no penalty       vent similar incidents.
                                                           lows the lead of 45 American           for failing to disclose, and the          Opponents counter that
                                                           states to become the first Cana-       government has no intention of        mandatory reporting is a breach of
                                                           dian jurisdiction with manda-          introducing any form of censure,      doctor–patient confidentiality and
                                                           tory reporting of gunshot              says Andrew Hilton, spokesman         trust, and that it may deter some

                                                           wounds.                                for Ontario Minister of Com-          patients from seeking treatment.
                                                              Under the legislation, passed       munity Safety and Correctional        They say education and safety
                                                           May 31 and expected to be pro-         Services Monte Kwinter. “The          training are more effective tools
                                                           claimed by the fall, hospitals         bill was never really designed to     than mandatory reporting in pre-
                                                           must designate someone respon-         penalize people. The intent is to     venting gunshot wounds.
                                                           sible for promptly reporting to        make it easier for hospitals to re-       Equally problematic is the
                                                           the police the name and hospital       port gunshot wounds without           question of the efficacy of man-
                                                                                                  fear of recrimination or any con-     datory reporting. University of
                                                                                                  sequences for doing so.”              Alberta Health Law Institute
                                                                                                      Still, regulations may be in-     Executive Director Tracy Bailey
                                                                                                  troduced to extend the report-        says there’s little concrete evi-
                                                                                                  ing requirement beyond hospi-         dence indicating that mandatory
                                                                                                  tals, to clinics and doctors’         gunshot wound reporting actu-
                                                                                                  offices “if it turns out... we’re     ally results in a reduction in gun-
                                                                                                  missing a lot,” Hilton adds.          related violence.
                                                                                                      Opinion is divided over               The legislation also raises eth-
                                                                                                  whether the legislation is a justi-   ical dilemmas for health profes-
                                                                                                  fied breach of doctor–patient         sionals, because it places them in
                                                                                                  confidentiality and trust (CMAJ       the position of becoming crime

                                                                                                  2004;170:1256-7 and 2004;170:         investigators, Bailey adds. “It’s
                                                                                                  1255-6).                              not their role. I’d be a lot more
                                                                                                      Proponents argue that compul-     comfortable with discretionary
                     Proponents of mandatory gunshot wound re-                                    sory reporting limits the risk of     reporting.” — Wayne Kondro,
                     porting say it will reduce gun-related violence.                             further injury and danger to the      Ottawa

242                                                                     JAMC • 2 AOÛT 2005; 173 (3)

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