An editorial in the Victoria Times Colonist describes the intent of the legislation as follows:
Suppose you are involved in a car crash, and some of your bodily fluids spill onto an ambulance attendant. Emergency medical technicians wear protective clothing to guard against such spills. But occasionally, perhaps due to a tear or puncture wound, the safeguards fail.
In these circumstances, a private member’s bill drafted by Letnick would empower the EMT to demand a blood test, with or without the victim’s consent. The results would be disclosed to both parties. The test would focus on communicable diseases, like hepatitis or HIV.
The bill is being strongly supported by the Ambulance Paramedics of BC. It’s understandable that EMTs would be concerned about the spread of communicable diseases as an occupational health and safety issue. Many say that currently they’re forced to go on medication after coming in contact with bodily fluids because they can’t trust patients to reveal (or even know) if they have a communicable disease. As their letter to members on the Act states, “Too often Paramedics suffer exposures such as needle stick injuries or blood splashes from patients who are unwilling or unable to disclose blood borne illnesses. Such exposures can result in unnecessary prophylactic drug treatment, anxiety and stress to you and your family.”
But groups like YouthCo AIDS Society are concerned that forcing people to undergo unnecessary blood tests would jeopardize patients’ right to privacy and bodily integrity guaranteed in the Canadian Charter of Rights and Freedoms and only increase stigma and hysteria around the transmission of HIV and Hep C.
The Times Colonist editorial sees the concern of EMTs as legitimate, but questions the penalties imposed for non-compliance with the bill:
Physicians fear this kind of legislation destroys the essential element of trust between doctor and patient.
Not only does the bill compel an invasive medical procedure in circumstances where the victim may be blameless, it criminalizes a refusal. You can be fined $10,000 and spend six months in prison for declining to co-operate.
The existing situation is imperfect. But at a minimum, a more reasonable balance must be found between competing interests. Patient rights must be protected. And the criminal provisions should go.
The other part that may cause concern is the authority M-210 would give the Lieutenant Governor in Council to make regulations on: prescribing circumstances when confidential information under this Act may be disclosed; designating diseases or conditions as communicable diseases for the purposes of this Act; respecting the handling, retention and destruction of samples of bodily fluids; and designating other exposure situations under which an individual may be allowed to make an application for a testing order.
But even if the bill didn’t look likely to compromise patient rights, would it even be effective?
The BC Civil Liberties Association in an open letter to Norm Letnick and Christy Clark is the doubt around mandatory testing’s effectiveness in actually helping prevent the spread of disease. Given imperfect testing procedures and the time it might take for a compelled subject to provide a blood sample and for a sample to be processed, the BCCLA argues many emergency responders would still need to take medications immediately upon exposure. The standard for treatment is to commence anti-retroviral therapy within 2-4 hours of exposure. YouthCo also points out that the bill doesn’t define what would need to occur to be defined “contact” with a bodily fluid, and that not all types of contact actually carry the risk of disease transmission.
It still remains to be seen whether the bill will be amended to fix some of the ethical issues (it’s currently awaiting second reading, which can’t happen until the Legislature is recalled) or whether the bill will die altogether in the case of a fall election. But for now YouthCo has started collecting online signatures for a Change.Org petition directed to BC Members of the Legislative Assembly, asking them to vote against the bill.