College of Physicians and Surgeons of Ontario

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The College of Physicians and Surgeons of Ontario (CPSO) is the regulatory agency for medical care in the province of Ontario, Canada. The CPSO was created by the Ontario Regulated Health Professions Act 1991.[1] The CPSO lists the laws which it recognises on its Legislation and By-laws webpage. It does not list the Constitution Acts of Canada, including the Charter of Rights and Freedoms on that webpage.

The CPSO recognises the Regulated Health Professions Act 1991 as its governing legislature. It reportedly does not recognise the Constitution of Canada, including the Charter of Rights and Freedoms, as applying to the CPSO, nor does it recognise the rights granted to all Canadians by the Charter as being patient rights.

Ontario is the most populous province in Canada, with more than 14,000,000 inhabitants, so the CPSO regulates the health care of more than 38 percent of Canadians.[2]

Circumcision policy

The CPSO does not recognise the right to physical integrity provided by Section Seven of the Charter as a patient right, so it permits doctors to perform non-therapeutic circumcision of boys without medical indication. This non-compliance with the Constitution of Canada was affirmed by the Health Professions Appeal and Review Board.[3]

Deaths

The permissive policy of the CPSO has resulted in deaths of infant boys in Ontario from non-indicated circumcision.[4] [5] Schröder et al. (2021) reorted that two previously healthy boys died after circumcision at the Hospital for Sick Children.[6]

Complications

A recent survey of complications of non-therapeutic, non-indicated circumcision carried out at the Hospital for Sick Children in Toronto, Ontario reported:

Neonatal circumcision (NNC) is the most frequently performed surgical procedure worldwide and is generally considered safe in Western societies. Deaths attributed to NNC are seldom reported and are mostly explained by lack of adherence to medical standards. We reviewed our emergency department database for circumcision-related emergency admissions. During 2000–2013, 19 previously healthy neonates were admitted for acute complications after circumcision. Four were admitted for bleeding, with hemophilia identified in two cases and von Willebrand disease in one. Eight boys required emergency surgery, three for severe bleeding. Four boys with amputation of the glans underwent immediate surgical reconstruction. One infant was taken to the operating room to remove an obstructing Plastibell ring. Seven boys were admitted to the intensive care unit with severe bleeding or sepsis, three of whom ultimately progressed to hemorrhagic or septic shock. Two of these children died of their complications. We estimate that the annual incidence of severe complications requiring hospitalization after NNC in the Greater Toronto Area was approximately 0.01%, and the incidence of fatalities over the 14-yr review period was approximately 0.0012%. Our results indicate that the risk of serious complications and death as a result of NNC is greater than generally assumed.[6]

Right of appeal

Actions of the CPSO are subject to review on appeal by the Health Professions Appeal and Review Board.

External links

References

  1. ↑ REFdocument Regulated Health Professions Act 1991, CanLll. (1991). Retrieved 23 August 2022.
  2. ↑ REFweb (2022). Ontario Population 2022, Canada Population. Retrieved 24 August 2022.
  3. ↑ REFweb (15 August 2022). Little v Glowacki, 2022 CanLII 73178 (ON HPARB). Retrieved 4 September 2022.
  4. ↑ REFjournal Cairns J, et al. Circumcision: A minor procedure?. Paediatr Child Health. April 2007; 12(4): 311-2. PMID. PMC. Retrieved 24 August 2022.
  5. ↑ REFnews Blackwell, Tom (25 October 2015)."Ontario newborn bleeds to death after family doctor persuades parents to get him circumcised", National Post. Retrieved 24 August 2022.
  6. ↑ a b REFjournal Schröder, Annette, Farhat, Walid A., Chiasson, David, Wilson, Gregory J., Koyle, Martin A.. Serious and Fatal Complications after Neonatal Circumcision. Eur Urol. 12 December 2021; 29: S2405-4569(21)00316-3. PMID. DOI. Retrieved 15 January 2022.
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