Understanding the use of "genetic predisposition" in Canadian legal decisions

McGill Journal of Law and Health

Volumn 7, Issue 1, 2013, Pages 1-65

  Pioro, Mark ^a   Mykitiuk, Roxanne ^a   Finkler, Lilith ^b   Nisker, Jeff ^c  

^a YORK UNIVERSITY   (Canada)

^b Memorial University   (United States)

^c WESTERN UNIVERSITY   (Canada)

Author keywords

[No Author keywords available]

Indexed keywords

EID: 84875548476     PISSN: 19204825     EISSN: 19204833     Source Type: Journal    
DOI: None     Document Type: Article

References (366)

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23. See also Steve E Humphries, Paul M Ridker & Philippa J Talmud, "Genetic Testing for Cardiovascular Disease Susceptibility: A Useful Clinical Management Tool or Possible Misinformation?" (2004) 24:4 Arterioscler Thromb Vasc Biol 628 at 628-29, 634.
24. Ine Van Hoyweghen, Klasien Horstman & Rita Schepers, "Genetic 'Risk Carriers' and Lifestyle 'Risk Takers'. Which Risks Deserve our Legal Protection in Insurance?" (2007) 15:3 Health Care Anal 179 (both discussing the predictive and practical limits of genetic factors of disease in relation to non- genetic factors).
25. Abby Lippman, "Prenatal Genetic Testing and Screening: Constructing Needs and Reinforcing Inequities" (1991) 17:2 Am J L & Med 15-19.
26. Michel Morange, The Misunderstood Gene (Cambridge, MA: Harvard University Press, 2001) at 12.
27. See e.g. Kolokathis et Industries Maintenance Empire (22 January 2002), 114774- 71-9904 at para 37, online: QCCLP [Kolokathis].
28. See e.g. Decision no 2008-1082 (10 December 2008), 2008 CanLII 85217, online: AWCAC www.appealscommission.ab.ca.
29. Decision no 2004-05655 (27 October 2004), 2004 CanLII 71273, online: BCWCAT .
30. Péter Kakuk, "Genetic Information in the Age of Genohype" (2006) 9:3 Med Health Care Philos 325-335.
31. See also Rochelle Cooper Dreyfuss & Dorothy Nelkin, "The Jurisprudence of Genetics" (1992) 45:2 Vand L Rev 313 (discussing genetic essentialism at 320-21).
32. Susan M Wolf, "Beyond 'Genetic Discrimination': Toward the Broader Harm of Geneticism" (1995) 23:4 JL Med & Ethics 345 (Wolf goes farther by arguing that even when scientifically accurate, describing people in terms of genetic is still problematic, at 350).
33. See e.g. Hudson et al, supra note 4.
34. Karen Eltis, "Genetic Determinism and Discrimination: A Call to Re-Orient Prevailing Human Rights Discourse to Better Comport with the Public Implications of Individual Genetic Testing" (2007) 35:2 JL Med & Ethics 282.
35. Bartha Maria Knoppers, "Overview of Law and Policy Challenges" (December 2005) 66 La L Rev 21.
36. See e.g. Privacy Commissioner of Canada, "Genetic Testing and Privacy" (Ottawa: PCC, 1995), online: PCC www.priv.gc.ca/information/02_05_11_e.pdf.
37. United Kingdom, Department of Health, "Our Inheritance, Our Future: Realising the Potential of Genetics in the NHS" (London: DH, 2003), online: Department of Health www.dh.gov.uk/prod_consum_dh/groups/dh_digitalassets/@dh/@en/documents/digitalasset/dh_4019239.pdf.
38. United States, Department of Health & Human Services, U.S. System of Oversight of Genetic Testing: A Response to the Charge of the Secretary of Health and Human Services. Report of the Secretary's Advisory Committee on Genetics, Health, and Society (Bethesda, SACGHS, 2008), online: DHHS .
39. See e.g. Universal Declaration on the Human Genome and Human Rights, UNESCO (11 November 1997).
40. International Declaration on Human Genetic Data, UNESCO (16 October 2003).
41. Resolution 2004/9 on Genetic Privacy and Non-discrimination, E/RES/2004/9, ECOSOC (21 July 2004).
42. National Conference of State Legislatures, "Genetics and Health Insurance State Anti-Discrimination Laws" (January 2008), online: NCLS www.ncsl.org/issues-research/health/genetic-nondiscrimination-in-health-insurance-laws.aspx.
43. National Conference of State Legislatures, "Genetic Employment Laws" (January 2008), online: NCLS .
44. Pub L 110-233, 122 Stat 881.
45. National Human Genome Research Institute, "Existing Federal Anti-Discrimination Laws and How They Apply to Genetics" (28 February 2012), online: NHGRI www.genome.gov/12513979.
46. Americans with Disabilities Act, 42 USC § 12101 (1990).
47. Health Insurance Portability and Accountability Act of 1996, Pub L 104-191, 110 Stat 1936.
48. Convention for the Protection of Human Rights and Dignity of the Human Being with regard to the Application of Biology and Medicine: Convention on Human Rights and Biomedicine, 4 April 1997, 2137 UNTS 171, Eur TS164.
49. Nancy J King, Sukanya Pillay & Gail A Lasprogata, "Workplace Privacy and Discrimination Issues Related to Genetic Data: A Comparative Law Study of the European Union and the United States" (2006) 43:1 Am Bus LJ 79 at 82-83.
50. See Louise A Keogh et al, "Is Uptake of Genetic Testing for Colorectal Cancer Influenced by Knowledge of Insurance Implications?" (2009) 191:5 Med J Aust 255.
51. See e.g. Trudo Lemmens, Daryl Pullman & Rebecca Rodal, Genome Canada, "Revisiting Genetic Discrimination Issues in 2010: Policy Options for Canada", Policy Brief No. 2, (Ottawa: GPS, 2010), online: Genome Canada www.genomecanada.ca/medias/pdf/en/GPS-Policy-Directions-Brief-2-EN.pdf.
52. Trudo Lemmens, Mireille Lacroix & Roxanne Mykitiuk, Reading the Future?: Legal and Ethical Challenges of Predictive Genetic Testing (Montréal: Les Éditions Thémis, 2005).
53. Jo Ann Watton, "Fighting Genetic Discrimination in Canada: A New Coalition Takes Up the Cause" (2008) 22:6 GeneWatch 21, online: Council For Responsible Genetics www.councilforresponsiblegenetics.org/GeneWatch/GeneWatchPage.aspx?pageId=229.
54. Québec, Conseil de la santé et du bien-être, "La santé et le bien-être à l'ère de l'information génétique: enjeux individuels et sociaux à gérer" (Québec: Conseil de la santé et du bien-être, 2001), online: FQRSC www.fqrsc.gouv.qc.ca/upload/editeur/etique/avissantebienetre.pdf.
55. Privacy Commissioner of Canada, supra note 15.
56. Ontario Law Reform Commission, "Report on Genetic Testing" (Toronto: Queen's Printer, 1996), online: Osgoode Hall Law Library
57. Canadian Biotechnology Advisory Committee, "Protecting Privacy in the Age of Genetic Information" (Ottawa: CBAC, August 2004), online: Government of Canada Publications
58. See Roxanne Mykitiuk et al, "The Potential for Misusing 'Genetic Predisposition' in Canadian Courts and Tribunals" (2011) 183:14 CMAJ 1601.
59. Mykitiuk et al, "The Potential for Misusing".
60. This 2011 CMAJ study is based on the same comprehensive electronic search results as the present paper. The short 2011 study analyzes references to genetic predisposition in Canadian legal decisions. It discusses the health conditions cited, the areas of law and legal issues involved, and the purpose of referring to genetic predisposition.
61. Audet v Industrielle-Alliance, compagnie d'assurance sur la vie, [1990] RRA 500, [1990] JQ no 2532 (QL) (Qc Sup Ct).
62. Québec (Commission des droits de la personne et des droits de la jeunesse) v Montréal (City); Québec (Commission des droits de la personne et des droits de la jeunesse) v Boisbriand (City), 2000 SCC 27, [2000] 1 SCR 665.
63. RSQ, c C-12 [Québec Charter].
64. See e.g. Vetricek v 642518 Canada Inc (Algonquin Careers Academy), 2010 HRTO 757 at para 35, [2010] OHRTD no 697 (QL).
65. Petterson v Gorcak, 2009 BCHRT 439 at para 449, [2009] BCHRTD no 439 (QL).
66. Vantage Contracting Inc v Marcil, 2004 ABQB 247 at paras 31-32, 27 Alta LR (4th) 262.
67. Tanzos v AZ Bus Tours Inc, 2007 CHRT 33 at para 32, [2007] DCDP no 33 (QL).
68. New Brunswick (Human Rights Commission) v Griffin's Pub Ltd, 2005 NBQB 403 at para 14, 143 ACWS (3d) 899.
69. Evans v Health Care Corp of St John's, 2003 NLCA 13, 121 ACWS (3d) 508.
70. The following studies were conducted wholly or partly in Canada: Bombard et al, supra note 8.
71. Billings et al, supra note 8.
72. See also for an international perspective Hudson et al, supra note 4.
73. Taylor et al, supra note 8.
74. Mark A Hall & Ronald F Wright, "Systematic Content Analysis of Judicial Opinions" (2008) 96:1 Cal L Rev 63 at 64.
75. See also Matthew Herder, "Demythologizing PHOSITA: Applying the Non-Obviousness Requirement under Canadian Patent Law to Keep Knowledge in the Public Domain and Foster Innovation" (2009) 47:4 Osgoode Hall LJ 695 at 712.
76. Hall & Wright, supra note 31 at 100.
77. See Mykitiuk et al, "The Potential for Misusing", supra note 24 at 1601.
78. See Hall & Wright, supra note 31 at 79.
79. Decision no 2007-03289 (24 October 2007), online: BCWCAT at 13.
80. 2007 ONCJ 621, 170 ACWS (3d) 549, [2007] OJ no 5118 (QL) [Manitoulin].
81. See Mykitiuk et al, "The Potential for Misusing", supra note 24 at 1601-02.
82. See ibid.
83. [2003] BCCAAA no 217 (QL).
84. See also Mortimer v Cameron (1992), 32 ACWS (3d) 928, [1992] OJ no 764 (QL) (Ont Ct J (Gen Div)) [cited to QL] (referring to "genetic predisposition to a particular disease" as one factor determining average Canadian male mortality in the context of calculating damages for loss of future income, at 83).
85. R v Eckland, 2004 BCPC 298 at para 10, [2004] BCJ no 1747 (QL).
86. CFYI-AM re Focus on the Family (28 June 2001), 99/00-0724 at Appendix A, online: CBSC .
87. See Mykitiuk et al, "The Potential for Misusing", supra note 24 at 1603.
88. See ibid at 1601.
89. Statistics Canada, "Study: Work Injuries", The Daily (Ottawa: 10 July 2007), online: Statistics Canada at 2.
90. 176 references to musculoskeletal conditions occurred in labour law out of 188 total references to musculoskeletal conditions.
91. A combination of such conditions might include, for example, migraine, arthritis, and multiple chemical sensitivity.
92. (2001), 50 WCB (2d) 467, [2001] OJ no 2936 (QL) (Ont Ct J).
93. R v Ruzic, 2001 SCC 24 at para 34, [2001] 1 SCR 687, 197 DLR (4th) 577.
94. [1999] 2 SCR 290, 173 DLR (4th) 66 [cited to SCR].
95. [1999] 2 SCR 290, 173 DLR (4th) 66 [cited to SCR].
96. RSC 1985, c C-46.
97. Ibid, ss 16(2)-(3).
98. 2005 ONCJ 294, 35 CR (6th) 205, 68 WCB (2d) 49.
99. R v Luedecke, 2008 ONCA 716 at para 106, 93 OR (3d) 89, 269 OAC 1.
100. R v Luedecke, 2010 ONCJ 59, [2010] OJ No 804 (QL) at paras 16-18.
101. [2009] OJ no 3988 (QL) (ONCJ).
102. (1999), 43 WCB (2d) 375, 46 MVR (3d) 35, [1999] BCJ no 2022 (BC SC) [Campagna trial decision].
103. [1999] BCJ no 2023 (QL) (BC SC) [Campagna sentencing hearing].
104. Campagna trial decision, supra note 74 at paras 19-21.
105. Campagna sentencing hearing, supra note 74 at para 41.
106. [2005] OJ no 4781 (QL) (Ont Sup Ct) [Carmichael]
107. 2000 BCSC 388, [2000] BCJ no 452 (QL).
108. 2004 BCPC 200, 77 WCB (2d) 500, [2004] BCJ no 1396 (QL).
109. Nita A Farahany & James Coleman, "Genetics and Responsibility: To Know the Criminal from the Crime" (2006) 69:1 & 2 Law & Contemp Probs 115 at 115-16.
110. 148 ACWS (3d) 416, [2006] OJ no 1962 (QL) (Ont Sup Ct J) [Children's Aid Society of Ottawa].
111. [2002] OJ no 2760 (QL) (Ont Sup Ct J).
112. 2006 QCCQ 10753, [2006] JQ no 11954 (QL) (Youth Div).
113. "un manque de jugement".
114. To paraphrase: The psychologist described X as a child with an anxious temperament. She behaved like a young, fragile, and insecure girl. The child, taking account of the mental disorder suffered by each of her parents, has the genetic predispositions to develop a mental illness.
115. Ms. Pothier's opinion is that X suffers from obsessive-compulsive disorder as a result of post-traumatic stress. According to the information she has obtained, including that originating from X, the mother's instructions regarding menstrual hygiene were the trigger for post-traumatic shock that caused the O.C.D.
116. The psychologist specifies that the event was not in itself cause of the trauma but the child's interpretation that in fact led to the impacts already described.
117. The psychologist Pothier is adamant: it is necessary that the contacts of the child and her mother are suspended for as long as the disease X is not perfectly under control.
118. Protection de la jeunesse - 061, 2006 QCCQ 12335 at para 78, [2006] JQ no 13429 (Youth Div). To paraphrase: On the occasion of her testimony on March 28, 2006, Ms.
119. Pothier said she believes the child developed obsessive-compulsive disorder after experiencing traumatic stress. According to her, the remarks her mother made about menstruation are the traumatic event causing her disorder. She adds that it is not the event itself that carries trauma, but rather its interpretation by X. A little later, the psychologist also reported genetic predispositions that favour the development of mental illness in X.
120. The psychologist says that children whose parents suffer from mental illness run a 50% risk of developing such illness. She added that the birth of X, which occurred in traumatic circumstances, could cause sequelae in the child that left imprints in her brain and body memory. She speculates that the events in October 2005 could awaken the body memory of her birth and thus trigger strong emotions.
121. Supra note 42 at para 13.
122. 2005 ABPC 222, [2005] WDFL 3793, [2005] AWLD 3085.
123. 161 ACWS (3d) 275, [2007] OJ no 4026 (QL) (Sup Ct (Fam Div)).
124. (1989), 97 AR 38, 15 ACWS (3d) 432, [1989] AJ no 515 (QL) (Alta QB) [Nguyen cited to QL].
125. This is the term used by the court.
126. Nguyen, supra note 108 at 7.
127. (1990), 106 AR 196, 26 RFL (3d) 301, [1990] AJ no 1289 (QL) (Alta QB).
128. (1992), 35 ACWS (3d) 708, 82 Man R (2d) 101, [1992] MJ no 432 (QL) (Man QB (Fam Div)) [cited to QL].
129. See Clements v Clements, 2012 SCC 32 at paras 7-8, 346 DLR (4th) 577, [2012] SCJ No 32 (QL).
130. See e.g. The Automobile Accident Insurance Act, RSS 1978, c A-35; Automobile Insurance Act, RSQ, c A-25.
131. Pension Act, RSC 1985, c P-6.
132. See e.g. Workers Compensation Act, RSBC 1996, c 492 [BC WCA].
133. Workers' Compensation Act, RSA 2000, c W-15 [AB WCA].
134. Resurfice Corp v Hanke, 2007 SCC 7 at para 21, [2007] 1 SCR 333, 278 DLR (4th) 643.
135. Athey v Leonati, [1996] 3 SCR 458 at para 15, 140 DLR (4th) 235 [Athey].
136. But see Lynda M Collins & Heather McLeod-Kilmurray, "Material Contribution to Justice? Toxic Causation after Resurfice Corp. v. Hanke" (2010) 48 Osgoode Hall LJ 411-439, arguing that this formulation of causation has since been rejected by the Supreme Court of Canada.
137. Nevertheless, because of its influence on the decisions we cite, we have included it.
138. Athey, ibid at para 17 [emphasis in original].
139. Husky Oil Operations Ltd v MNR, [1995] 3 SCR 453 at paras 124-25, 128 DLR (4th) 1, citing Reference re: Workers' Compensation Act, 1983 (Nfld), 44 DLR (4th) 501, 67 Nfld & PEIR 16 (NLCA), aff'd [1989] 1 SCR 922, 26 DLR (4th) 765.
140. See e.g. Workers Compensation Act, CCSM c W200, s 4(1).
141. Workplace Safety and Insurance Act, 1997, SO 1997, c 16, Schedule A, s 13(1) [ON WSIA].
142. See similarly Workers' Compensation Act, SNu 2007, c 15, s 10 and Workers' Compensation Act, SNWT 2007, c 21, s 10, both of which describe compensable injuries as "arising out of and during the course of employment".
143. The Yukon statute uses "work-related" (Workers' Compensation Act, SY 2008, c 12, s 4(1) [YK WCA]).
144. See e.g. Decision no 2003-01384 (9 July 2003), 2003 CanLII 69913, online: BCWCAT (using the language of "significant cause" at 6).
145. Decision no 398/92 (16 June 1992), 1992 CanLII 5812, online: OWSIAT ("significant causal factor" at 6).
146. Decision no 1919/09, 2009 ONWSIAT 2661, online: OWSIAT ("significant contributing factor" at para 28).
147. Decision no 2007-4682 (19 July 2007), 2007 CanLII 70361, online: NBWHSCC ("significant contributing factor" at 5).
148. See e.g. Decision no 2003-04042 (9 December 2003), online: BCWCAT www.wcat.bc.ca.
149. Decision no 09082 (April 2009), online: NLWHSCRD ("significiant aggravation" at 9).
150. See e.g An Act respecting industrial accidents and occupational diseases, RSQ, c A-3.001, Chapter III [An Act respecting industrial accidents].
151. See e.g. Ontario Workplace Safety and Insurance Board, "Operational Policy Manual: Benefit Payments" (Ontario: WSIB, 2013), online: WSIB .
152. See e.g. BC WCA, supra note 121 s 5(5).
153. Workers' Compensation Board of British Columbia, "Rehabilitation Services and Claims Manual, vol 1" (British Columbia: WCB, 2002), online: WorkSafeBC at 2220.
154. Workers' Compensation Board of British Columbia, "Rehabilitation Services & Claims Manual, vol 2" (British Columbia: WCB, 2002), online: WorkSafeBC at 44.10 [RSCM II].
155. Workplace Health, Safety and Compensation Act, RSNL 1990, c W-11, s 43.1 [NL WHSCA].
156. Workers' Compensation Act, RSNB 1973, c W-13, s 7(5)(b) [NB WCA].
157. Decision no 2004-224 (12 March 2004), 2004 CanLII 70776, online: AWCAC at para 27.
158. Decision no 2011-01198 (13 May 2011), 2011 CanLII 51258, online: BCWCAT at paras 48-49.
159. BC WCA, supra note 121, s 99.
160. Workers' Compensation Act, SS 1979, c W-17.1, s 25(2) [SK WCA].
161. ON WSIA, supra note 134, s 119(2).
162. NL WHSCA, supra note 139, s 60(1).
163. Workers' Compensation Act, SNS 1994-95, c 10, s 187 [NS WCA].
164. Workers Compensation Act, RSPEI 1988, c W-7.1, s 17 [PEI WCA].
165. YK WCA, supra note 134, s 19.
166. See e.g. YK WCA, ibid, s 3(1) "injury" (d).
167. BC WCA, supra note 121, s 6(1).
168. Workers Compensation Act, RSM 1987, c W200, CCSM c W200, s 4(4) [MB WCA].
169. PEI WCA, supra note 140, s 3(10).
170. MB WCA, supra note 142, s 1(1) "occupational disease".
171. YK WCA, supra note 134, s 3(1) "injury".
172. RSCM II, supra note 139 at 2603.
173. See e.g. BC WCA, supra note 121, s 6(3), Schedule B.
174. AB WCA, supra note 121, s 24(6).
175. Workers' Compensation Regulation, Alta Reg 325/2002, Schedule B.
176. ON WSIA, supra note 134, s 15(3).
177. General, O Reg 175/98, Schedule 3 [General].
178. An Act respecting industrial accidents, supra note 137, s 29, Schedule I.
179. NS WCA, supra note 140, s 12(3).
180. Workers' Compensation General Regulations, NS Reg 22/96, Appendix B.
181. ON WSIA, supra note 134, s 15(4).
182. General, supra note 145, Schedule 4.
183. See also NS WCA, supra note 140, s 35.
184. See e.g. AB WCA, supra note 121, ss 91(4), 95-97.
185. See e.g. NS WCA, supra note 140, s 18.
186. An Act respecting industrial accidents, supra note 137, s 328.
187. NL WHSCA, supra note 139, s 116.
188. NB WCA, supra note 139, s 65.
189. An Act respecting industrial accidents, supra note 137, s 330.
190. ON WSIA, supra note 134, s 98.
191. SK WCA, supra note 140, s 144.
192. BC WCA, supra note 121, s 39(1)(d).
193. An Act respecting industrial accidents, supra note 137, s 329.
194. Manitoba, Workers Compensation Board, "Policy Manual: Cost Relief/Cost Transfers" (Winnipeg: WCB, 2011), online: MWCB at s 31.05.10.
195. BC WCA, supra note 121, s 39(1)(e).
196. Ontario, Workplace Safety and Insurance Board, "Operational Policy Manual: Second Injury and Enhancement Fund" (Hamilton: WSIB, 2006), online: OWSIB [SIEF Policy].
197. That is, the predisposition together with other factors amount to an unnecessary but sufficient cause for the development of the disease. This type of causal condition has been described as "an insufficient but non-redundant part of an unnecessary but sufficient condition" or to use the first letters of the italicized words, an "inus condition".
198. JL Mackie, The Cement of the Universe: A Study of Causation (Oxford: Clarendon, 1980) at 62.
199. Decisions containing this sort of statement, but which we do not discuss in detail include: NP c SAAQ (19 April 2005), SAS-Q-096423-0303, 2005 CanLII 70841, online: TAQ at para 30.
200. Decision no 737/91 (17 August 1995), [1995] OWCATD no 846 (QL) at para 50, 1995 CanLII 8158, online: OWSIAT .
201. Decision no 1358/97 (30 November 1998), [1998] OWSIATD no 2185 (QL), 1998 CanLII 17325, online: OWSIAT at para 61-62.
202. Campbell v Vancouver (City of), 2001 BCSC 350 at para 34, 103 ACWS (3d) 621 (quoting a previous decision not in our sample).
203. Decision no 321/91 (22 June 1994), [1994] OWCATD no 492 (QL) at para 23, online: OWSIAT www.wsiat.on.ca.
204. Decision no 161/04 (18 November 2004), 2004 ONWSIAT 2379 at paras 18, 26, [2004] OWSIATD 2284 (QL), online: OWSIAT www.wsiat.on.ca.
205. Mitchell v Mason Estate (2002), 117 ACWS (3d) 648, [2002] OJ no 4030 (QL) at para 94 (Ont Sup Ct J).
206. Morgan v Metropolitan Toronto (Municipality of) (2006), 153 ACWS (3d) 749, 44 CCLT (3d) 198. [2006] OJ no 4951 (QL) at para 348 (Ont Sup Ct J).
207. Decision no 2003- 04042, supra note 136.
208. 2001 BCSC 1783, 110 ACWS (3d) 289, [2001] BCTC 1783
209. EB v Order of the Oblates of Mary Immaculate in the Province of British Columbia, 2003 BCCA 289, 227 DLR (4th) 298, 14 BCLR (4th) 99.
210. Kolokathis, supra note 11.
211. citing Snell v Farrell, [1990] 2 SCR 311 at para 34, 72 DLR (4th) 289, 107 NBR (2d) 94. (1 August 2001), SAS-Q-065751-0007, 2001 CanLII 36580, online: TAQ .
212. To paraphrase: This damage usually occurs as a result of a genetic predisposition, that is to say, in the event that the person has inherited a susceptibility to react in the pancreas. In this case, the violent blow to the abdomen during the accident has necessarily resulted in a significant beta cell failure, which precipitated the onset of diabetes.
213. The blaze has been a precipitating factor without which the victim's diabetes would never have appeared or, at least, would not have appeared at that time.
214. (3 April 1995), [1995] OWCATD no 314 (QL), 1995 CanLII 8151, online: OWSIAT [cited to QL].
215. Dupuyren's contracture is a disease marked primarily by the contracture/bending of some of the fingers toward the palm
216. see J Vernon Luck, "Dupuytren's Contracture: A New Concept of the Pathogenesis Correlated with Surgical Management" (1959) 41 J Bone Joint Surg Am 635-636.
217. Decision no 935/90, supra note 166-5.
218. See Gavin MacKenzie, "Breaking the Dichotomy Habit: The Adversary System and the Ethics of Professionalism" (1996) 9 Can JL & Jur 33-45.
219. [1990] OWCATD no 626 (QL), 1990 CanLII 4596, online: OWSIAT [cited to QL]
220. Decisions featuring this type of argument include Decision no 2008-01239 (24 April 2008), 2008 CanLII 25521, online: BCWCAT www.wcat.bc.ca.
221. Decision no 320/87 (9 November 1989), [1989] OWCATD no 1013 (QL) at paras 28-29, 1989 CanLII 1936, online: OWSIAT www.wsiat.on.ca.
222. Haney v Malischewski (1997), 41 BCLR (3d) 230 at paras 9, 35, 73 ACWS (3d) 247, [1997] BCJ no 1894 (BC SC).
223. Aubin v Tremblay (1991), [1991] BCWLD 2055, [1991] BCJ no 2458 (QL) (BC SC).
224. Bonin et Cargill ltée (21 July 2008), 2008 QCCLP 4192, online: QCLP www.clp.gouv.qc.ca.
225. Comeau v Canada (Attorney General), 2005 FC 1648 at para 14, 284 FTR 107, 144 ACWS (3d) 744.
226. Blackwater v Plint, 2001 BCSC 997 at para 711, 93 BCLR (3d) 228, [2001] BCJ no 1446 (QL).
227. 2006 NLSCTD 44, 254 Nfld & PEIR 61, 146 ACWS (3d) 747.
228. Williams v Thomas Development (1989) Corp, 2007 NFCA 54, 269 Nfld & PEIR 290, 283 DLR (4th) 273.
229. leave to appeal to SCC refused, Williams v Thomas Development (1989) Corp, [2007] SCCA no 535 (QL), 2008 CanLII 3200.
230. Supra note 135.
231. (19 November 2004), 2004 ONWSIAT 2392, [2004] OWSIATD no 2306 (QL), online: OWSIAT .
232. Decision no 2008-01428 (14 May 2008), 2008 CanLII 33577, online: BCWCAT at p. 4.
233. Decision no 1188/00 (30 April 2001), 2001 ONWSIAT 1460 at para 37, [2001] OWSIATD no 1435 (QL), online: OWSIAT .
234. See e.g. Decision no 2005-03494 (30 June 2005), online: BCWCAT www.wcat.bc.ca.
235. Decision no 710/99 (24 January 2001), 2001 ONWSIAT 158 at para 20, [2001] OWSIATD no 233 (QL), online: OWSIAT www.wsiat.on.ca.
236. Dinyer-Fraser v Laurentian Bank, 2005 BCSC 225 at para 138, 28 CCLT (3d) 205, 40 BCLR (4th) 39.
237. Decision no 02213 (June 2002), 02056-02, online: NLWHSCRD .
238. Decision no 2004-02756 (27 May 2004), online: BCWCAT www.wcat.bc.ca.
239. Decision no 2004-04487 (26 August 2004), online: BCWCAT www.wcat.bc.ca.
240. Decision no 2003- 00481 (9 May 2003), 2003 CanLII 70178, online: BCWCAT www.wcat.bc.ca.
241. Hall v MacDougall, 2007 BCSC 1296 at para 63, 161 ACWS (3d) 248.
242. Bittante v Zichy, 2008 BCSC 728 at para 125, 168 ACWS (3d) 791.
243. Bas de Nylon Doris Ltée et Nicolas Ulysse Bélizaire (19 February 2001), 128525, online: QCLP at para 48.
244. Decision no 2008-01512 (22 May 2008), online: BCWCAT www.wcat.bc.ca.
245. Decision no 2003-02849 (2 October 2003), online: BCWCAT www.wcat.bc.ca.
246. Decision no 2005-00539 (31 January 2005), online: BCWCAT .
247. 2009 BCSC 750, [2009] BCJ no 1128 (QL).
248. Supra note 12.
249. Another decision featuring similar statements, also concerning degenerative disc disease and involving two of the same panel members is Decision no 2008-219, 2008 CanLII 86645, online: AWCAC .
250. Decision no 2008-1082, supra note 12 at para 233.
251. Supra note 12.
252. See e.g. Decision no 2004-03193 (18 June 2004), online: BCWCAT (worker denying he has non-occupational risk factors for inguinal hernia, including genetic predisposition).
253. Decision no 2004-06212 (25 November 2004), online: BCWCAT (worker arguing that mother's hearing loss, and therefore her own, was not due to a genetic predisposition).
254. Decision no 2004-02471 (12 May 2004), online: BCWCAT (worker's family physician provides evidence that he is not aware of any genetic predisposition to osteoarthritis as indicated by the worker's history).
255. Decision no 03251 (October 2003), 03298-07, online: NLWHSCRD (in response to the suggestion that genetic predisposition was a factor in his condition, the worker responded, "[i]t is very wrong to state this because I did not experience hip problems prior to the injury" at 7).
256. Decision no 347/97 (20 June 1997), 1997 CanLII 14105, online: OWSIAT at para 25.
257. Decision no 1203/03 (15 July 2003), 2003 ONWSIAT 1627 at para 43, online: OWSIAT www.wsiat.on.ca.
258. Decision no 375/01 (28 February 2003), 2003 ONWSIAT 454 at para 34, online: OWSIAT .
259. (27 May 2004), online: BCWCAT www.wcat.bc.ca
260. (1997), 44 BCLR (3d) 154, 73 ACWS (3d) 785 (SC) [DJB cited to BCLR].
261. [1988] BCJ no 456 (QL) (BC SC).
262. Lindquist v Neufeld, [1984] BCJ no 3076 (QL) at para 11 (BC SC) [Lindquist].
263. Decision no 2370/01 (31 January 2002), 2002 ONWSIAT 274 at para 51, online: OWSIAT www.wsiat.on.ca.
264. Decision no 2004-01988 (21 April 2004), online: BCWCAT at 2.
265. Decision no 1176/05 (16 August 2005), 2005 ONWSIAT 1828 at para 22, online: OWSIAT www.wsiat.on.ca.
266. Decision no 651/96 (17 February 1998), 1998 CanLII 15371, online: OWSIAT at para 20.
267. Decision no 2005-1109, 2005 CanLII 76251 at para 18.3, online: AWCAC www.appealscommission.ab.ca.
268. Decision no 1419/09 (22 July 2009), 2009 ONWSIAT 174 at para 29, online: OWSIAT .
269. See e.g. Decision no 398/92, supra note 135 at para 30.
270. AD v MD, 2000 OTC 52, 94 ACWS (3d) 807 at para 33, [2000] OJ no 248 (QL) (Ont Sup Ct J).
271. Decision no 134/87 (27 July 1988), 1988 OWCATD no 817 (QL) at para 31, 1988 CanLII 1766, online: OWSIAT www.wsiat.on.ca.
272. Sparkes-Morgan v Webb (1999), 178 Nfld & PEIR 237 at para 222, 1999 NJ 205 (QL) (Nfld SC (TD)).
273. (5 June 2003), 2003 CanLII 69839, online: BCWCAT
274. This passage was similarly employed in Nicole Bédard v Cadrin Fleury Inc (12 January 2001), online: QCLP at paras 62-63.
275. To paraphrase: Although the worker carries a genetic predisposition to anxiety (panic type), she would never have become ill were it not for the particular risks of her work. The "thin skull" rule applies even where a psychological illness is at issue.
276. Alberta, Workers' Compensation Board, "Policy 03-02 Part I: Aggravation of a Pre-Existing Condition" (Alberta: WCB, 26 November 1996), online: AWCB at 10.
277. Alberta, Workers' Compensation Board, "Policy 05-02 Part II - Application 1: Cost Relief" (Alberta: WCB, 30 November 2010), online: AWCB at 1.
278. Decision no 2005-963, 2005 CanLII 76428 at para 26, online: AWCAC
279. An Act respecting industrial accidents, supra note 137.
280. See Alimentation JA Drolet Inc (8 March 2001), online: QCLP www.clp.gouv.qc.ca
281. At para 15 [Alimentation] citing Municipalité Petite-Rivière Saint-François et CSST Québec (1999), online: QCLP .
282. See also René Matériaux composites Ltée et CSST Chau- dière-Appalaches (21 July 2003), online: QCLP at para 41 [René Matériaux].
283. Les Silos Port-Cartier et CSST Côte-Nord (23 December 2003), online: QCLP at para 31 [Les Silos Port-Cartier].
284. Reboitech inc (15 March 2004), online: QCLP at para 15 [Reboitech].
285. CSSS de l'Énergie (26 May 2009), 2009 QCCLP 3609, online: QCLP at para 106 [CSSS].
286. Entreprises DF (27 April 2010), 2010 QCCLP 3174, online: QCLP at para 51.
287. To paraphrase the definition: A loss of substance or an alteration of a psychological, physiological, or anatomical structure or function that corresponds to a deviation from a biomedical norm.
288. See Alimentation, supra note 227 at para 16
289. citing Hôpital Général de Montréal (29 November 1999), online: QCLP .
290. See also René Matériaux, supra note 227 at para 44.
291. Reboitech, supra note 227 at para 18.
292. See e.g. René Matériaux, supra note 227 at para 39, citing several previous decisions.
293. Camoguid inc (22 April 2010), 2010 QCCLP 3067, online: QCLP at para 27.
294. Commission scolaire de la Seigneurie des- Mille-Iles (23 February 2010), 2010 QCCLP 1590 at para 38, online: QCLP .
295. Reboitech, supra note 227 at para 34.
296. To paraphrase: In addition, each individual has a genetic background of their own and it would be somewhat risky, even dangerous, to conclude that the genetic makeup of a person is poor, simply because he has developed a particular disease.
297. A genetic predisposition, were it proven, which is not the case here, constitutes only a vague, hypothetical potential that may never be realized. It cannot, therefore, be treated as a disability. A risk factor does not constitute a disability in itself.
298. See e.g. Deniso Lebel inc (7 March 2004), online: QCLP at para 29.
299. Les Magasins Hart inc (3 November 2005), online: QCLP www.clp.gouv.qc.ca.
300. Radiateur d'auto Drummond inc (17 September 2009), 2009 QCCLP 6325, online: QCLP .
301. Supra note 227.
302. Les Silos Port-Cartier, supra note 227.
303. See also Usine Bois Saumon inc (29 January 2009), 2009 QCCLP 590, online: QCLP www.clp.gouv.qc.ca.
304. Meubles Laurier ltée (12 March 2009), 2009 QCCLP 1792, online: QCLP www.clp.gouv.qc.ca.
305. Boulangerie Weston Québec ltée (10 May 2004), online: QCLP .
306. Transport Bourret inc (10 May 2004), online: QCLP www.clp.gouv.qc.ca.
307. CSSS, supra note 227.
308. Finition Chez Soi inc (10 June 2008), 2008 QCCLP 3354, online: QCLP www.clp.gouv.qc.ca.
309. Entreprises DF, supra note 227.
310. SIEF Policy, supra note 150.
311. Decision no 1094/06 (26 July 2006), 2006 ONWSIAT 1638 at para 13, [2006] OWSIATD no 1614 (QL), online: OWSIAT .
312. Decision no 2164/07 (16 October 2007), 2007 ONWSIAT 2599 at para 9, [2007] OWSIATD no 2604 (QL), online: OWSIAT .
313. See Troyen A Brennan, "Causal Chains and Statistical Links: The Role of Scientific Uncertainty in Hazardous-Substance Litigation" (1987) 73:3 Cornell L Rev 469.
314. Daniel A Farber, "Toxic Causation" (1987) 71:5 Minn L Rev 1219-1228.
315. Clifford Fisher, "The Role of Causation in Science as Law and Proposed Changes in the Current Common Law Toxic Tort System" (2001) 9:1 Buff Envtl LJ 35-126.
316. Compare Anita Bernstein, "Formed by Thalidomide: Mass Torts as a False Cure for Toxic Exposure" (1997) 97:7 Colum L Rev 2153-2166 (for a rare example of a substance associated with overwhelmingly strong evidence of causation).
317. See Russell Brown, "The Possibility of 'Inference Causation': Inferring Cause-in- Fact and the Nature of Legal Fact-Finding" (2010) 55:1 McGill LJ 1 at 30-31.
318. See e.g. Katherine Lippel et al, "La preuve de la causalité et l'indemnisation des lésions attributables au travail répétitif: recontre des science de la santé et du droit" (1999) 17:1 Windsor YB Access Just 35 at 54-55 (discussing the role of biomedical knowledge in workers' compensation cases involving musculoskeletal injury).
319. See e.g. Decision no 2008-01934 (27 June 2008), 2008 CanLII 43525, online: BCWCAT www.wcat.bc.ca.
320. Decision no 2008-01708 (10 June 2008), 2008 CanLII 43297, online: BCWCAT www.wcat.bc.ca.
321. Decision no 2006-04298 (23 November 2006), online: BCWCAT www.wcat.bc.ca.
322. Decision no 2003-01415 (10 July 2003), 2003 CanLII 69111, online: BCWCAT .
323. See e.g. Decision no 2006-416 (4 May 2006), 2006 CanLII 78859 at para 28.2, online: AWCAC www.appealscommission.ab.ca.
324. Fernande Proulx et Pâtisserie Saint-Lambert Ltée (19 September 2003), 207570-62-0305, online: QCLP at paras 19-32.
325. See e.g. Decision no 2005-1126 (22 November 2005), 2005 CanLII 76255 at paras 38-39, AWCAC www.appealscommission.ab.ca.
326. Decision no 2003-02614-RB (22 September 2003), online: BCWCAT www.wcat.bc.ca.
327. Decision no 1203/03, 2003 ONWSIAT 1627 at paras 43-45, online: OWSIAT .
328. See e.g. Succession EM c SAAQ (3 November 2008), 2008 QCTAQ 10901 at paras 46-47, SAS-M-118134-0605, 2008 CanLII 60899, online: TAQ www.taq.gouv.qc.ca.
329. Decision no 2008-00782 (11 March 2008), 2008 CanLII 18365, online: BCWCAT .
330. See e.g. DJB, supra note 203.
331. Lindquist, supra note 210.
332. Decision no 09235, supra note 212.
333. AP c Régie des rentes du Québec (14 March 2005), SAS-Q-103321-0312, 2005 CanLII 70668, online: TAQ www.taq.gouv.qc.ca.
334. Decision no 1121/06, 2007 ONWSIAT 3330, online: OWSIAT .
335. See Morange, supra note 10 at 12.
336. See Cooper Dreyfuss & Nelkin, supra note 13 at 320-21.
337. See Lippman, supra note 9 at 18-19.
338. Ron Amundson, "Disability, Ideology, and Quality of Life: A Bias in Biomedical Ethics" in David Wasserman, Jerome Bickenbach & Robert Wachbroit, eds, Quality of Life and Human Difference: Genetic Testing, Health Care, and Disability (New York: Cambridge University Press, 2005) 101 at 101-02.
339. Gregor Wolbring, The Triangle of Enhancement Medicine, Disabled People, and the Concept of Health: A New Challenge for HTA, Health Research, and Health Policy (Edmonton: Alberta Heritage Foundation for Medical Research, 2005) at 12.
340. Amundson, supra note 256.
341. Wolbring, ibid at 17-18.
342. Erik Parens & Adrienne Asch, "The Disability Rights Critique of Prenatal Genetic Testing: Reflections and Recommendations" in Erik Parens & Adrienne Asch, eds, Prenatal Testing and Disability Rights (Washington: Georgetown University Press, 2000) 3-14.
343. See also Adrienne Asch, "Why I Haven't Changed My Mind about Prenatal Diagnosis: Reflections and Refinements" in Parens & Asch at 234.
344. Adrienne Asch & David Wasserman, "Where is the Sin in Synecdoche? Prenatal Testing and the Parent-Child Relationship" in Wasserman, Bickenbach & Wachbroit, supra note 256 at 172.
345. Esther Shainblum, Terrence Sullivan & John W Frank, "Multicausality, Non- traditional Injury, and the Future of Workers' Compensation" in Morley Gunderson & Douglas Hyatt, eds, Workers' Compensation: Foundations for Reform (Toronto: University of Toronto Press, 2000) 58.
346. This dynamic has been explored in the context of the wrongful birth and wrongful life causes of action.
347. See Wendy F Hensel, "The Disabling Impact of Wrongful Birth and Wrongful Life Actions" (2005) 40 Harv CR-CLL Rev 141 ("Any benefits secured by individual litigants in court are thus taxed to the community of people with disabilities as a whole, placing at risk, in the drive for individual compensation, the gains secured by collective action and identity" at 144).
348. See e.g. Campagna trial decision, supra note 74 at para 21.
349. Carmichael, supra note 81 at para 16.
350. Children's Aid Society of Ottawa, supra note 92 at para 49.
351. RM (Re), supra note 104 at para 13.
352. Lyn Jongbloed, "Disability Policy in Canada: An Overview" (2003) 13 Journal of Disability Policy Studies 203-205.
353. Kakuk, supra note 13 at 326-30.
354. James P Evans et al, "Deflating the Genomic Bubble" (2011) 331 Science 861 at 861.
355. Kakuk, supra note 13 at 326-28.
356. George Davey Smith et al, "Genetic Epidemiology and Public Health: Hope, Hype, and Future Prospects" (2005) 366 Lancet 1484 at 1485-88.
357. Humphries, Ridker & Talmud, supra note 8 at 630.
358. Ian Kerr & Timothy Caulfield, "Emerging Health Technologies" in Jocelyn Downie, Timothy Caulfield & Colleen M Flood, eds, Canadian Health Law and Policy, 3d ed (Toronto: LexisNexis Canada, 2007) 509-516.
359. But see JA Lowden, "Genetic Discrimination and Insurance Underwriting" (1992) 51 Am J Hum Genet 901.
360. See Lizabeth A Barclay & Karen S Markel, "Discrimination and Stigmatization in Work Organizations: A Multiple Level Framework for Research on Genetic Testing" (2007) 60 Human Relations 953-973.
361. See e.g. British Columbia (Public Service Employee Relations Commission) v BCGSEU, [1999] 3 SCR 3, 176 DLR (4th) 1.
362. Hydro-Québec v Syndicat des employé-e-s de techniques professionnelles et de bureau d'Hydro-Québec, section locale 2000 (SCFP-FTQ), 2008 SCC 43, [2008] 2 SCR 561, 294 DLR (4th) 407.
363. Trudo Lemmens, "Selective Justice, Genetic Discrimination, and Insurance: Should We Single Out Genes in Our Laws?" (2000) 45 McGill LJ 347 at 404-06 [emphasis in original].
364. Kakuk, supra note 13 at 335.
365. See generally Mark A Rothstein, Yu Cai & Gary E Marchant, "The Ghost in Our Genes: Legal and Ethical Implications of Epigenetics" (2009) 19 Health Matrix 1.
366. Supra note 259 at 69-70.