Understanding your Health Rights
All Canadian youth have legal health rights. The list below is not inclusive of every scenario. Our aim is to give you a good starting point to understanding your rights.
RIGHT TO CONSENT
In most Canadian provinces and territories, there is no minimum age to consent to health care treatment. People of any age can consent to health care treatment, except in Quebec where the age of consent to treatment is 14. If you are capable of consenting to health care treatment, then you have the right to do so.
VIEW BY PROVINCE
Having capacity means that you understand the information you are getting about your treatment, and can make a decision to accept the treatment or not.
In order to have capacity, you must be able to:
- understand the consequences of both accepting treatment and refusing treatment, and;
- make these decisions on your own, without persuasion or influence from anyone.
It is possible that you will be able to make some decisions on your own, while others that are more complicated may have to be made for you.
A capable person under the age of majority (18 or 19 years depending on the province or territory) is commonly called a “mature minor.”
Who decides if I have capacity?
The health care provider suggesting treatment, whether it be a doctor, nurse, therapist, etc. decides if you have capacity.
When do I not have capacity? What happens then?
If you don’t understand or are unconscious, another person must make decisions for you. This person is called a Substitute Decision Maker, and must make decisions that are in your best interests. Usually this person will be a parent/guardian or another family member. In certain provinces, if you are over 16 years of age, you can appoint someone else to make decisions for you. This is called a Power of Attorney for Personal Care. There are forms for you to fill out online to obtain this.
RIGHT TO PRIVACY
Without your consent, no health care provider can tell anyone, including your parents or guardians, anything about your health care. In most provinces and territories, you have the right to privacy when it comes to your own personal health information.
In most provinces and territories, the right to personal health information privacy depends on your capacity to make health care decisions and/or to understand the implications of privacy.
Parents and legal guardians have a right to access the personal health information of youth up to the age of 18 unless the youth has capacity or if the health care provider believes that disclosing the personal health information may be harmful or potentially harmful.
Some exceptions to your right to privacy: If you are under 16 in most provinces, or under 18 in other provinces and territories, and a health professional believes that you are not safe from abuse and/or neglect, it is their job to report your situation to child welfare. The same thing goes If there are safety concerns where providing information could prevent harm, especially reporting about some spreadable communicable diseases or reporting to the police to protect individuals from a threat. There also may be cases where courts request health care records for the purpose of legal proceedings. You would normally know if this is the case.
If your privacy rights are violated, you can report this to the appropriate professional college and the Provincial Offices for Privacy Protection.
RIGHT TO HEALTH COVERAGE
Like all legal residents of Canada, as a young Canadian you have a right to access free public health services. This means your provincial and territorial health plan covers the cost of medically necessary physician and hospital services.
The health services you are covered under depend on your status in Canada:
You have the right to have a health card that entitles you to obtain free health care in your province/territory.
In some provinces, it will also cover other health care professionals like physiotherapists, social workers etc. Most provinces/territories have government drug programs, some are free, for others you must pay a portion of the cost.
If you get sick in another province or territory your health card will pay for emergency health care services and hospitalization. This applies to if you are attending school outside of your province but plan to return home and do not want to change health card – your home health card will cover your emergency services
If you travel outside the country you should get private insurance because your provincial coverage will only pay for a small portion of hospital bills and in some cases will not cover any medical costs.
I Am a First Nations, Inuit or Metis Person: Your health care is paid for by the Federal Government through NIHB (Non Insured Health Benefits) but you may also qualify for provincial health care. For on reserve First Nations and Inuit youth, the Federal Nations and Inuit Health Branch (FNIHB) administers health care. This includes both primary health care as well as hospital, drug and other health benefits.
I Am a Convention Refugee or Person in Need of Protection: If you are a refugee you are a Permanent Resident or have the right to apply for Permanent Residency, you can apply for the provincial health card (e.g. OHIP, MCP). Interim Federal Health Program will cover you until you have your provincial/territorial health card. This coverage will generally last for one year. After that you have the same rights as other residents to apply for provincial/territorial health cards.
I Am a Refugee Claimant: You will have Interim Federal Health Program (IFHP) coverage while your claim is being decided. All hospitals and some doctors outside of hospitals will accept IFHP. You must renew this coverage every year. This will also cover extended benefits like prescription drugs and eye glasses. If you lose your claim, IFHP will end when all appeals are exhausted. If you win your claim, you will be a Permanent Resident and entitled to provincial/territorial plans.
I Am Without Status-Undocumented or Illegal (issued a deportation order & did not leave): You must pay for health care. Some provinces such as Ontario have community health centres where you can receive free primary care. Some larger cities have free health clinics. Hospitals cannot refuse to treat you for emergencies and hospitals do not report non status people to Citizenship and Immigration.
All other health services that are not free are typically all paid for through third-party insurance, such as employee health benefits, or out of pocket.
You may be eligible for third-party health insurance through your college or university. You may also be covered under your parent or guardian’s insurance which often extends while you are a student, or you may be eligible for insurance through your workplace. If you are not eligible for insurance or your insurance is limited (as many are), you will have to pay out of pocket for these services.
What are other services?
- Often covered out-of pocket or by private insurance.
- Vision care may be covered for some youth – for example, in Ontario, annual eye examinations are covered by the Ontario Health Insurance Plan for persons under 19 years of age or for those persons of any age who have a medical condition requiring regular eye exams.
Drugs (except those administered in hospital)
Other health services (e.g., physiotherapy, psychological counselling)
- Some community-based mental health services may be publicly funded as well, particularly if provided by a physician; however, wait lists for such services may be lengthy. As coverage decisions are made by each province or territory, there may be some variability in service availability for youth in different parts of the country.
RIGHT TO NON-DISCRIMINATION
This would be discrimination. You have the right not to be discriminated against.
Sometimes doctors, nurses and other health professionals do not know the law about capacity or have forgotten and may think they have to tell your parents so they can consent to treatment. You may have to ask them to check on the web pages of their licensing College. Some may have been treating you since you were very young and had no capacity; they may forget that you are now more mature and can make your own decisions. You might need to remind them that you are now capable.
If the provider insists on seeking parental permission, you can report the situation to the health care provider’s superiors, you can tell someone you trust, or you can switch providers. You also have the right to report it to your province or territory’s human rights commission, or to the provincial college of physicians and surgeons or other professional licensing college. You do not have to see the provider again.
What about LGBTQ2S Health Rights?
You have the right to be treated with respect. You have the right to determine your gender identity including the pronoun that you would like your health care providers to use. Health records by law must be kept in your legal name for safety reasons, however you do not have to wait until you are 18 to change your legal identity markers. If you feel you are being discriminated against in your health care because of your identity, you can report this to your provincial or territorial human rights commission.
Gender-Affirming Health Care-What Are My Rights?
In some provinces such as Ontario, there is no age restriction for gender affirming surgery. If you want reassignment (affirming) surgery outside of your province or territory, you will need prior approval from your provincial or territorial health plan. Primary health care, such as hormone treatment, is available from some, but not all health care providers.
BARRIERS TO EXERCISING RIGHTS
Despite having health rights, there are barriers that you may face in exercising your rights and accessing your health care needs.
- health care providers make (mistaken) assumptions about gender or sexual identity
- health care can underestimate youth’s capacity to consent to (or refuse) treatment because of biases related to age
- health needs are unrecognized or unmet due to stereotypes
Social Norms and Stigma
- shame or fear of stigmatization in accessing certain services because of sex, gender, religious or cultural beliefs/values
- fear of losing (present or future) partner, children, or employment because of health condition or treatment
- self-trust is compromised due to stigma
- power difference between providers and youth inhibits youth from expressing their needs in the absence of trust
- fear of violence in seeking to access health services
- youth are unjustly denied access to needed care on the basis of their personal characteristics
- systemic racism is reinforced through negative stereotypes
Privacy and Confidentiality Factors
- lack of understanding about whether and when parents or guardians should be involved in health care decision-making
- youth worry that someone will see them at the facility or that their information will be leaked into their community
- lack of anonymous testing and services in the area
Only 25% of youth surveyed said they understood their rights to privacy well.