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Updated and corrections / mise à jour et corrections: 9 November 2007

©by / par François Lareau, 2007, Ottawa, Canada
First posted on the internet on 8 November 2007

Selected Bibliography on Surgical Operations
 -- Section 45 of the Criminal Code
-------------------------
Bibliographie choisie sur les interventions chirurgicales --
article 45 du Code criminel


Note:
See also the bibliographies at / voir aussi les bibliographies à http://www.lareau-law.ca/droitpenal_.htm

• Authority of the law/ L'autorité de la loi
• Consent / Consentement
• Necessity / État de nécessité

AUSTRALIA, Queensland, Queensland Criminal Code Act, 1899, available at http://www.legislation.qld.gov.au/LEGISLTN/CURRENT/C/CriminCode.pdf  (accessed on 3 November 2007);

"282  Surgical operations

A person is not criminally responsible for performing in good faith and with reasonable care and skill a surgical operation upon any person for the patient’s benefit, or upon an unborn child for the preservation of the mother’s life, if the performance of the operation is reasonable, having regard to the patient’s state at the time and to all circumstances of the case."

__________Tasmania, Criminal Code Act 1924, available at http://www.thelaw.tas.gov.au/tocview/index.w3p;cond=;doc_id=69%2B%2B1924%2BAT%40EN%2B20070920230000;histon=;prompt=;rec=;term=  (accessed on 25 October 2007);

"51. Surgical operations
(1) It is lawful for a person to perform in good faith and with reasonable care and skill a surgical operation upon another person, with his consent and for his benefit, if the performance of such operation is reasonable, having regard to all the circumstances.
(2) In the case of a child too young to exercise a reasonable discretion in such a matter, such consent as aforesaid may be given by his parent or by any person having the care of such child.
(3) In the case of a person in such a condition as to be incapable of giving such consent as aforesaid, such operation may be performed without such consent."

___________Western Australia,  Criminal Code, available at  http://www.austlii.edu.au/au/legis/wa/consol_act/cc94/ (accessed on 30 August 2005); also available at http://www.slp.wa.gov.au/statutes%5Cswans.nsf/PDFbyName/33020351352A05ED4825673600082D53?OpenDocument (accessed on 25 October 2007);

"Surgical and medical treatment

259 . Surgical and medical treatment

A person is not criminally responsible for administering, in good faith and with reasonable care and skill, surgical or medical treatment —

(a) to another person for that other person’s benefit; or

(b) to an unborn child for the preservation of the mother’s life,

if the administration of the treatment is reasonable, having regard to the patient’s state at the time and to all the circumstances of the case."


BÉLIVEAU, Pierre, "La réforme de l'avortement et l'avortement d'un réforme", (1975) 35 Revue du Barreau 563-592;

BURBIDGE, George Wheelock, 1847-1908, A Digest of the Criminal Law of Canada (Crimes and Punishments) Founded By Permission on Sir James Fitzjames Stephen's Digest of the Criminal Law, Toronto: Carswell, 1890, lxiii, 588 p., and see article 260, Right to consent to bodily injury for surgical purposes at p. 198; article 261, Surgical Operation on person incapable of assent at p. 199; and article 262, Right to consent to bodily injury short of main, at p. 199; pdf completed on 4 September 2006;
PDF
- Table of Contents and Index
- i-lxiii and 1-41 (Cover page; Table of cases cited; Table of statutes cited (U.K. and Canada); List of Abbreviations; Contents; articles 1-34);
- 42-140    (articles 35-184);
- 141-239  (articles 185-308);
- 240-340  (articles 309-434);
- 341-448  (articles 435-561);
- 449-537  (articles 562-629 and Appendix of Notes);
- 539-588   (Index; p. 538 is blank)


CANADA, Department of Justice Canada, Reforming the General Part of the Criminal Code: A Consultation Paper, [Ottawa]; [Department of Justice Canada], [November 1994], v, 35 p., and see "Appendix -- What this consultation paper does not deal with", at p. 35; this publication is available at my Digital Library at http://www.lareau-law.ca/DigitalLibrary.html; also published in French/aussi publié en français: Ministère de la Justice Canada, Projet de réforme de la Partie générale du Code criminel: Document de consultation, [Ottawa], [Ministère de la Justice Canada], [Novembre 1994], v, 39 p., et voir "ANNEXE -- Quelles questions le présent document n'aborde-t-il pas?", à la p. 39; cette publication est disponible à ma Bibliothèque digitale à http://www.lareau-law.ca/DigitalLibrary.html;

"APPENDIX
What this consultation paper does not deal with
...
For a variety of reasons, this paper does not discuss a number of other General Part  issues.  These include: the way to deal with the physical element of an offence, some fault elements of crimes , attempts to commit an offence, people who counsel others to commit offences or conspire with others to commit offences, other defences (such as entrapment, emergency surgical or medical treatment), the principle of legality, omissions, extraterritorial jurisdiction, double jeopardy, the treatment of people who act under legal authority or have been given orders to act a certain way, and the rules concerning people who have authority over children." (p. 35; emphasis added)

-----------------

"ANNEXE
Quelles questions le présent document de consultation n'aborde-t-il pas?

[...]

Pour diverses raisons, le présent document ne traite pas des questions suivantes concernant la Partie générale : l'élément matériel des infractions, l'élément moral exigé pour certaines infractions , les tentatives de commettre une infraction, le fait de conseiller à une personne de commettre une infraction ou de comploter avec une autre personne de commettre une infraction, la notion d'impossibilité, certains moyens de défense (notamment la provocation policière et le traitement chirurgical ou médical d'urgence), le principe de la légalité, les omissions, l'application extra-territoriale, la double incrimination, le traitement des personnes qui exercent des pouvoirs légaux ou qui ont reçu des ordres de supérieurs les forçant à agir d'une certaine façon et la discipline des enfants." (p. 39; mots mis en gras à la fin par moi)

CANADA, Department of Justice Canada and James W. O'Reilly, Toward a New General Part of the Criminal Code of Canada -- Details on Reform Options --, [Ottawa]: [Department of Justice Canada], [December 1994], ii, 50 p., and see at p. 48 the comments on clause 11 amending s. 45 of the Criminal Code; available at my Digital Library, http://www.lareau-law.ca/DigitalLibrary.html; information on the French version/informations sur la version française: Ministère de la Justice Canada et James W. O'Reilly, Pour une nouvelle codification de la Partie générale du Code criminel du Canada -- Options de réforme --, [Ottawa]: [Ministère de la Justice Canada], [décembre 1994], ii, 51 p., et voir à la p. 50, l'article 11 modifiant l'article 45 du Code criminel; disponible à ma Bibliothèque digitale, http://www.lareau-law.ca/DigitalLibrary.html;


CANADA, The Minister of Justice of Canada,  Proposals to Amend the Criminal Code (general principles), [Ottawa], [Department of Justice Canada], 28 June 1993, 17 p., and see section 11 amending section 45, at p. 14; available at my Digital Library, http://www.lareau-law.ca/DigitalLibrary.html / information on the French version /informations sur la version française:  CANADA, Ministre de la Justice du Canada, Proposition de modification du Code criminel (principes généraux), [Ottawa], [Ministère de la Justice Canada], 28 ¸juin 1993, 17 p., et voir l'article 11 modifiant l'article 45 à la p. 14; disponible à ma Bibliothèque digitale, http://www.lareau-law.ca/DigitalLibrary.html;


CANADA, Parliament, House of Commons,  Minutes of Proceedings and Evidence of the Sub-Committee on the Recodification of the General Part of the Criminal Code of the Standing Committee on Justice and the Solicitor General, [Ottawa]: Queen's Printer for Canada, 1992-1993, 11 Issues; note that the 11th issue consists of the report:  First Principles: Recodifying the General Part of the Criminal Code of Canada: Report of the Sub-Committee on the Recodification of the General part of the Criminal Code of the Standing Committee on Justice and the Sollicitor General; see in the report, "Chapter XII Exceptions for Medical Practice", at pp. 53-58; also published in French/aussi publié en français: Parlement, Chambre des Communes, Procès-verbaux et témoignages du Sous-comité sur la Recodification de la Partie générale du Code criminel du Comité permanent de la justice et du Solliciteur général,  [Ottawa]: I'Imprimeur de la Reine pour le Canada, 1992-1993, 11 fasicules;  noter que le 11e fasicule contient le rapport : Principes de base: recodification de la Partie générale du Code criminel du Canada.  Rapport du Sous-comité sur la recodification de la Partie générale du Code criminel du Canada du Comité permanent de la justice et du Solliciteur général; voir dans le rapport,  "Chapitre XII Les exceptions en ptaique médicale", aux pp. 57-62;


CASTEL, J.-G., "Nature znd Effects of Consent with Respect to the Right to Life and the Right to Physical and Mental Integrity in the Medical Field : Critical and Private Law Aspects", (1978) 16 Alberta Law Review 293-356, and see pp. 314-316;

Cataford c.  Moreau [1978] C.S. 933  et voir PDF p. 936  (Deschênes C.J.);


Code civil du Québec, disponible à http://www.canlii.org/eliisa/highlight.do?text=code+civil&language=fr&searchTitle=Qu%C3%A9bec&path=/qc/legis/loi/ccq/20070910/tout.html  (vérifié le 31 octobre 2007) /  Civil Code of Québec, available at http://www.canlii.org/eliisa/highlight.do?language=en&searchTitle=Quebec&path=/qc/laws/sta/ccq/20070910/whole.html  (accessed on 31 October 2007);

"13.  En cas d'urgence, le consentement aux soins médicaux n'est pas nécessaire lorsque la vie de la personne est en danger ou son intégrité menacée et que son consentement ne peut être obtenu en temps utile.

Il est toutefois nécessaire lorsque les soins sont inusités ou devenus inutiles ou que leurs conséquences pourraient être intolérables pour la personne."

-----

13.  Consent to medical care is not required in case of emergency if the life of the person is in danger or his integrity is threatened and his consent cannot be obtained in due time.

It is required, however, where the care is unusual or has become useless or where its consequences could be intolerable for the person."

Code criminel, 1892; 55-56 Victoria (1892), chapitre 29,  et voir l'article 57 opérations chirurgicales; conversion pdf terminée le 29 août 2006 et 17 mars 2007;
PDF
-  Table des matières et Index;
-  1-113     (Table des matières et articles 1 à 302);
-  114-224 (articles 303 à 648);
-  225-326  (articles 649-983);
-  327 à 405 et 409-422  (Première annexe -- formules, pp. 327-379; deuxième annexe -- Actes abrogés, pp. 380-381;
       Appendice -- Actes et parties d'actes qui ne sont pas affectés par le présent acte, pp. 382-405; Index, pp.409-422);

CRANKSHAW, James, 1844-1921, The Criminal code of Canada and the Canada Evidence  Act, 1893, with an extra appendix containing the Extradition Act, the extradition convention with the United States, the Fugitive Offenders' Act, and the House of Commons debates on the code ; and an analytical index, Montreal : Whiteford & Theoret, 1894, lxxxviii, 976 p., and see section 57 Surgical operations at pp. 34-35; pdf et internet completed on 20 May 2007;
PDF
- Table of Contents; and Index;
- i-lxviii and 1-101 (Table of Contents; Preface, Arrangement of Titles; Table of Cases; Abbreviations, Corrections, Introduction; sections 1 to 101);
- 102-265 (sections 170-302);
- 266-426 (sections 303-465);
- 427-618 (sections 466-658);
- 619-777 (sections 659-777);
- 778-976 (The Canada Evidence Act 1893, House of Commons Debates on the Criminal Code; The Extradition Act; The Fugitive Offenders Act; General Index);


Criminal Code, R.S. 1985, c. C-46, available at http://laws.justice.gc.ca/en/  (accessed on 5 October 2007); also published in French/aussi publié en français: Code criminel, L.R. 1985, ch. C-46, disponible à http://laws.justice.gc.ca/fr/home (visité le 5 octobre 2007);

"Surgical operations
45. Every one is protected from criminal responsibility for performing a surgical operation on any person for the benefit of that person if
  (a) the operation is performed with reasonable care and skill; and
  (b) it is reasonable to perform the operation, having regard to the state of health of the person at the time the operation is performed and to all the circumstances of the case."
------
"Opérations chirurgicales
 45. Toute personne est à l’abri de responsabilité pénale lorsqu’elle pratique sur une autre, pour le bien de cette dernière, une opération chirurgicale si, à la fois :
 a) l’opération est pratiquée avec des soins et une habileté raisonnables;
 b) il est raisonnable de pratiquer l’opération, étant donné l’état de santé de la personne au moment de l’opération et toutes les autres circonstances de l’espèce."

Criminal Code -- Annotated codes used by practioners/ codes annotés utilisés par les practiciens

    in English (published every year) /en anglais:

GOLD, Allan D., The Practioner's Criminal Code, Markham, Ont.: LexisNexis Canada, 2008;

GREENSPAN, Edward L. and Marc Rosenberg, annotations by, Martin's Annual Criminal Code 2008, Aurora: Canada Law Book Inc.;
WATT, David and Michelle Fuerst, annotations by, The 2008 Annotated Tremeear's Criminal Code, Toronto: Carswell, A Thomson Company;
 
     in French/en français (publié chaque année):
COURNOYER, Guy et Gilles Ouimet, Code criminel annoté 2008, Cowansville: Éditions Yvon Blais, une société Thomson; note: législation bilingue/bilingual legislation;
DUBOIS, Alain et Philip Schneider, Code criminel et lois connexes annotés 2008, Brossard: Publications CCH Ltée;

The Criminal Code, 1892, 55-56 Victoria (1892), chapter 29, and see section 57 Surgical operations; pdf completed on 16-18 March 2007 and put on the Internet on 18 March 2007;
PDF
- Table of Contents and Index;
- 1-141 (sections 1 to 429);
- 142-290 (sections 430-906);
- 291-389 et 393-403 (sections 907-983;  Schedule 1 -- Forms, pp. 313-364; Schedule 2 -- Acts Repealed, pp. 365-366;
      Appendix, Acts and Parts of Acts which Are Not Affected by this Act, pp. 367- 389; Index, pp. 393-403;


The Criminal Code of Canada with Annotations and Notes by J.C. Martin, Q.C., Toronto: Cartwright & Sons, 1955, lxxxiii, 1206 p.; see article 45 at p. 119; Mr. J.C. Martin was counsel to the Royal Commission to Revise the Criminal Code, 1947-1952;

"This [s. 45] is the former s. 65.  It was s. 57 in the Code of 1892, and s. 67 in the E.D.C.  Obviously, it operates to protect physicians and surgeons, but in any case it will under the new Code, be complementary to the definition of criminal negligence.  See ss. 187 [Duty of persons undertaking acts dangerous to life], 188 [Duty of persons undertaking acts] and 191 [criminal negligence], especially the reference to R. v. BATEMAN (1925), 19 Cr. App. R. 8." (p. 119) 


DICKENS, Bernard M., and Rebecca J. Cook, "Development of Commonwealth  Abortion Laws", (July 1979) 28(3) The International and Comparative Law Quarterly  424-457, and see pp. 440-441;


FORTIN, Jacques, André Jodouin et A. Popovici, "Sanctions et réparations des atteintes au corps humain en droit québécois", (1975) 6 Revue de droit de l'Université de Sherbrooke 180;

     "Le Code criminel met, à certaines conditions à couvert de responsabilité criminelle la personne qui pratique sur une autre une opération chirurgicale.  Le fait justificatif n'existe aux termes de l'article [45] que si l'opéraion est faite por le 'bien' du patient.  Dans l'état actuel du droit, on ne peut définir avec certitude la véritable portée de cet article.  En effet, énonce-t-il une politique générale voulant que l'opération effectuée pour le bien du patient soit légale sans égard au consentement de celui-ci?  Ou signifie-t-il plutôt qu' en plus du consentement explicite ou implicite du patient l'opération doive être faite pour son bien?

    La seconde interprétation semble plus conforme à l'économie générale du Code criminel et du Common Law puisque toute atteinte à la personne sans le consentement de cette dernière constitue des voies de fait à moins que les circonstances ne donnent ouverture à un fait justificatif.  Par ailleurs, il est certain, selon une jurisprudence récente, que le législateur a mis l'exception médicale prévue à l'article 45 au rang des faits justificatifs même si elle n'a d'effet qu'à l'égard de la responsabilité criminelle126.  Il faut donc conclure que la justification  médicale est assortie d'une double condition: un consentement implicite ou  explicite de la part  du patient et le bien de celui-ci.  Il faut cependant préciser que le législateur n'a pas cru nécessaire de définir ce qu'il entend par ce bien du patient.

    Cette imprécision soulève la question de savoir si le 'bien' du patient relève d'un jugement médical ou d'un jugement moral.  Les tribunaux canadiens n'ont pas encore eu l'occasion de trancher cette question, dont la pertinence ne ferait pas de doute en matière de chirurgie esthétique, de transsexualisme ou de stérilisation volontaire  Le fait que ces pratiques soient depuis quelques temps entrées dans les moeurs explique sans doute l'absence de jurisprudence.  On peut donc penser que les tribunaux n'interviendraient que dans des cas d'une extrême gravité.  Il reste que la loi criminelle tient une épée de Damoclès suspendue au-dessus d'une opération.
------
126. R. v. Morgentaler, (1974) C.A. 247" (p. 180)   

FORTIN, Jacques et Louise Viau, Traité de droit pénal général,  Montréal: Éditions Thémis, 1982, xi, 457 p., voir la "Justification thérapeutique" aux pp. 281 à 283 et "Consentement et traitement médical", aux pp. 303-305; contribution importante;


KOURI, R.P. (Robert P.), "Réflexions sur les interventions chirurgicales et la défense de l'article 45 du Code criminel", (1981-82) 12 Revue de droit de l'Université de Sherbrooke 499-510;

"À vrai dire, les difficultés d'interprétation de l'article 45 se limitent à deux questions diistinctes; la première ayant trait à la nature du bienfait exigé pour la personne opérée, et la deuxième touchant la pertinence de cette défense lorsqu'il y a un consentement libre et éclairé fourni par le patient à l'acte incriminé. [...]

La notion nébuleuse de 'bien' [...]

Cette expression, employée sans qualificatif à l'article 45 doit plutôt être entendue dans son sens naturel et conforme à la réalité contemporaine.  À une époque où la chirurgie esthétique, la stérilisation purement contraceptive et la circoncision à des fins religieuses sont monnaie courante, doit-on toujours invoquer la fiction d'un bienfait psychologique (et donc d'un avantage thérapeutique) pour pouvoir bénéficier de la protection de l'article 45?  [...]

Le problème du consentement  [...]

D'après le contexte, nous sommes enclins à dire que le juge Dickson [dans l'arrêt Morgentaler, Cour suprême du Canada] ne cherche qu`à démontrer que son refus d'admettre l'application de l'article 45 en matière d'avortement, n'affecte aucunement sa pertinence quant aux autres genres d'opérations. [...]

[...] nous déduisons que l'article 45 vise à la fois les interventions chirurgicales où le patient est consentant et celles où il est incapable de donner son autorisation." (pp 501, 505-507 et 508; notes omises)



IRELAND, Law Reform Commission, Report on non-fatal offences against the person, Dublin: The Law Reform Commission, 1994, xii, 346 p.;

"6.22

Section 282 of the Queensland Code provides as follows:

“Surgical operations. A person is not criminally responsible for performing in good faith and with reasonable care and skill a surgical operation upon any person for his benefit, or upon an unborn child for the preservation of the mother's life, if the performance of the operation is reasonable, having regard to the patient's state at the time and to all the circumstances of the case.”
6.23 Clearly, such circumstances would include the presence or absence of the patient's consent." (p. 189)


KOURI, Robert P. et Suzanne Philips-Nootens, L'intégrité de la personne et le consentement aux soins, 2e éd., Cowansville (Québec): Éditions Yvon Blais, 2005, xxxv, 738 p., ISBN: 2894518986, et voir l'urgence aux pp. 351-356 et 383-384; voir aussi la table des matières à http://www.editionsyvonblais.com/Produits/753.asp (vérifié le 26 octobre 2007); copie à la Bibliothèque de la Cour suprême du Canada;

"L'autorisation légale d'agir sans consentement en cas d'urgence tombe lorsque les soins sont considérés comme 'inusités', 'inutiles' ou 'intolérables pour la personne', selon l'alinéa 2 de l'article 13 C.c.Q. [voir Code civil du Québec, supra].  Nous avons vu que le but de ces cas d'urgence est d'éviter l'audace scientifique, l'acharnement thérapeutique et l'outrage aux sentiments et aux croyances de la personne concernée." (p. 382; notes omises)


LAW REFORM COMMISSION OF CANADA, Medical Treatment and Criminal Law, Ottawa: Law Reform Commission of Canada, 1980, reprinted 1984, [vi], 136 p., (series; Working Paper; 26), ISBN: 0662506707; available at my Digital Library http://www.lareau-law.ca/DigitalLibrary.html; important contribution to the subject; pdf conversion finished on 27 October 2006; information on the French version/informations sur la version française, COMMISSION DE RÉFORME DU DROIT DU CANADA,  Le traitement médical et le droit criminel, Ottawa: Commission de réforme du droit du Canada, 1980, réimpression 1984, [vii], 152 p., (Collection; Document de travail; 26); ISBN: 0662506707;


___________Recodifying Criminal Law (Revised and Enlarged Edition of Report 30), Ottawa:  Law Reform Commission of Canada, 1987, [16], 213 p., see Clause 7(3)(a) Exceptions -- Medical Treatment, at pp. 62-63, (series; Report; 31), ISBN: 0662547578; available at my Digital Library http://www.lareau-law.ca/DigitalLibrary.html; information on the French version/informations sur la version française: COMMISSION DE RÉFORME DU DROIT DU CANADA, Pour une nouvelle codification du droit pénal (Édition révisée et augmentée du rapport no 30), Ottawa: Commission de réforme du droit du Canada, 1987, [16], 233 p., et voir le paragraphe 7(3) Exception -- Traitement médical, à la p. 71 (Collection; rapport; 31), ISBN: 0662547578;

"7(3) Exceptions
(a) Medical Treatment.  Clauses 7(2)(a) [assault by purposely harming] and 7(2)(b) [assault by recklessly harming] do not apply to the administration of treatment with the patient's informed consent for therapeutic purposes, or for the purpose of medical research, involving risk of harm  not disproportionate to the expected benefits." (p. 62)

-------

"7(3) Exceptions.
a) Traitement médical.  Les alinéas 7(2)a) [voies de fait commises en causant un préjudice corporel à dessein] et 7(2)b) [voies de fait commises en causant un préjudice corporel par témérité] ne s'appliquent pas à l'administration d'un traitement, avec le consentement du patient donné en connaissance de cause, dans un but thérapeutique ou pour des expériences médiacles comportant un risque de préjudice corporel non disproportionné avec les avantages attendus." (p. 71)
 

LEIGH, L.H., "Necessity and the Case of Dr. Morgentaler", [1978] Criminal Law Review 151-158;


Malette v. Shulman (1990), 72 Ontario Reports (2d) 417 (Ontario Court of Appeal); [1990] 67 DLR (4th) (Ont CA); 37 OAC 281 (CA);  disponible en français à http://www.uottawa.ca/associations/ctdj/cases/malette.htm (vérifié le 8 novembre 2007);


MAKSYMIUK, J.P., "The Abotion Law.  A Study of R. v. Morgentaler", (1974-75), 39 Saskatchewan Law Review 259-284, and see pp. 278-284;


MAYRAND, Albert, 1911-, L'inviolabilité de la personne humaine, Montréal, Wilson et Lafleur, 1975, 228 p. (Collection; Wainwright lectures, first series); copy at Ottawa University, FTX General, KEQ 228 .M3 1975;

"La théorie de l’intervention forcée justifiée par l’état de nécessité. – Les principes absolus ne restent pas longtemps incontestés; celui du respect absolu de la volonté du malade qui refuse le secours de son médecin n’a donc pas échappé à la contestation.

C’est précisément dans le principe de l’inviolabilité de la personne que l’on puise la justification d’une intervention imposée.  L’inviolabilité de la personne a pour but sa protection; or, les droits doivent être exercés dans le sens de leur finalité.  Ce serait fausser le droit à l’intégrité corporelle d’un malade que de lui permettre de l’invoquer pour faire échec à ce qui peut conserver sa vie et, par là même, son intégrité essentielle.

On ne se ferait pas scrupule de sauver malgré lui celui qui tenterait de se suicider.  Le Code criminel nous invite à utiliser ‘ la force raisonnablement nécessaire pour empêcher la perpétration d’une infraction ‘.  Mais si la tentative de suicide n’est plus une infraction, un agent de la paix pourrait sans doute intervenir pour faire échec au suicide.  Le refus d’un traitement ou d’une intervention peut équivaloir à un suicide.  Le suicide par abstention ou inertie ne mérite pas plus d’égards que le suicide par acte positif et direct.  Que l’on nourrisse malgré lui le gréviste de la faim sur le point de succomber ou que l’on vide l’estomac de celui qui veut mourir de poison qu’il vient d’absorber, ces atteintes à la personne sont commandées par l’état de nécessité.  Le respect de la vie, parce qu’il est conforme à l’intérêt de l’individu, prime le respect de sa volonté.  De même que la volonté d’une personne est impuissante à autoriser une atteinte dommageable, ainsi sa volonté doit être impuissante à empêcher une intervention salvatrice.  Il n’est pas sans intérêt d’observer que l’article 45 du Code criminel ne fait aucune allusion au consentement du patient quand il exonère de toute responsabilité criminelle le chirurgien lorsqu’ ‘ il est raisonnable de pratiquer l’opération étant données l’état de santé de la personne au moment de l’opération et toutes les circonstances de l’espèce ’.  Lorsque l’une des circonstances est le fait que l’opération seule peut sauver la vie du malade, on peut croire que le chirurgien est aussi exonéré de toute responsabilité civile.

Entre le droit du malade de refuser le secours du médecin et le droit du médecin de guérir son patient malgré lui, le choix n’est toujours facile.  Le médecin n’a pas le droit d’imposer à son patient une opération ou un traitement pour la seule raison qu’il est utile.  Mais la nécessité de l’intervention pour sauver le malade d’une mort prochaine nous paraît une raison suffisante pour faire échec à son refus.  Encore faudrait-il que cette nécessité soit indiscutable et que la survie du malade grâce à l’intervention soit un résultat suffisamment assuré.  Auquel des intérêts en conflit faut-il donner prépondérance?  La volonté du malade est une valeur qu’il faut respecter; on ne peut la mettre de côté que pour atteindre un avantage supérieur.  Or, l’on ne procure pas au malade un avantage supérieur en ne prolongeant sa vie que pour une courte période de temps ou si l’on doit le mutiler gravement et en faire un infirme misérable.

[…]

C’est donc dans la seule hypothèse où l’on évite à autrui une mort éminente tout en lui assurant une survie appréciable qu’on peut être justifié de la secourir malgré lui.  La contrainte momentanée est alors sans importance si on la compare au bienfait procuré.  Ainsi, c’est dans les rares cas où le malade a pratiquement tout à gagner et rien à perdre que le médecin peut sauver la vie de son patient contre son gré.  L’opposition du malade en pareille circonstance semble d’ailleurs inspirée par un égarement momentané de l’esprit ou par un désir morbide de la mort."  (pp. 48-49; notes omises)
  

Morgentaler Case, The, 1973-1975 / L'affaire Morgentaler 1973-1975

Morgentaler v. The Queen [1976] 1 S.C.R. 616, 1975 CanLII 8 (S.C.C.); available at http://www.canlii.org/en/ca/scc/doc/1975/1975canlii8/1975canlii8.html  (accessed on 26 October 2007);

La Reine c. Morgentaler, [1974] C.A. 129 (C.A. du Québec) et voir les pp.PDF 130-145; also at (1974) 17 C.C.C. (2d) 289;


Regina v. Morgentaler (No. 4), (1974) 14 C.C.C. (2d) 455 (Huguessen, A.C.J. Quebec Court of Queen's Bench (Crown Side));

    "[Translation]  On the question of the defence based on s. 45 of the Criminal Code, I understand that counsel have been unable to find any authority one way or the other, and I admit that I have also studied this question to the best of my ability, and have found no Canadian authority...

    Section 45 is an exception, a defence for those who performs a surgical operation under certain circumstances. ...I have not the least doubt that this defence would apply, for instance, to a charge of assault.

    Anyone who performs a surgical operation commits an assault on the person of the patient and it is only by virtue of s. 45 that he is not guilty.

    I am of the opinion that, before the amendments of 1969, the Omnibus Bill [Criminal Law Amendment Act, 1968-69, c. 38], this same defence applied to a charge of abortion.

    Section 251 of the Criminal Code [on abortion], the first three subsections, which were the law before 1969, do not mention a surgical operation, and do not constitute an exception to the general rule enunciated in s. 45.  ...

    ...it seems clear to me that the rule, the general rule, is contained in s. 45 and s. 251 does not include a specific exception for the case of a surgical operation. ...

     Section 45 is found in Part I of the Criminal Code, which contains the general provisions; and these provisions ought normally to apply to all the rest of the Criminal Code, in the absence of a specific exception in another section.  I think s. 45 would be a possible defence, for instance, to a charge of assault under s. 244 and hence would be as available as a defence in a prosecution under s. 251 [], unless it was specifically excluded by the text.

    By way of analogy, s. 212 says:
212.  Culpable homicide is murder.
(a) where the person who causes the death of a human being
(i) means to cause his death ...

So there you have a very clear legislative provision; it no less clear than s. 251.

    If you intend to cause the death of a human being, and you actually cause it, this is murder.  But it has always been conceded that s. 34 which is found in the same general part of the Criminal Code, respecting legitimate self-defence, can be applied to a charge of murder even if the person, indeed, intended to cause the death of his victim.  He can claim legitimate self-defence under s. 34, and I am of the opinion that exactly the same principles apply to the defence of s. 45 with respect to s. 251.

    Mr. Robichaud says that s. 45 is not restricted to a physician; I entirely agree. ...

    I believe that it was not today but during a previous argument that someone mentioned an emergency tracheotomy, performed by anyone, in a restaurant with a table knife.  the defence of s. 45 would be applicable and it is not limited to a physician....

    Next, Mr. Robichaud asks me if the defence of s. 45 is available, why did Parliament include the defence one finds in the second subsection of s. 221?

    To this my first reply, as I have already had occasion to say, is that it is asking too much that a Parliament should always be consistent. ..." (pp. 456-459)

Regina v. Morgentaler (No. 5), (1974) 14 C.C.C. (2d) 459 (Huguessen, A.C.J. Quebec Court of Queen's Bench (Crown Side));

    "[Translation; Charge to the jury]

    Added to the defence of necessity, but with a wider and more detailed import, is the defence based on s. 45 of the Criminal Code. ...

    You will notice that this section includes four element.  First, the act in question must be a surgical operation in the ordinary meaning of the term.  Secondly, the act must be undertaken for the benefit of the patient.  Thirdly, the operation must be performed with reasonable care and skill.  Fourtly, considering the state of health of the patient and all other relevant circumstances, it must be reasonable to perform the operation. ...

    ...to put the subsection in common language, a qualified physician, in a hospital which meets certain conditions established by the law, is permitted to perform an abortion if he receives in advance the approval of the majority of threee other physicians of the same hospital, approval in the form of a certificate to the effect that continuation of the pregnancy of the patient would or would be likely to endanger the life or health of the latter.

    Therefore, it is in this context where abortion on demand is not permitted but where, by contrast, in certain well-defined circumstances therapeutic abortion may be performed, that you must judge if it was medically reasonable to abort [Miss P] on August 15, 1973.

    In other words, in assessing the defence of s. 45, the law obliges you to consider all the circumstances of the case, but the law itself is one of the circumstances because it offers medical solutions other than that of abortion prohibited by s. 251(1).

    It is on this point that the defence of s. 45 is close to the defence of necessity which I just explained to you.  It is not the same defence.  The law allows what is medically reasonable in all the circumstances of the case, but in asking if the act performed  was reasonable one must ask if it was necessary to transgress a legislative prohibition or whether it might not have been possible to achieve the same purpose while remaining within the limits of the solutions that the law itself provides.

    I give you an example: to perform an operation on the person of another without the consent of the latter would be an assault prohibited by s. 245 [re. & sub. 1972, c. 13, s. 21] of the Criminal Code.  I am not speaking now of abortion but of any operation.  To perform it without the consent of the person concerned would be an assault, but the physician who, in an emergency, performs an operation on the victim of an automobile accident and who, by reason of his state of unconsciousness following the accident has been unable to obtain his consent, is protected if he meets the requirements of s. 45 and especially, since we are speaking now of this fourth element, if the operation which he has performed was medically reasonable in all the circumstances."   

MURRAY, Michael, The Criminal Code - A General Review, [presented to the Attorney-General of Western Australia], Wembley, Western Australia : Government Printer, 1983, 2 volumes (xvi, 653 p.), and see in vol. 1, "SECTION 259" at PDF pp. 163-165; about section 259 of the Queensland Criminal Code Act, 1899, see, supra, AUSTRALIA, Queensland;

NEW ZEALAND, Crimes Act 1961, avaiable at  http://rangi.knowledge-basket.co.nz/gpacts/ (accessed on 17 October 2005); also available at http://www.legislation.govt.nz/libraries/contents/om_isapi.dll?clientID=1263869900&infobase=pal_statutes.nfo&jump=a1961-043&softpage=DOC (accessed on 25 October 2007);

"Surgical operations
61.  Every one is protected from criminal responsibility for performing with reasonable care and skill any surgical operation upon any person for his benefit, if the performance of the operation was reasonable, having regard to the patient's state at the time and to all the circumstances of the case.

61A Further provisions relating to surgical operations
(1)  Every one is protected from criminal responsibility for performing with reasonable care and skill any surgical operation upon any person if the operation is performed with the consent of that person, or of any person lawfully entitled to consent on his behalf to the operation, and for a lawful purpose.
(2)   Without limiting the term “lawful purpose” in subsection (1) of this section, a surgical operation that is performed for the purpose of rendering the patient sterile is performed for a lawful purpose."

___________Crimes Bill 1989, May 1989;

"45.  Necessary treatment without patient's consent --
(1) Everty person is protected fromn criminal responsibility for administering with reasonable care and skill any necessary therapeutic treatment to any person, without the consent of that person or of any other person entitled to give consent on the patient's behalf, if it would be unreasonable to delay treatment until such consent is obtained.

(2)  For the purposes of this section, 'therapeutic treatment' means medical treatment intended to benefit the patient's health; and includes any necessary ancillary medical procedures." (p. 22)
----------
"EXPLANATORY NOTE ...

Clause 45 is based on section 61 of the present Act.  It is specifically aimed at medical treatment given without consent.  Such treatment is justified if it is administered with reasonable care and skill and it would have been unreasonable to delay treatment until consent could be obtained." (pp. i and ix)


___________Crimes Consultative Committee, Crimes Bill 1989 -- Report of the Crimes Consultative Committee: Presented to the Minister of Justice, [Wellington], 1991, 123 p., ISBN: 0477076165, see at pp. 24-25,  on clause 45 "Necessary treatment without patient's consent" (Chairman: Mr. Justice Casey);

"Clause 45 -- Necessary treatment without patient's consent

It has not been clear to what extent section 61 of the Act (Surgical operations) applies to operations performed where the consent of the patient cannot be obtained.  No reference to consent is made in the provision itself.  Clause 45 attempts to deal expressly with those cases where consent is unobtainable at the time when medical treatment is being considered.
 
The Committee considers it appropriate to introduce such a provision and approves the approach taken in Clause 45.  However, we are concerned that subclause (2) of this clause should not allow too high a level of discretion to the person administering treatment as to what is therapeutic treatment 'intended to benefit the patient's health'.

We recommend that the phrase 'having regard to all the circumstances of the case' should be added at the end of subclause (1).  This is intended to indicate to the relevant persons that they should not take an unduly subjective approach when deciding whether to give treatment without a patient's consent." (pp. 24-25)


___________Royal Commission of Inquiry into Contraception, Sterilisation and Abortion in New Zealand, Contraception, Sterilisation and Abortion in New Zealand, Report of the Royal Commission of Inquiry, Wellington: Government Printer, 1977, 454 p.;

    "The purpose behind the enactment of section 61 [of the Crimes Act 1961] was discussed by the late Sir Francis Adams in Criminal Law and Practice in New Zealand, 2nd edition.  It need only be said here that, whatever the limits of section 61, it is doubtful whether it would apply to a voluntary sterilisation performed for considerations of social convenience only, rather than for 'therapeutic' reaosns.  It would still be open to a person performing a voluntary sterilisation operation for social reasons to raise the defence of consent on the part of the patient, even if he were unable to invoke section 61.  Although we consider that the defence of consent would be likely to succeed in such a case, it is here that the element of uncertainty creeps into the law.  For this reason, we think it advisable to explain why we believe this area of the law has given rise to a measure of uncertainty.

    The criminal law of New Zealand, as contained in the Crimes Act 1961 and other statutes, does not specifically provide for a defence of consent  to an act which otherwise would be criminal.  The defence of consent is preserved, however, by section 20(1) of the Crimes Act 1961 which provides that all rules and principles of the common law which render any circumstances a justification or excuse for any act or omission, or a defence to any charge, shall remain in force and apply in respect of a charge of any offence under the Crimes Act 1961 or any other enactment, except so far as they are altered by or are inconsistent with the Act or any other enactment.  The question now to be answered is whether the common law of England recognises a defence of consent to a charge of assault.  The view now prevailing in England is that consent does provide a defence to charges of assault, of a lesser grade at least." (pp. 120-121)


NOEL-McHALE, Wanda, "CRIMINAL LAW: DEFENCE: § 45 CRIMINAL CODE: CHARGE OF PERFORMING ILLEGAL ABORTION: WHETHER DEFENCE AVAILABLE WHERE CRIMINAL CODE PROCEDURE NOT FOLLOWED: ELEMENTS OF THE DEFENCE: CRIMINAL CODE § 45, 251: Morgentaler v. The Queen, 20 Can. Crim. Cas. 2d 449 (Sup. Ct. 1975)", (1976) 8 Ottawa Law Review 59-69;


ONTARIO, Health Care Consent Act, 1996, S.O. 1996, c. 2, Sch. A, and see sections 25-28 on emergency treatment, available at http://www.canlii.org/on/laws/sta/1996c.2sch.a/20070911/whole.html  (accessed on 8 November 2007);  information on the French version/informations sur la version française: Consentement aux soins de santé (Loi de 1996 sur le), L.O. 1996, c. 2, ann. A et voir les articles 25-28 sur le traitement d'urgence, disponible à http://www.canlii.org/on/legis/loi/1996c.2ann.a/20070911/tout.html (vérifié le 8 novembre 2007);


PAPUA NEW GUINEA, Criminal Code Act 1974, available at http://www.paclii.org/pg/legis/consol_act/cca1974115/  (accessed on 8 November 2007);

 "280. SURGICAL OPERATIONS.

A person is not criminally responsible for performing in good faith and with reasonable care and skill a surgical operation on–

(a) any person for his benefit; or
(b) an unborn child for the preservation of the mother’s life,

 if the performance of the operation is reasonable, having regard to the patient’s state at the time and to all the circumstances of the case."

RIVET, Michèle, "Le Dr. Morgentaler devant la Cour d'appel", (1974) 15 Cahiers de droit 889-896, et voir "L'article 45 du Code criminel constitue-t-il un moyen de défense permis à l'encontre d'une accusation d'avortement?" aux pp. 892-894;


ROBERTSON, J. Bruce, Adams on Criminal Law -- 2nd Student Edition, Wellington (New Zealand): Brookers, 1998, xcvii, 1034 p., ISBN: 0864722826; research note: excellent textbook on the criminal law of New Zealand;

"Surgical operations and the infliction of actual bodily harm

    Historically, the primary purpose of s. 61 [of the New Zealand's Crimes Act 1961]¸ was probably to affirm that a reasonable surgical operation intended for the patient's benefit is lawful even though it could be regarded as involving wounding or the infliction of bodily harm.  ...

    When enacted s. 61 overcame any problems which might result from a surgical operation as a form of bodily harm. ....
   
Patients incapable of consenting to surgical operations

     Section 61 may also be read so that it has another effect.  It can be taken to protect a person from criminal responsibility if he or she performs a 'surgical operation' to save a patient from death or serious bodily harm, in circumstances where it was not possible to obtain consent and where there was no reason to believe that the patient would refuse consent, if given the opportunity of doing so.  Hence if there were an emergency and a doctor performed a life-saving operation on an unconscious patient, the doctor could be taken to have a statutory defence to a charge of assault; even though consent had not been given to the patient or by any one who was entitled to consent on the patient's behalf: Morgentaler v. The Queen (1975) 53 DLR (3 ed) 161, 182 per Laskin CJC, 208 per Dickson J.  However s. 61 would not justifify the doctor in performing an operation which was inflicted only for the benefit of another person (for example, the removal of one of the patient's kidneys for transplantation) or one which was intended only to increase medical knowledge.

    Section 61 does not protect a doctor from civil liability, nor from criminal responsibility for emergency medical intervention which cannot be regarded as a 'surgical operation'.  In such cases it is necessary to rely on the common law defence explained by the House of Lords in Re F (Mental Patient Sterilisation) [1990] 2 AC 1 (On the application of common law defences, see s. 20.)

Patients who refuse consent

    Section 61 does not explicitly require the consent of the person on whom a 'surgical operation' is performed, even where that person is capable of giving or witholding consent.  Hence in the past there was a theoretical possibility that it could be interpreted so as to ensure that a doctor would not incur criminal liability for performing a life-saving operation on a patient, even though the patient had refused to consent to the operation.  However, such an interpretation would now be contrary to the New Zealand Bill of Rights Act 1990.  Subject to justified limitations (s. 5) that Act affirms (s. 2) that 'every one has the right to refuse to undergo any medical treatment' (s. 11).  'Medical treatment' would here be taken to include a surgical operation.  Section 6 New Zealand Bill of Rights Act 1990 provides that:

'Wherever an enactment can be given a meaning which is consistent with the rights and freedom contained in this Bill of Rights, that meaning shall be preferred to any other meaning.'

In view of s. 6, a Court would have to regard a patient's refusal of consent as a highly relevant circumstance of the case, when deciding whether the operation 'was reasonable having regard to the patient's state at the time and to all the circumstances of the case'.  Section 61 should not, therefore, be interpreted so as to prevent a doctor incurring criminal liability if he or she performed an operation on a patient for that patient's benefit, in the face of the patient's refusal of consent." (pp. 137-138)
   

SNEIDERMAN, Barney, 1938-, John C. Irvine, and Philip H. Osborne, Canadian Medical Law: An Introduction for Physicians, Nurses and other Health Care Professionals, 3rd ed.,Scarborough (Ontario): Carswell/Thomson, 2003, xxxiii, 766 p., ISBN: 0459240749;copy at the Library of the Supreme Court of Canada, KF3821 S64 2003;

"EMERGENCY TREATMENT

    There are circumstances in which a patient is unable to consent to treatment.  He may be rendered unconscious by an accident or by illness, as in the case of a heart attack.  He may be severely intoxicated or under the influence of an illicit drug.  It would, of course, be inappropriate to refuse therapeutic treatment on the ground that the patient could not consent.  The law has for a long time contained rules which provide a privilege to interfere with the interests of another on the ground of necessity.  Consequently, when a patient is unable to consent, the physician has the right to provide treatment which is urgent and necessary to preserve his life and health.  This legal privilege is referred to as the emergency doctrine.  A physician may consult with the members of the patient's family and may seek their guidance and approval.  This is a useful practice which can minimize the risks of dispute and controversy, but it is more of a courtesy extended to the family than a legal requirement." (p. 26)

SOMERVILLE, Margaret A., 1942-, Consent to Medical care: A Study Paper prepared for the Law Reform Commission of Canada, Ottawa: Law Reform Commission of Canada, 1980, viii, 186 p. (series; Protection of Life Series; Study Papers), ISBN: 0662104528; available at my Digital Library http://www.lareau-law.ca/DigitalLibrary.html; put on the Internet on 20 April 2007; information on the French version/informations sur la version française, SOMERVILLE, Margaret A., 1942-, Le consentement à l'acte médical : une étude effectuée pour la Commission de réforme du droit du  Canada, Ottawa: Commission de réforme du droit du Canada, 1980, viii, 214 p., (Collection; Série protection de la vie; Documents d'étude), ISBN: 066290270X;


___________ "Medical Interventions and the Criminal Law: Lawful or Excusable Wounding?", (1980) 26 McGill Law Journal 82-96, available at http://www.cirp.org/library/legal/somerville/ (accessed on 26 October 2007);

STARKMAN, Bernard, "A Defence to Criminal Responsibility for Performing Surgical Operations: Section 45 of the Criminal Code", (1981) 26 McGill Law Journal 1048-1055;


___________"A Defence to Criminal Responsibility for Performing Surgical Operations", in Andre de Vries and Amon Carmi, eds., The Dying Human, Ramat Gan (Israel) Turtledove Pub., 1979,x, 490 p., at pp. 161-168, ISBN: 965200006X and 096520000X; copy at the University of Ottawa, MRT General, HQ 1073 .D94 1979;

"Section 45 of the Criminal Code is ultimately derived from an article of the [Stephen's] Digest dealing with circumstances where consent cannot be obtained." (p. 166)


___________Preliminary Study on Law and the Control of Life, [Ottawa : Law Reform Commission of Canada], 1974, vii, 92 leaves, and see "Section 45 of the Criminal Code: A Defence to Criminal Responsibility for Performing Surgical Operations", at pp. 1-12; an unpublished paper prepared for the Law Reform Commission of Canada, Aug. 23, 1974; copy at the University of Ottawa, KE 8809.5 .S738 1974 and also K 235 .W67 v.60-063 1974a;

STEPHEN, James Fitzjames, Sir, 1829-1894, A Digest of the Criminal Law (Crimes and Punishments), 1st ed., London: Macmillan, 1877, xlvi, 411 p.; copy at the University of Ottawa, FTX General, ;


___________A Digest of the Criminal Law (Crimes and Punishments), 4th ed., London: Macmillan, 1887, xl, 441, and see articles 203-209 at pp. 147-150; pdf conversion completed on 17 August 2006;
PDF
- Table of Contents
- i-xl and 1-29        (Cover page; Table of cases; Table of statutes; List of Abbreviations; Contents; Preliminary; articles 1-34);
- 30-94     (articles 35-134);
- 95-164   (articles 135-222);
- 165-232  (articles 223-294);
- 233-295 (articles 295-354);
- 296-365  (articles 355-398); and
- 366-441 (Appendix of Notes, Index).

 
STUART, Don, 1943-, Canadian Criminal Law: A Treatise, Scarborough (Ontario) Carswell, A Thomson Company, 20010, liv, 733 p., and see "Surgery", at pp 507-512, ISBN: 0459261703 and 0459261118 (pbk.); important contribution;

TREMEEAR, W.J. (William J.), 1864-1926, The Criminal Code and the Law of Criminal Evidence in Canada being an annotation of the Criminal Code of Canada, and of the Canada Evidence Act, 1893, as amended to 1902 inclusive, with special reference to the law of evidence and the procedure in criminal courts, including the practice before justices and on certiorari and habeas corpus, 1st ed., Toronto: Canada Law Book, 1902, xxxix, 934 p., and see section 57 Surgical operations at pp. 42-43; pdf and internet completed on 12 April 2007;
PDF
- Table of Contents and Index;
- i-xxxix and 1-116;
- 117-314;
- 315-523;
- 524-734;
- 735-934;

UNITED KINGDOM, CRIMINAL CODE BILL COMMISSION, Report of the Royal Commission Appointed to Consider the Law Relating to Indictable Offences: With an Appendix Containing a Draft Code Embodying the Suggestions of the Commissioners, London: HMSO, 1879, 209 p., and see section 67 Surgical operations (series; C.(Command); 2345), (President: C.B. Blackburn); also published  in British Parliamentary Papers, (1878-79), vol. 20, pp. 169- 378; pdf and Internet completed on 25 July 2007;
PDF
-  Report: pp. 1-48;
- Appendix -- Draft Code -- Table of Contents: pp. 49-62;
- Appendix -- Draft Code: pp. 49-209;


"SECTION 67.
 SURGICAL OPERATIONS
Every one is protected from criminal responsibility for performing with reasonable care and skill any surgical operation upon any person for his benefit : Provided that performing the operation was reasonable, having regard to the patient's state at the time, and to all the circumstances of the case." (p. 75; emphasis added)

-------------

"There is a difference in the language used in the sections of this Part which probably requires explanation.  Sometimes  it is said  that the person doing an act  is 'justified'  in so doing under particular circumstances.  The effect of an enactment using that word would be not only to relieve him from punishment, but also to afford him a statutable defence against a  civil action for what he had done.  Sometimes it is said that the person doing an act 'is protected from criminal responsibility' under particular circumstances.  The effect of an enactment using this language is to relieve him from punishment, but to leave his liability to an action  for damages  to be determined on other grounds, the enactment neither giving a defence to such an action where it does exist, nor taking it away where it does.  This difference is rendered necessary by the proposed abolition of the distinction between felony and misdemeanour." (p. 11)


___________ House of Commons, Bill 178, Criminal Code (Indictable Offences), 1878,  xviii, 218 p., and see section 124 Surgical operations; British Parliamentary Papers,  (1878), vol. 2, pp. 5-245; notes:  Bill drafted by Sir James Fitzjames Stephen; first reading in the House of Commons on 14 May 1878 (introduced by the Attorney General Sir John Holker);  it was that Bill that the Criminal Code Bill Commission was created to study; pdf completed 21 August 2006;
PDF
- i-xviii and 1-40  (Table of Contents; clauses 1-97);
- 41-101  (clauses 41-251);
- 102-166  (clauses 252-385); and
- 167-218  (clauses 386-425 at pp. 167-188;  Schedule I, Forms, at pp. 189-218; and Schedule II, "Acts and Parts of Acts Repealed", at pp. 189-218);

"Section 124.
Surgical Operations
No one commits an offence by inflicting on another any bodily injury in the nature of a surgical operation performed either by the patient's own consent, or if he is incapable of consenting, then by the consent of any person who has a lawful right to consent thereto, or if no such person's consent can be had, then if it is inflicted in good faith for the benefit of the patient, provided that this section shall be subject to the provisions herein-after contained as to culpable negligence, and to the provision of section 159 [maiming oneself or another by consent]."