POGG as a Basis for Federal Jurisdiction over Public Health Surveillance
Sina A. Muscati*
Introduction Public Health – An Overview In the a#ermath of Severe Acute Respirato- De!ning Public Health ry Syndrome (SARS) and with concern growing about avian $u, mad cow, and other emerging &e concept of “public health” has not been diseases, public health surveillance has become explicitly de%ned in any Canadian legislation a matter of importance to Canadians. Such sur- or case law. A 2003 report published by Health veillance is a key component of the %ght against Canada’s National Advisory Committee on these diseases; it involves the systematic collec- SARS and Public Health (the Naylor Report) tion, analysis, interpretation, and dissemination de%nes public health as “the science and art of of data about health-related events for use in promoting health, preventing disease, prolong- public health responses. Indeed, new technolo- ing life and improving quality of life through 1 gies enable “data mining” at an unprecedented the organized e'orts of society.” &e report scale, both in the amount and type of informa- emphasizes two elements: “the prevention of tion that can be collected, and in the extent to disease, and the health needs of the population 2 which that information can be used to identify as a whole.” &is description of public health public health concerns. All this has made the has also been adopted by the Canadian Public 3 concept of “anonymous” information less and Health Association. Similarly, the federal De- less realistic. partment of Health Act describes the Minister’s public health mandate as one of “the promotion Laws are needed to govern the collection, and preservation of the physical, mental and use, and disclosure of personal health infor- social well-being of the people of Canada . . . mation. &e question at issue is whether or not the protection of the people of Canada against the federal government has the jurisdiction to risks to health and the spreading of diseases . . . legislate in this area. &is article will argue that [and] the investigation and research into public it does. A#er %rst providing an overview of the health, including the monitoring of diseases.”4 history of public health regulation in Canada, the article will identify di'erent constitution- On this basis, public health is perhaps best al bases for federal jurisdiction. It will focus described as the practice of developing mea- in particular on the national concern branch sures to prevent illness and promote the gen- of the “Peace, Order, and Good Government” eral health of the entire population. &is is to (POGG) power to justify federal involvement in be contrasted with “health care,” which is more the %eld of public health surveillance. curative in approach and focuses on treating the particular ailments of an individual. Public health can cover a wide range of e'orts to keep Canadians healthy as well as e'orts to relieve pressure on health care systems. &ese include
Constitutional Forum constitutionnel !" such measures as immunization, infection con- local or private Nature in the Province.”9 &ere trol, emergency preparedness and response, dis- is evidence indicating that in 1867 health was ease detection, surveillance, laboratory testing, viewed primarily as a matter of private or local and regulations to support these and other pub- interest, with most people depending primarily lic health activities.5 Depending on the circum- on their families, neighbours, charities or reli- stances, these activities could fall within either gious institutions for care in times of illness.10 federal or provincial jurisdiction, or in some Few institutionalized health services were de- cases both. Jurisdiction, of course, is deter- livered by the state, and the administration of mined in accordance with the federal division public health was at a primitive stage. &is was of powers set out in the Constitution Act, 1867.6 clearly recognized by &e Royal Commission Under the Constitution, public health matters on Dominion-Provincial Relations in 1938: of a local nature, including city drinking water safety, school health checks, private workplace In 1867 the administration of public health was still in a very primitive stage, the assumption safety, and immunization fall within provincial being that health was a private matter and state jurisdiction. In turn, provinces frequently del- assistance to improve or protect the health of egate these powers to municipalities. the citizen was highly exceptional and toler- able only in emergencies such as epidemics, or Constitutional Support for a Federal Role for purposes of ensuring elementary sanitation Traditional provincial jurisdiction over in urban communities. Such public health ac- tivities as the state did undertake were almost health-related matters wholly a function of local and municipal gov- A key reason why public health has been so ernments. It is not strange, therefore, that the di)cult to de%ne, particularly from a consti- British North America Act does not expressly allocate jurisdiction in public health, except tutional standpoint, is that it did not exist as a that marine hospitals and quarantine (pre- concrete concept at the time of Confederation. sumably ship quarantine) were assigned to the &e attempt to %nd constitutional support for Dominion, while the province was given juris- federal jurisdiction over public health surveil- diction over other hospitals, asylums, charities lance is further complicated by the fact that and eleemosynary institutions.11 courts have traditionally assigned jurisdiction over many health-related matters to the prov- Over time, health matters have come to inces. One example is the Supreme Court deci- adopt an increasingly public role in Canada. sion in Schneider v. !e Queen, where the ap- Correspondingly, the courts have come to hold pellant argued that British Columbia’s Heroin that provinces possess jurisdiction to legis- Treatment Act 7 (which provided for compulso- late over such public health-related matters as ry treatment and detention of heroin users) was sanitation and prevention of the spread of com- ultra vires the provincial legislature. In dismiss- municable diseases.12 Provinces have exercised ing the appeal, Justice Dickson stated for the this jurisdiction to engage in such activities majority: “the view that the general jurisdiction as health surveillance, outbreak investigation, over health matters is provincial (allowing for quarantine, isolation and mandatory health a limited federal jurisdiction either ancillary to treatment.13 Each province has its own public the express heads of power in s. 91 or the emer- health legislation regulating these activities. gency power under peace, order and good gov- Recognition of federal jurisdiction over health ernment) has prevailed and is now not seriously 8 questioned.” Despite this traditional provincial jurisdic- tion over health-related matters, courts have &e basis for provincial jurisdiction over also recognized a federal role in those aspects health matters is tied largely to the power of the of public health that are national in scope. &e provinces pursuant to the Constitution Act, 1867 Supreme Court has on di'erent occasions held to legislate in relation to “&e Establishment, that the federal government can legislate on pub- Maintenance and Management of Hospitals,” lic health matters in its own right, even in %elds as well as to “Generally all Matters of a merely
!( Volume 16, Number 1, 2007 in which provinces have already legislated. In POGG – National Concern Schneider, for example, Justice Laskin referred to a legitimate %eld of public health regulation Concern to the Nation under the POGG power, “directed to protection of the national welfare.”14 &e national concern branch of the POGG power was analyzed by the Supreme Court in R. Also in Schneider, Justice Estey argued in v. Crown Zellerbach Canada Ltd. In that case, favour of federal legislation in relation to health the respondent argued that section 4(1) of the problems having a national rather than local Ocean Dumping Control Act,21 which applied to dimension.15 He pointed out that health “is an the dumping of waste in waters within a prov- amorphous topic which can be addressed by ince, was ultra vires Parliament. In allowing valid federal or provincial legislation, depend- the appeal, the Court held that section 4(1) is ing on the circumstances of each case and on constitutionally valid as enacted in relation to a the nature or scope of the health problem in matter falling within the national concern doc- question.”16 Justice LaForest in RJR-MacDonald trine of the POGG power. Inc. v. Canada (Attorney General) later added that the “amorphous” nature of health as a con- &e Court went on to elaborate that the stitutional matter means “that Parliament and national concern branch itself has two sub-ele- the provincial legislatures may both validly leg- ments. &e %rst of these is that the power ap- islate in this area.”17 plies only to matters that are of concern to the nation, in other words, to matters that have at- Hence, even if the provinces have, to date, tained such signi%cant national dimensions as been the primary actors in such %elds as public to warrant the granting of federal jurisdiction.22 health surveillance and infectious disease con- As acknowledged in Crown Zellerbach, this as- trol, the federal government retains jurisdiction pect of the national concern doctrine was %rst to legislate in these %elds. However, provinces formulated by the Privy Council in Attorney- are still likely to view the creation of any pub- General of Ontario et al. v. Canada Temperance lic health system as a form of encroachment Federation et al.23 &at case examined the valid- on their traditional jurisdiction. It is essential, ity of the Canada Temperance Act,24 which pro- therefore, that such a system be grounded “on an vided an option for municipalities to opt-in to a incontrovertible constitutional foundation.”18 scheme for prohibition. &e Court held that the true test was whether the matter was one of na- &ere are a number of possible bases for tional concern and therefore supported by the federal authority over public health, including POGG power: federal constitutional authority over crimi- nal law, quarantine, spending, inter-provincial [T]he true test [in invoking POGG] must be trade, and peace, order and good government.19 found in the real subject-matter of the legisla- Of these, the POGG power is probably the most tion: if it is such that it goes beyond local or helpful. Over a series of cases, courts have in- provincial concern or interests and must from terpreted the POGG provision as having emer- its inherent nature be the concern of the Do- minion as a whole . . . then it will fall within gency, gap, and national concern branches.20 the competence of the Dominion Parliament &e emergency branch has been interpreted to as a matter a'ecting the peace, order and good apply to temporary legislative measures enact- government of Canada, though it may in an- ed to address an emergency situation. &e gap other aspect touch upon matters specially re- branch has been interpreted to apply to matters served to the Provincial Legislatures. War and not contemplated at the time of Confederation, pestilence, no doubt, are instances” [emphasis or inadvertently omitted from the Constitution added]. 25 Act, 1867. It is the third branch, national con- cern, that is likely to lend the most support to a As can be seen, it was speci%cally suggested federal power in public health surveillance. &is in Canada Temperance Federation that federal branch is described in more detail in the next legislation in response to such public health section. matters as an epidemic of “pestilence” would
Constitutional Forum constitutionnel !* fall within the purview of the POGG national bation period for many communicable diseases, concern doctrine.26 &e case went so far as to which increases the likelihood of the transmis- state that federal legislation based on national sion of infectious diseases via human migration. concern in respect of pestilence or disease need As the recent SARS crisis has illustrated, a local not be limited to an emergency measure, but disease a'ecting China’s Guangdong province could also extend to a preventative measure: may be very quickly carried by travellers from there to Hong Kong, and then to Vietnam, Sin- To legislate for prevention appears to be on the gapore and on to Canada.31 same basis as legislation for cure. A pestilence has been given as an example of a subject so af- &e Naylor Report also points out that cer- fecting, or which might so a"ect, the whole Do- tain emerging infectious diseases are a new minion that it would justify legislation by the phenomenon of the late twentieth and twenty- Parliament of Canada as a matter concerning %rst centuries. Over thirty previously unknown the order and good government of the Domin- ion. It would seem to follow that if the Parlia- viral and bacterial diseases have emerged in ment could legislate when there was an actual recent decades including Ebola virus, Legion- epidemic it could do so to prevent one occurring naire’s disease, HIV/AIDS, hepatitis C, variant and also to prevent it happening again” [em- Creutzfeldt-Jakob disease, avian $u, and West phasis added].27 Nile virus.32 &ese are diseases of international signi%cance. &ere are also other new infectious Canada Temperance Federation was also disease trends threatening Canadians. Environ- cited by the Supreme Court in Schneider to sup- mental changes such as global warming, defor- port its assertion that “federal legislation in re- estation, and water pollution have increased the lation to ‘health’ can be supported where the di- incidence of Lyme disease, for example.33 &e mension of the problem is national rather than new health risks posed by disease re-emergence, 28 local in nature.” environmental change, and such factors as glo- balization and bioterrorism, have arguably al- Increasing national dimension of public tered the scope and response time expected of health any health surveillance program.34 According to Crown Zellerbach, matters Various parliamentary and government falling within the national concern branch may bodies have begun to acknowledge the impor- be new, but they may also be “matters which, tance of an increased federal role in some areas although originally matters of a local or private of public health. Between 1999 and 2001, for nature in a province, have since, in the absence example, the Standing Senate Committee on of national emergency, become matters of na- Social A'airs, Science and Technology stud- tional concern.”29 On this basis, it can be argued ied the state of the Canadian health care sys- that in comparison to 1867, today’s society is tem and the federal role in that system. In its far more national or global than provincial, a subsequent multi-volume report (the Kirby Re- change that is signi%cant in the context of health port), the Committee declared that the federal risk, particularly the risk of infectious disease. government has an important role to play in &e increasing permeability of internation- the %elds of health protection, disease preven- al borders and the changing nature of trans- tion, and health and wellness promotion. It also portation methods have altered the potential recommended that some of the objectives of the impact of what were once considered merely federal government in this area should be to: local health problems. Globally, there were 715 (a) “strengthen our national capacity to iden- million international tourist arrivals registered 30 tify and reduce risk factors which can at international borders in 2002. &e volume, cause injury, illness and disease, and to speed, and reach of contemporary travel did reduce the economic burden of disease in not exist in 1867; today, Canadians live within Canada”; and twenty-four hours of virtually any location on Earth. &is time frame is shorter than the incu- (b) “encourage population health strategies by studying and discussing the health out-
!! Volume 16, Number 1, 2007 comes of the full range of determinants straddles the divide between provincial and of health, encompassing social, environ- federal jurisdiction, the case for federal juris- mental, cultural and economic factors.”35 diction is stronger.40 One prominent Canadian scholar of health law, Professor Dale Gibson, International and inter-provincial aspects of has suggested that the following two public public health health matters would fall “unquestionably” Another factor making certain areas of within the POGG (national concern) power: public health a matter of national concern is (a) “taking measures to prevent the spread Canada’s recent assumption of international of disease from one province to another”; reporting commitments, cannot be met which and unless the federal government has national ju- risdiction over personal health information. (b) “negotiation, implementation and en- &e World Health Organization (WHO) has forcement within Canada of interna- established International Health Regulations tional treaties concerning health-related 41 (IHRs)36 laying out expectations for member matters.” states regarding surveillance, reporting, and Gibson authored an in$uential 1976 article outbreak management to help stem the spread in which he described the national concern of infectious diseases. IHRs emphasize the col- branch of POGG,42 and argued that the “na- lection of national data regardless of internal tional dimensions”43 branch matters cover “be- boundaries and the establishment of a single yond the ability of the provincial legislatures contact point for data collection. Both factors to deal with.”44 He also argued that where the support the case for federal jurisdiction. matter at issue “requires the co-operative ac- In 1995, the World Health Assembly in- tion of two or more legislatures, the ‘national structed the WHO Secretariat to begin the dimension’ concerns only the risk of non-co- process of revising the IHRs. Following the operation, and justi%es only federal legisla- 45 SARS outbreak of 2003 and the 2004 epidemic tion addressed to that risk.” In fact, Gibson’s of avian $u, this revision process was acceler- approach to the national dimension branch ated. In May 2005, the World Health Assembly of POGG was adopted by the majority of the %nally approved a new set of IHRs to “prevent, Supreme Court in Crown Zellerbach, which re- protect against, control and provide a public mains the most comprehensive court review of health response to the international spread of the POGG power to date. disease.”37 &ese regulations provide member Single, Distinctive and Indivisible states with even broader obligations to build national capacity for routine preventive meas- &e second sub-element of the national ures as well as to detect and respond to public concern branch pursuant to Crown Zellerbach health emergencies of international concern.38 is that the matter at issue must have a “single- For example, the revised IHRs call for state ness, distinctiveness and indivisibility that parties to “utilize existing national structures clearly distinguishes it from matters of pro- and resources to meet their core capacity re- vincial concern.”46 According to the Court, quirements under these Regulations, includ- in making this determination it is relevant to ing with regard to…their surveillance, report- consider what the e'ect on extra-provincial ing, noti%cation, veri%cation, response, and interests of a provincial failure to deal e'ec- collaboration activities.”39 &e new regulations tively with the control or regulation of the “in- are to come into force 15 June 2007. tra-provincial aspects of the matter” would be; this has come to be known as the provincial In this context, it is important to note inability test.47 that it is the federal government which has re- sponsibility over treaty making. Moreover, the Impacts on other provinces Supreme Court has held that where an inter- national treaty stipulates that a policy matter To satisfy the provincial inability test, it
Constitutional Forum constitutionnel !+ must be shown that signi%cant deleterious ef- cia of provincial inability.55 Hence, the failure of fects would result from the inability of the prov- the federal and provincial governments to agree inces to address a matter. &is might occur in on an e'ective system of national surveillance areas where the impact of policy both within supports an argument for federal jurisdiction and outside a province is linked, where a prov- over this %eld. ince cannot e'ectively regulate a policy area on its own, or where the failure of one province to Every province and territory would bene%t regulate would a'ect the health of residents of from more e'ective public health policy. &is is another province.48 All that is required is that especially true for provinces with populations the “provincial failure to deal e'ectively with smaller than those of even medium-sized cities the intra-provincial aspects of the matter could around the world (e.g., Prince Edward Island, have an adverse e'ect on extra-provincial inter- Newfoundland, and Saskatchewan), which may ests” [emphasis added].49 &eoretically at least, not be able to generate large enough sample federal jurisdiction in this context could even sizes to produce meaningful research or iden- extend to a disease outbreak con%ned entirely tify signi%cant health trends on their own. &e to one province. relatively small population of Canada, and the preference this creates for a national approach &ere is a strong argument to be made that to disease surveillance, was highlighted in a infectious disease surveillance satis%es these 2002 Health Canada Report,56 which urged the requirements. As was noted in the Naylor Re- creation of a single national database of person- port, “if any province fails to contain an out- al health information on the basis that: break [of disease] e)ciently, the results for all of Canada are devastating on multiple levels.”50 (a) it would allow for sensitivity to patterns that may emerge from the analysis of a Even Ontario’s SARS Commission in its In- large number of cases, but which may not terim Report lamented the lack of federal-pro- be as evident when analysing a smaller vincial cooperation in public health protection. number of cases within a province or ter- &e report states outright that, “[o]ne of the big- ritory; gest problems during the Ontario SARS crisis was the inability of the federal and provincial (b) it is important in disease prevention to be governments to get their acts together.”51 &e able to “make comparisons between di'er- SARS Commission goes on to argue that “the ent regions of the country regarding ways evidence from SARS makes one thing crys- [a disease] is transmitted between people, the types or symptoms of the disease and tal clear: the greatest bene%t from new public the e'ectiveness of di'erent prevention or health arrangements can be a new federal pres- control programs”; ence in support of provincial delivery of public health.”52 It also warns that, “[i]f a greater spirit (c) it would be a “cost-e'ective means of en- of federal-provincial co-operation is not forth- suring that all provinces and territories, coming in respect of public health protection, and national agencies, have access to these Ontario and the rest of Canada will be at greater services”; risk from infectious disease and will look like 53 (d) di'erences exist across provinces in how fools in the international community.” they keep statistics, how they de%ne health terms, and how they count cases, making According to the Interim Report, “[p]roblems it di)cult to “aggregate provincial and ter- with the collection, analysis and sharing of data ritorial statistics into a national picture.”57 beset the e'ort to combat SARS.” &is “prevent- ed the timely transmission from the Ontario Other bene!ts of a federally-run surveillance Public Health Branch of vital SARS information system needed by Ottawa to ful%ll its national and inter- national obligations.”54 &is point is signi%cant In contrast to the e'orts of ten individual because federal-provincial or inter-provincial provinces, the larger scale of a national sur- collective action problems are important indi- veillance network may be more e)cient and cost-e'ective. It would facilitate the sharing of
!, Volume 16, Number 1, 2007 expertise and the accumulation of experience Distinction between infectious and chronic within a single network.58 &is in turn would disease breaking down make it more competitive in attracting the type of scientists needed for a world-class health &ere are important distinctions between protection system. It would also provide a focal infectious and chronic disease which explain point for Canada to manage health issues at its why jurisdiction should extend only to the for- borders and to interact with the global commu- mer in any federal public health system. For ex- nity.59 For example, the Naylor Report cites the ample, the threat from infectious disease is di- example of observers who feel that Canadian rect and immediate: “an outbreak of infectious o)cials failed to communicate adequately with disease, if not controlled, can bring a province o)cials in Hong Kong, Singapore and China and eventually the country to its knees within during the SARS crisis, thus missing the op- days or weeks, a threat not posed by chronic or 63 portunity to learn from foreign public health lifestyle diseases.” Moreover, “infectious dis- o)cials with relevant experience. &is problem ease prevention requires an immediate over- could have been more easily addressed had there all response because it moves rapidly on the been a national surveillance body to coordinate ground and spreads quickly from one munici- these e'orts. pality to another and from province to province and country to country, thus engaging an inter- &e increasing mobility of Canada’s popu- national interest.”64 lation also means that national record shar- ing is needed to ensure consistency of care. In Nevertheless, many of the traditional dis- this vein, the Naylor Report recommended a tinctions between infectious and chronic dis- national surveillance system and argued that, ease are beginning to blur. &is is due in part “surveillance … should not only detect emerg- to the changing nature of our understanding ing health risks, but include systems that allow of chronic disease. More and more chronic dis- public health o)cials to monitor and evaluate eases are now understood to be caused by infec- 65 progress in health protection and disease pre- tions, or at least to have infection co-factors. vention.”60 Furthermore, the report of the Com- Furthermore, the ability to %ght chronic disease mission on the Future of Health Care in Canada is closely linked to the ability of a population to recommended both public health programs that withstand the onslaught of infectious disease. deal with epidemics and a national immuniza- Consider the fact that the very people already tion strategy.61 su'ering from a chronic disease tend to be the ones at highest risk of contracting an infectious Infectious vs. Chronic Diseases disease. &is was aptly demonstrated during the SARS crisis, when most SARS victims were At this point it is worthwhile to consider people already su'ering from diabetes and oth- an important secondary question arising in the er chronic diseases.66 context of debate over the existence of federal ju- risdiction over health surveillance particularly Chronic disease a matter of increasing under the POGG “national concern” branch: is national concern [since 1867] federal jurisdiction restricted to infectious dis- ease, or can it also extend to chronic diseases In the past 100 years, chronic disease has such as cancer, diabetes, and heart disease? A taken on an increased signi%cance relative to in- look at the history of public health regulation fectious disease as a matter of national concern in Canada seems to suggest that the original to Canadians. In the early 1900s, infectious dis- mission of public health was to protect against ease was the leading cause of death in Canada; infectious disease. For example, one of the ear- today, it account for only 5 percent of all deaths liest pieces of public health legislation was an in Canada and many of those are of people (particularly the elderly) already a.icted with Act passed in 1833 in Upper Canada calling for 67 the establishment of boards of health “to guard chronic disease. Not only has chronic disease against the introduction of malignant, conta- become the leading cause of death and disabil- gious and infectious diseases in this province.”62 ity in Canada, it also accounts for the largest
Constitutional Forum constitutionnel !- proportion of the economic burden of illness.68 it posed an economic threat to Canada).72 &is As the picture of health changes dramatically, applies to powers exercised to address a na- governments should respond accordingly. tional emergency. &ere are cases holding that epidemics or pestilence would likely constitute A number of government reports have also such an emergency.73 However, the emergency recommended increased federal involvement power is temporary, applying only for the du- in public health regulation to counter chronic ration of the emergency.74 It cannot, therefore, disease. For example, the Kirby Report recom- constitute the basis of either preventative or mends the establishment of a National Chronic permanent federal legislation in the %eld of Disease Prevention Strategy that would incor- public health. It was for these reasons that the porate public education e'orts, mass media Naylor Report concluded that, “the emergency 69 programs, and so on. &e Naylor Report also branch of the POGG power could not serve as recommended a national public health strat- the constitutional basis of mandatory reporting egy addressing infectious disease, but also the for a national surveillance system.”75 “causes of chronic diseases and injuries.”70 In this regard, it is interesting to note that the U.S. Center for Disease Control and Prevention al- Quarantine ready has jurisdiction over chronic disease pre- vention and control.71 Another federal power worth analyzing in greater detail is the quarantine power pursuant to section 91(11) of the Constitution Act, 1867. POGG – Gap and Emergency &e scope of this power is unclear, for example, as to whether its application is only to ship’s Gap quarantine, to quarantine at entry into and exit from Canada, or to something broader.76 An ar- In addition to the national concern branch, gument can be made that the power should be the POGG power also has gap and emergency interpreted broadly today to re$ect the chang- branches that can also be analysed in the con- ing norms of domestic and international travel text of public health. &e gap branch applies to referred to earlier. matters not contemplated at Confederation, or to matters inadvertently omitted from the Con- &ere is also some suggestion that the federal stitution Act, 1867. Indeed, the success of any quarantine power can be derived not only from gap analysis will likely depend on how the pub- the section 91(11) quarantine provision of the lic health surveillance issue is framed. Constitution Act, 1867, but also from the POGG power itself. For example, in Labatt Breweries v. For example, an argument could be made Attorney General of Canada, the Supreme Court that concerns such as the disease trends referred commented that “Parliament can make laws in to earlier or the volume and extent of interna- relation to health for the peace, order and good tional travel today, as well as the corresponding government of Canada: quarantine laws come need for an intricate and wide-ranging health to mind as one example.”77 On this basis, per- information network, stem from phenomena haps the quarantine power in conjunction with not contemplated at Confederation. However, if POGG can assist in compelling the collection the matter were framed as one concerning the of information not only at Canada’s borders, collection, control and use of personal health but within Canada as well, pursuant to national information, then it would likely not be novel surveillance legislation and policy. enough to qualify under the gap branch. Emergency Conclusion &e last branch of POGG is the emergency Public health is an area of concurrent fed- power. &e emergency power has been referred eral and provincial jurisdiction. Federal juris- to in the past to grant Parliament the jurisdic- diction can be derived from di'erent parts of tion to regulate in$ation (on the grounds that
!/ Volume 16, Number 1, 2007 the Constitution, the most useful being the online:
Constitutional Forum constitutionnel !0 Canadians – !e Federal Role, Volume 2: Current 34. Trends and Future Challenges (Ottawa: 2002) 56 Population and Public Health Branch Surveil- (Chair: Michael Kirby) at 47 [Kirby Report, Vol- lance Coordination Committee, Case Studies: lume 2]. Examples of Health Canada’s Use of Personal 34 Naylor Report, supra note 1 at 92. Information for Health Surveillance and Research 35 Canada, Standing Senate Committee on Social Activities (Ottawa: Health Canada, 2002). A'airs, Science and Technology, !e Health of 57 Ibid. at 35-48. Canadians - the Federal Role, Volume 4: Issues 58 Federal/Provincial/Territorial Advisory Com- and Options (Ottawa: 2001) (Chair: Michael mittee on Health Infostructure, National Surveil- Kirby) at 23. lance Networks for Chronic Disease in Canada: 36 See generally International Health Regulations Charting a Path Forward (Ottawa: 2001) at 10. (1969), World Health Organization, online: 59 Canada, &e Standing Senate Committee on
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