The Divisional Court has held that decisions of hospital
committees can be subject to judicial review by the courts. If
committee decisions are not reasonable, or if the process they
follow is not procedurally fair, the courts can intervene.
The applicants in Asa et al. v. University Health
Network1 were researchers and authors in the field
of endocrine oncology. They had been engaged in clinical practice
and medical research at the respondent hospital (the
"Hospital") for many years. Their research was
widely-published. The Hospital had a research policy which defined
"research misconduct" as including falsification,
fabrication and material non-compliance with accepted standards and
regulations. The policy also set out a 2-step process for
addressing allegations of research misconduct: 1) an inquiry is
launched to determine if there are "reasonable grounds to
proceed to an investigation"; and 2) if there are sufficient
grounds to proceed, a formal investigation committee is formed.
According to the policy, decisions of the investigation committee
could be appealed to the CEO of the hospital.
The Hospital received a complaint involving certain papers
written by the applicants. The Hospital determined that the
allegations had enough merit to launch a formal investigation. The
Hospital informed the applicant researchers that an investigation
committee of three scientists would be investigating the
allegations of research misconduct. In the course of the
investigation, the applicants had an opportunity to make oral and
written submissions, and to respond to the committee's draft
report. Although there was no formal oral hearing, the applicants
were represented by a lawyer throughout the investigation.
After a 22-month investigation, the committee released a final
report. It found, among other things, that the applicants had
committed research misconduct. They found that the applicants had
falsified data, fabricated data, and had not complied with accepted
standards. The committee decided that in light of the extent and
duration of the policy violations, the applicants' research
activities would be suspended.
The applicants appealed to the hospital's CEO. The CEO
upheld the committee's decision.
The applicants went to court. They filed an application for
One of the threshold issues was whether or not the decision was
even subject to review by the courts. The Hospital argued that the
courts had no oversight over this type of decision. The court
disagreed. It held that the decision was of a sufficient public
character to be reviewable by the courts. The standard the court
would apply in reviewing the decision was whether the decision was
reasonable. In other words, although the court would afford some
deference and discretion to the hospital, it has the power to
intervene if the decision was not reasonable. In addition, the
court held that the process followed by the court must be
procedurally fair and that the court can intervene if the process
is not fair.
In the result, the court found that part of the decision was
reasonable, but other parts were not. Although it was reasonable to
find that there had been material non-compliance with certain
reasearch standards, it was unreasonable to find that there
had been falsification and fabrication. The evidence before the
committee did not support that conclusion. The court quashed that
part of the decision, and sent the matter back to the Hospital
committee to reconsider what sanction would be appropriate in light
of the more limited findings.
With respect to the issue of procedural fairness, the court
found that the applicants were awarded the procedural fairness to
which they were entitled. A formal hearing was not required as the
applicants were given appropriate opportunities to respond.
This case is important for hospitals. It cautions that internal
committee decisions of hospitals can be reviewed by the courts. It
is critical to ensure that when committees are making decisions,
their processes are procedurally fair, and their decisions are
1 Asa et al. v. University Health Network, 2016 ONSC
Effective September 1, 2016, the Disposition of Surplus Real Property Regulation to the Ontario Education Act was amended with the intention to reduce barriers to the formation of health and community hubs in Ontario.
This appeal relates to two generic drug submissions for two different products: exemestane and infliximab. Both submissions cross-referenced the submission of another generic company that had received a Notice of Compliance.
Two recent decisions from the Supreme Court of Canada directly affect Quebec's farm businesses by confirming La Financière Agricole du Québec's discretion in the administration of the farm income stabilization program...
On October 6, 2016, the Ontario Legislature reintroduced the Patients First Act, 2016 as Bill 41. Bill 41 is very similar to its predecessor, Bill 210, which was introduced in June 2016, but makes some important changes to the previous bill.
Register for Access and our Free Biweekly Alert for
This service is completely free. Access 250,000 archived articles from 100+ countries and get a personalised email twice a week covering developments (and yes, our lawyers like to think you’ve read our Disclaimer).