Case 1995-047f

The petitioners were challenging a provision of a law that required the King to authorize every emergency medical training center in each province, where he would determine the “rules for organization and function and monitoring of the centers as well as the method for training and development”. They cited to article 128 of the Constitution, which disallowed the King from any authoritative power over ‘community matters’. The petitioner requested that the law be amended and the words ‘By the King’ removed from the law.  The government responded that emergency medical assistance is an assistance service, like civil protection, state police and fire services. And because all those are under Federal authority, emergency medical centers should also be subject to Federal authority and it would be inconsistent not to do so.

The Court rejected the petitioners’ argument and held that the authority of the King over the emergency medical training centers did not violate the Constitution. The Court noted how the legislation distinguishes emergency medical assistance from typical health care. Emergency medical assistance imposes specific obligations, some enforced with criminal sanctions, and can be delivered to a recipient without free choice. The Court also pointed to the requirement that emergency medical assistance be ‘uniform’ and guided by a consistent structure in order to define obligations and be most effective.

“L'aide médicale urgente, ainsi organisée, s'analyse comme une matière ayant un objet propre, qui comporte à la fois un dispositif technique dont l'efficacité exige qu'il soit uniforme, un ensemble d'obligations pénalement sanctionnées qui s'incorporent à la déontologie des professions médicales et paramédicales qui sont tenues d'apporter leur concours à l'application de la loi et un mécanisme qui garantit la rétribution des personnes et des établissements pour les prestations qu'ils sont obligés d'accomplir.” (B.5)

“Emergency medical assistance organized in this way, is analyzed as a matter with its own purpose, which includes both a technical provision whose effectiveness requires that it be uniform, a group of obligations that can be criminally sanctioned which incorporate the ethics of medical and paramedical professions which are required to bring their contribution to the application of the law, and a mechanism that guarantees the retribution of persons and institutions for the services that they are obliged to accomplish” (B.5)