Chaoulli v. Quebec (Attorney General), (2005) 335 N.R. 25 (SCC)

• Judge: McLachlin, C.J.C., Major, Bastarache, Binnie, LeBel, Deschamps and Fish, JJ.
• Court: Supreme Court of Canada
• Case Date: June 09, 2005
• Jurisdiction: Canada (Federal)
• Citations: (2005), 335 N.R. 25 (SCC);2005 SCC 35;254 DLR (4th) 577;130 CRR (2d) 99;[2005] SCJ No 33 (QL);53 CHRR 1;139 ACWS (3d) 1080;335 NR 25;AZ-50317608;[2005] 1 SCR 791;[2005] ACS no 40;[2005] CarswellQue 5795;JE 2005-1144

Chaoulli v. Que. (A.G.) (2005), 335 N.R. 25 (SCC)

MLB headnote and full text

[French language version follows English language version]

[La version française vient à la suite de la version anglaise]

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Temp. Cite: [2005] N.R. TBEd. JN.001

Jacques Chaoulli and George Zeliotis (appellants) v. Attorney General of Quebec and Attorney General of Canada (respondents) and Attorney General of Ontario, Attorney General of New Brunswick, Attorney General for Saskatchewan, Augustin Roy, Senator Michael Kirby, Senator Marjory Lebreton, Senator Catherine Callbeck, Senator Joan Cook, Senator Jane Cordy, Senator Joyce Fairbairn, Senator Wilbert Keon, Senator Lucie Pépin, Senator Brenda Robertson and Senator Douglas Roche, Canadian Medical Association and Canadian Orthopaedic Association, Canadian Labour Congress, Charter Committee on Poverty Issues and Canadian Health Coalition, Cambie Surgeries Corp., False Creek Surgical Centre Inc., Delbrook Surgical Centre Inc., Okanagan Plastic Surgery Centre Inc., Specialty MRI Clinics Inc., Fraser Valley MRI Ltd., Image One MRI Clinic Inc., McCallum Surgical Centre Ltd., 4111044 Canada Inc., South Fraser Surgical Centre Inc., Victoria Surgery Ltd., Kamloops Surgery Centre Ltd., Valley Cosmetic Surgery Associates Inc., Surgical Centres Inc., British Columbia Orthopaedic Association and British Columbia Anesthesiologists Society (Qué.) (intervenors)

(29272; 2005 SCC 35; 2005 CSC 35)

Indexed As: Chaoulli v. Quebec (Attorney General)

Supreme Court of Canada

McLachlin, C.J.C., Major, Bastarache, Binnie, LeBel, Deschamps and Fish, JJ.

June 9, 2005.

Summary:

Section 15 of the Health Insurance Act (HEIA) (Que.) and s. 11 of the Hospital Insurance Act (HOIA) (Que.) prohibited Quebecers from taking out insurance to obtain in the private sector services that were available under Quebec's public health care plan. Chaoulli and Zeliotis brought a motion for a declaration that s. 15 HEIA and s. 11 HOIA were unconstitutional and invalid. They argued that the legislative prohibition deprived them of access to private sector health care services and thereby avoid the waiting lists in the public system. They submitted that the delays resulting from waiting lists violated their rights to life and to personal security, inviolability and free­dom protected by s. 1 of Quebec's Charter of Human Rights and Freedoms (the Quebec Charter) and ss. 7, 12 and 15 of the Cana­dian Charter of Rights and Freedoms (the Canadian Charter). Chaoulli also argued that the prohibition was within the federal Parlia­ment's legislative jurisdiction respecting criminal law.

The Quebec Superior Court, in a decision reported [2000] R.J.Q. 786, dismissed the motion. Chaoulli and Zeliotis appealed.

The Quebec Court of Appeal, in a decision reported [2002] R.J.Q. 1205, dismissed the appeal. Chaoulli and Zeliotis appealed.

The Supreme Court of Canada, Binnie, LeBel and Fish, JJ., dissenting, allowed the appeal. The argument that the prohibition under s. 15 HEIA and s. 11 HOIA was within Parliament's criminal law jurisdiction could not succeed. Deschamps, J., (McLach­lin, C.J.C., Major and Bastarache, JJ., con­curring in the result) ruled that the prohib­ition violated s. 1 of the Quebec Charter and was not saved under s. 9.1. McLachlin, C.J.C., and Major, J. (Bastarache, J. concur­ring), ruled that the prohibition violated s. 7 of the Canadian Charter and could not be saved under s. 1.

Civil Rights - Topic 1391

Security of the person - Health care (incl. mental health) - General - [See first Civil Rights - Topic 7124 ].

Civil Rights - Topic 1391

Security of the person - Health care (incl. mental health) - General - Waiting lists were used as a tool to manage Quebec's public health care plan - Section 15 of the Health Insurance Act (HEIA) (Que.) and s. 11 of the Hospital Insurance Act (HOIA) (Que.) prohibited Quebecers from taking out insurance to obtain in the private sector services that were avail­able under the public health care plan, and thereby avoid the waiting lists - Chaoulli and Zeliotis invoked s. 7 of the Canadian Charter of Rights and Freedoms (the Canadian Char­ter) and challenged the above provisions - The Supreme Court of Canada, per Mc­Lachlin, C.J.C., Major and Bastarache, JJ., held that on the evidence adduced, Chaoul­li and Zeliotis established that in the face of delays in treatment that caused psycho­logical and physical suffering, the prohib­ition on private insurance jeopardized the right to life, liberty and security of the person of Canadians in an arbitrary man­ner, and was therefore not in accordance with the principles of fundamental justice -Also, the prohibition was not saved under s. 1 where neither the rational connection, minimal impairment and proportionality requirements of the R. v. Oakes test were met - In sum, the prohibition on obtaining private health insurance, while it might be constitutional in circumstances where health care services were reasonable as to both quality and timeliness, was not consti­tutional where the public system failed to deliver reasonable services - Life, liberty and security of the person had to prevail - See paragraphs 102 to 160.

Civil Rights - Topic 7003

Federal, provincial or territorial legislation - General - Interpretation of human rights legislation - Section 1 of the Quebec Char­ter of Human Rights and Freedoms pro­vided: "Every human being has a right to life, and to personal security, inviolability and freedom" - The Supreme Court of Canada, per Deschamps, J., stated: "Limit­ing the scope of s. 1 of the Quebec Charter to matters connected with the administra­tion of justice is not justified in light of the general scope of this quasi-constitutional instrument" - See paragraph 33.

Civil Rights - Topic 7004

Federal, provincial or territorial legislation - General - Application of legislation (incl. retroactivity) - The Supreme Court of Canada, per Deschamps, J., stated that in the case of a challenge to a Quebec statute, it was appropriate to look first to the rules that apply specifically in Quebec, namely the rules under the Quebec Charter of Human Rights and Freedoms, before turn­ing to the Canadian Charter of Rights and Freedoms, especially where the provisions of the two charters were susceptible of producing cumulative effects, but where the rules were not identical - See para­graphs 25 and 26.

Civil Rights - Topic 7124

Federal, provincial or territorial legislation - Particu­lar rights - Life, personal security, inviol­abil­ity and freedom - Section 15 of the Health Insurance Act (HEIA) (Que.) and s. 11 of the Hospital Insurance Act (HOIA) (Que.) prohibited Quebecers from taking out insurance to obtain in the pri­vate sector services that were available under Que­bec's public health care plan - The Supreme Court of Canada, per Des­champs, J. (McLachlin, C.J.C., Major and Bastara­che, JJ., concurring in the result) ruled that s. 15 HEIA and s. 11 HOIA violated the right to life and security guaranteed by s. 1 of Quebec's Charter of Human Rights and Freedoms where Que­becers were denied a solution that would permit them to avoid waiting lists which were used as a tool to manage the public plan - Also, the prohibition was not jus­tified under s. 9.1 of the Quebec Charter - Applying the same test as under s. 1 of the Canadian Charter of Rights and Freedoms (the Cana­dian Charter), Deschamps, J., held as follows: (1) preserving the public plan was a pressing and substantial pur­pose; (2) there was an "undeniable connec­tion" between the objective and the protec­tion measure; and (3) given the expert evidence at trial, the situation in other Canadian provinces and in certain OECD countries and the appropriate level of court defer­ence required where the government chose among a number of measures that could impair protected rights, the Attorney Gen­eral of Quebec failed to discharge his burden of proving that a total prohibition on private insurance met the minimal impairment test - See paragraphs 1 to 101.

Civil Rights - Topic 7124

Federal, provincial or territorial legislation - Particu­lar rights - Life, personal security, inviol­abil­ity and freedom - Waiting lists were used as a tool to manage Quebec's public health care plan - Section 15 of the Health Insur­ance Act (HEIA) (Que.) and s. 11 of the Hospital Insurance Act (HOIA) (Que.) prohibited Quebecers from taking out insurance to obtain in the private sector services that were available under the public health care plan, and thereby avoid the waiting lists - The Supreme Court of Canada, per Deschamps, J., held that limits on access to health care could infringe the right to personal inviolability guaranteed under s. 1 of Quebec's Charter of Human Rights - The prohibition could not be characterized as an infringement of econ­omic rights - See paragraph 34.

Civil Rights - Topic 7168

Federal, provincial or territorial legislation - Application - Exceptions - Legislative limits to rights and freedoms - [See first Civil Rights - Topic 7124 ].

Civil Rights - Topic 8344

Canadian Charter of Rights and Freedoms - Applications - Exceptions - Principles of fundamental justice - [See second Civil Rights - Topic 1391 ].

Civil Rights - Topic 8348

Canadian Charter of Rights and Freedoms - Applications - Exceptions - Reasonable limits prescribed by law (Charter, s. 1) - [See second Civil Rights - Topic 1391 ].

Courts - Topic 2022

Jurisdiction - Conditions precedent - Re­quirement of justiciable issue - Waiting lists were used as a tool to manage Que­bec's public health care plan - Section 15 of the Health Insurance Act (HEIA) (Que.) and s. 11 of the Hospital Insurance Act (HOIA) (Que.) prohibited Quebecers from taking out insurance to obtain in the pri­vate sector services that were available under Quebec's public health care plan, and thereby avoid the waiting lists - Chaoulli and Zeliotis invoked s. 7 of the Canadian Charter of Rights and Freedoms and s. 1 of Quebec's Charter of Human Rights and Freedoms and challenged the above provisions - The Attorneys General of Canada and Quebec argued that Chaoulli and Zeliotis' claims were inher­ently political and, therefore, were not properly justiciable by the courts - The Supreme Court of Canada, per Deschamps, Binnie, LeBel and Fish, JJ., disagreed - The courts had a duty to rise above politi­cal debate - They left it to the legislatures to develop social policy - But when such social policies infringed rights that were protected by the charters, the courts could not shy away from considering them - See paragraphs 85 to 98, 183 to 185.

Practice - Topic 207

Persons who can sue and be sued - Indi­viduals and corporations - Status or stand­ing - Class or representative actions - Re­specting validity of legislation - [See Que­bec Procedure - Topic 110 ].

Quebec Procedure - Topic 110

Capacity to sue - Individuals and corpor­ations - Public or constitutional matters - Standing - Waiting lists were used as a tool to manage Quebec's public health care plan - Section 15 of the Health Insurance Act (HEIA) (Que.) and s. 11 of the Hospi­tal Insurance Act (HOIA) (Que.) prohibited Quebecers from taking out insurance to ob­tain in the private sector services that were available under the public health care plan, and thereby avoid the waiting lists - Chaoulli and Zeliotis invoked s. 7 of the Canadian Charter of Rights and Freedoms and s. 1 of Quebec's Charter of Human Rights and Freedoms and challenged the above provisions - An issue arose as to whether Chaoulli and Zeliotis had standing - The Supreme Court of Canada, per Des­champs, Binnie, LeBel and Fish, JJ., ruled that Chaoulli and Zeliotis had standing where the issue was serious, the claimants were directly affected or had a genuine interest as citizens and where there were no other effective means available to them - See paragraphs 35, 36, 186 to 189.

Cases Noticed:

Eldridge et al. v. British Columbia (A­ttor­ney General) et al., [1997] 3 S.C.R. 624; 218 N.R. 161; 96 B.C.A.C. 81; 155 W.A­.C. 81, refd to. [para. 16].

YMHA Jewish Community Centre of Win­nipeg Inc. v. Brown and Labour Board (Man.), [1989] 1 S.C.R. 1532; 97 N.R. 161; 59 Man.R.(2d) 161, refd to. [para. 16].

Skapinker v. Law Society of Upper Canada, [1984] 1 S.C.R. 357; 53 N.R. 169; 3 O.A.C. 321, refd to. [para. 25].

Singh v. Minister of Employment and Immigration, [1985] 1 S.C.R. 177; 58 N.R. 1, consd. [para. 26].

Gosselin v. Quebec (Procureur général), [2002] 4 S.C.R. 429; 298 N.R. 1; 2002 SCC 84, refd to. [paras. 29, 196].

R. v. Collins, [1987] 1 S.C.R. 265; 74 N.R. 276, refd to. [para. 30].

Rio Hotel Ltd. v. Liquor Licensing Board (N.B.), New Brunswick (Attorney General) and Saskatchewan (Attorney General), [1987] 2 S.C.R. 59; 77 N.R. 104; 81 N.B.R.(2d) 328; 205 A.P.R. 328, refd to. [para. 30].

Operation Dismantle Inc. et al. v. Canada et al., [1985] 1 S.C.R. 441; 59 N.R. 1, refd to. [para. 35].

Borowski v. Canada (Minister of Justice) et al., [1981] 2 S.C.R. 575; 39 N.R. 331, refd to. [para. 35], consd. [para. 188].

Québec (Curateur public) v. Syndicat national des employés de l'Hôpital St-Ferdinand et autres, [1996] 3 S.C.R. 211; 202 N.R. 321, consd. [para. 41].

R. v. Morgentaler, [1988] 1 S.C.R. 30; 82 N.R. 1; 26 O.A.C. 1, consd. [paras. 43, 118, 167].

Rodriguez v. British Columbia (Attorney General) et al., [1993] 3 S.C.R. 519; 158 N.R. 1; 34 B.C.A.C. 1; 56 W.A.C. 1, refd to. [paras. 43, 205], consd. [para. 122].

New Brunswick (Minister of Health and Community Services) v. J.G. and D.V., [1999] 3 S.C.R. 46; 244 N.R. 276; 216 N.B.R.(2d) 25; 552 A.P.R. 25, refd to. [paras. 43, 116, 205].

Blencoe v. Human Rights Commission (B.C.), [2000] 2 S.C.R. 307; 260 N.R. 1; 141 B.C.A.C. 161; 231 W.A.C. 161; 2000 SCC 44, refd to. [paras. 43, 197].

Ford v. Québec (Attorney General) - see Chaussure Brown's Inc. et al. v. Québec (Procureur général).

Chaussure Brown's Inc. et al. v. Québec (Procureur général), [1988] 2 S.C.R. 712; 90 N.R. 84; 19 Q.A.C. 69, consd. [para. 47].

R. v. Oakes, [1986] 1 S.C.R. 103; 65 N.R. 87; 14 O.A.C. 335, refd to. [paras. 48, 155].

Egan and Nesbitt v. Canada, [1995] 2 S.C.R. 513; 182 N.R. 161; 124 D.L.R.(4th) 609, refd to. [para. 48].

Charles Bentley Nursing Home Inc. v. Ministre des Affaires sociales, [1978] C.S. 30 (Que.), refd to. [para. 51].

Southam Inc. v. Hunter, [1984] 2 S.C.R. 145; 55 N.R. 241; 55 A.R. 291, refd to. [para. 85].

Vriend et al. v. Alberta, [1998] 1 S.C.R. 493; 224 N.R. 1; 212 A.R. 237; 168 W.A.C. 237, refd to. [para. 85], consd. [para. 184].

Reference Re Secession of Quebec, [1998] 2 S.C.R. 217; 228 N.R. 203; 161 D.L.R.(4th) 385, refd to. [para. 85].

Irwin Toy Ltd. v. Québec (Procureur général), [1989] 1 S.C.R. 927; 94 N.R. 167; 24 Q.A.C. 2, refd to. [paras. 94, 269].

RJR-MacDonald Inc. et Imperial Tobacco Ltd. v. Canada (Procureur général), [1995] 3 S.C.R. 199; 187 N.R. 1, consd. [para. 95].

Reference Re Section 94(2) of the Motor Vehicle Act (B.C.), [1985] 2 S.C.R. 486; 63 N.R. 266, consd. [paras. 107, 198].

Amax Potash Ltd. et al. v. Saskatchewan, [1977] 2 S.C.R. 576; 11 N.R. 222, refd to. [para. 107].

R. v. Malmo-Levine (D.) et al., [2003] 3 S.C.R. 571; 314 N.R. 1; 191 B.C.A.C. 1; 314 W.A.C. 1; 2003 SCC 74, refd to. [paras. 109, 176].

Auton et al. v. British Columbia (Minister of Health) et al., [2004] 3 S.C.R. 657; 327 N.R. 1; 206 B.C.A.C. 1; 338 W.A.C. 1; 2004 SCC 78, consd. [para. 163].

Canadian Council of Churches v. Canada et al., [1992] 1 S.C.R. 236; 132 N.R. 241; 88 D.L.R.(4th) 193, refd to. [para. 188].

Reference Re Sections 193 and 195.1(1)(c) of the Criminal Code, [1990] 1 S.C.R. 1123; 109 N.R. 81; 68 Man.R.(2d) 1; 56 C.C.C.(3d) 65, refd to. [para. 197].

Child and Family Services of Winnipeg Central v. K.L.W. et al., [2000] 2 S.C.R. 519; 260 N.R. 203; 150 Man.R.(2d) 161; 230 W.A.C. 161; 2000 SCC 48, refd to. [para. 197].

Sheena B., Re, [1995] 1 S.C.R. 315; 176 N.R. 161; 78 O.A.C. 1, refd to. [para. 197].

R.B. v. Children's Aid Society of Metropolitan Toronto - see Sheena B., Re.

Lochner v. New York (1905), 198 U.S. 45, consd. [para. 201].

West Coast Hotel Co. v. Parrish (1937), 300 U.S. 379 (Sup. Ct.), refd to. [para. 201].

R. v. Videoflicks Ltd. et al., [1986] 2 S.C.R. 713; 71 N.R. 161; 19 O.A.C. 239, refd to. [para. 202].

Edwards Books and Art Ltd. v. R. - see R. v. Videoflicks Ltd. et al.

R. v. Edwards Books and Art Ltd. - see R. v. Videoflicks Ltd. et al.

Canadian Foundation for Children, Youth and the Law v. Canada (Attorney General), [2004] 1 S.C.R. 76; 315 N.R. 201; 183 O.A.C. 1; 2004 SCC 4, refd to. [para. 208].

Stein v. Tribunal administratif du Québec, [1999] R.J.Q. 2416 (S.C.), refd to. [para. 224].

Housen v. Nikolaisen et al., [2002] 2 S.C.R. 235; 286 N.R. 1; 219 Sask.R. 1; 272 W.A.C. 1; 2003 SCC 33, refd to. [para. 235].

Godbout v. Longueuil (Ville), [1995] R.J.Q. 2561 (C.A.), refd to. [para. 270].

Statutes Noticed:

Canadian Charter of Rights and Freedoms, 1982, sect. 7 [para. 27].

Charter of Human Rights and Freedoms, R.S.Q. 1977, c. C-12, sect. 1 [para. 27]; sect. 9.1 [para. 46].

Health Insurance Act, R.S.Q. 1977, c. A-29, sect. 15 [para. 3].

Hospital Insurance Act, R.S.Q. 1977, c. A-28, sect. 11 [para. 3].

Authors and Works Noticed:

Armstrong, Wendy, The Consumer Ex­peri­ence with Cataract Surgery and Pri­vate Clinics in Alberta: Canada's Canary in the Mine Shaft (2002), generally [para. 244].

Arpin Report - see Québec, La complé­men­tarité du secteur privé dans la pour­suite des objectifs fondamentaux du système public de santé au Québec: Constats et recommandations sur les pistes à explorer: Synthèse.

Bergman, Howard, Expertise déposée par Howard Bergman (1998), pp. 5 [para. 222]; 6 [para. 248]; 7 [paras. 248, 255]; 8 [para. 244].

Brunelle, Yvon, Aspects critiques d'un rationnement planifié (1993), p. 21 [para. 39].

Canada, Department of Finance, Federal Support for Health Care: The Facts (2004), generally [para. 173].

Canada, Final Report of the Commission on the Future of Health Care in Canada, Building on Values: The Future of Health Care in Canada (Romanow Report) (2002), pp. xx [para. 166]; xxiv [para. 254]; 8 [para. 254]; 14 [para. 251]; 43 [para. 252]; 60 [para. 16]; 60 ff. [para. 253]; 92 [para. 247]; 139 [paras. 217, 243]; 166 [para. 247].

Canada, Final Report of the Standing Senate Committee on Social Affairs, Science and Technology, The Health of Canadians - The Federal Role (Kirby Report) (2002), vol. 6 [para. 96].

Canada, Health Canada, Waiting Lists and Wait­ing Times for Health Care in Can­ada: More Management!! More Money? (1998), generally [paras. 96, 217]; p. 14 [para. 220].

Canada, Interim Report of the Standing Senate Committee on Social Affairs, Science and Technology, The Health of Canadians - The Federal Role (Kirby Report) (2001), vol. 1, pp. 101 [para. 251]; 105 [para. 247]; 111 [para. 221]; vol. 2, pp. 75, 137 [para. 247]; vol. 3, pp. 14 [para. 143]; 15 [paras. 144, 145]; 29 to 36 [para. 142]; 31 to 33 [para. 81]; 37 to 44 [para. 146]; 31, 32 [para. 227]; 38 [paras. 80, 146, 228]; 48 [para. 251]; 66 [paras. 147, 148]; 67 [para. 252]; 73 [para. 228]; 166 [para. 148]; vol. 4, pp. 7 [para. 247]; 23 [para. 252]; 28 [para. 251]; 31 [para. 253]; 41 [paras. 217, 221]; 42 [para. 243]; 67 [para. 170]; 107 [para. 247]; 137 [para. 173]; vol. 5, pp. 56, 57 [para. 223]; vol. 6, pp. 109, 110 [para. 217]; 301 [para. 249]; 321 [para. 230].

Canada, National Advisory Council on Aging, The NACA Position on the Privatization of Health Care (1997), p. 14 [para. 252].

Canada, Royal Commission on Health Services, Voluntary Medical Insurance and Prepayment (1965), generally [para. 171].

Canada, Statistics Canada, Health Analysis and Measurement Group, Access to Health Care Services in Canada in 2001, by Sanmartin, Claudia et al. (2002), pp. 17 [para. 115]; 20 [para. 117].

Canadian Health Services Research Foundation, Mythbusters: Myth: A parallel private system would reduce waiting times in the public system (2001), generally [para. 244].

Canadian Institute for Health Information, Public and Private Shares of Total Health Expenditure, by Use of Funds, Canada, 2001 (2001), http://secure:cihi.­ca/cihiweb/en/media_17­dec2003_fig8­_e.html, generally [para. 17].

Castonguay - Nepveu Report - see Québec, Report of the Commission of Inquiry on Health and Social Welfare.

Choudhry, Sujit, and Howse, Robert, Constitutional Theory and The Quebec Secession Reference (2000), 13 Can. J. L. & Jur. 143, pp. 160, 161 [para. 90].

Clair Commission Report - see Québec, Commission d'étude sur les services de santé et les services sociaux, Emerging Solutions: Report and Recommendations (Clair Commission Report).

Davidov, Guy, The Paradox of Judicial Deference (2000-2001), 12 N.J.C.L. 133, p. 143 [para. 87].

DeCoster, Carolyn, MacMillan, Leonard, and Walld, Randy, Waiting Times for Surgery: 1997/98 and 1998/99 Update (2000), generally [para. 244].

DeNavas-Walt, Carmen, Proctor, Bernadette D., and Mills, Robert, J., Income, Poverty, and Health Insurance Coverage in the United States: 2003: Current Population Reports: Consumer Income (2004), pp. 56 to 59 [para. 175].

Denis, Jean-Louis, Un avenir pour le système public de santé (1998), pp. 5 [para. 248]; 8 [para. 252]; 11 [para. 223]; 12 [para. 251]; 13 [para. 39]; 14 [para. 247]; 16 [para. 251]; 20 [para. 216].

Hogg, Peter W., Constitutional Law of Canada (4th Ed. 1997) (2001 Looseleaf Update, Release 1), vol. 1, pp. 6 to 15 [para. 16]; 44, 43 [para. 30].

Hurley, Jeremiah, et al., Parallel Private Health Insurance in Australia: A Cautionary Tale and Lessons for Canada (2002), p. 17 [para. 245].

Kirby Report - see Canada, Interim Report of the Standing Senate Committee on Social Affairs, Science and Technology, The Health of Canadians - The Federal Role.

Kirby Report - see Final Report of the Standing Senate Committee on Social Affairs, Science and Technology, The Health of Canadians - The Federal Role.

Laberge, A., Bernard, P.M., and Lamarche, P.A., Relationships between the delay before surgery for a hip fracture, postoperative complications and risk of death (1997), 45 Rev. Epidém. et Santé Publ. 5, p. 9 [para. 113].

Lajoie, Andrée, L'impact des Accords du Lac Meech sur le pouvoir de dépenser, in L'adhésion du Québec à l'Accord du Lac Meech (1988), p. 164 ff. [para. 16].

Laverdière, Marco, Le cadre juridique canadien et québécois relatif au dé­vel­oppement parallèlle de services privés de santé et l'article 7 de la Charte canadi­enne des droits et libertés (1998-1999), 29 R.D.U.S. 117, generally [para. 51]; p. 170 [para. 54].

Lewis, Steven, Ending waiting-list mis­man­agement: principles and practice (2000), 162 C.M.A.J. 1297, generally [para. 212].

Marmor, Theodore R., Expert Witness Re­port (1998), pp. 5 [para. 247]; 6 [para. 248]; 8 [paras. 248, 255]; 9 [para. 252]; 10 [para. 255]; 11 [paras. 219, 222].

Mayo, Nancy E., Waiting time for breast cancer surgery in Quebec (2001), 164 C.M.A.J. 1133, generally [para. 212].

McDonald Report - see Canada, Health Canada, Waiting Lists and Waiting Times for Health Care in Canada: More Management!! More Money?.

McDonald, Waiting Lists and Waiting Times for Health Care in Canada: More Management!! More Money? (McDonald Report) (1998), generally [para. 217]; p. 14 [para. 220].

Montmarquette Committee Report - see Québec, Ministère de la Santé et des Services sociaux, Pour un régime d'assurance médicaments équitable et viable.

Morel, André, La coexistence des Chartes canadienne et québécoise: problèmes d'interaction (1986), 17 R.D.U.S. 49, pp. 80, 81 [para. 270].

Nepveu Report - see Québec, Report of the Commission of Inquiry on Health and Social Welfare (Castonguay - Nepveu Report).

Québec, Commission d'étude sur les services de santé et les services sociaux, Emerging Solutions: Report and Recommendations (Clair Commission Report) (2001), pp. 135 [para. 223]; 243 [para. 173].

Québec, Conseil de la santé et du bien-être, Rapport: Le financement privé des services médicaux et hospitaliers (2003), pp. 6 [para. 247]; 7 [para. 248]; 23 [para. 254]; 24 [para. 255]; 30 [paras. 244, 246]; 33 [para. 254].

Québec, La complémentarité du secteur privé dans la poursuite des objectifs fondamentaux du système public de santé au Québec: Constats et recommandations sur les pistes à explorer: Synthèse (Arpin Report) (1999), p. 37 [para. 221].

Québec, La complémentarité du secteur privé dans la poursuite des objectifs fondamentaux du système public de santé au Québec: Rapport du groupe de travail (Arpin Report) (1999), p. 34 [para. 173].

Québec, Ministère de la Santé et des Services sociaux, Pour un régime d'assurance médicaments équitable et viable (Montmarquette Committee Report) (2001), generally [para. 96].

Québec, Ministère de la Santé et des Services sociaux du Québec et Ministère de l'Emploi et de la Solidarité de la France, Health Indicators: International Comparisons: 15 years of Evolution: Canada, France, Germany, Québec, United Kingdom, United States (1998), p. 55 [para. 80].

Québec, Rapport de la Commission d'enquête sur les services de santé et les services sociaux (Rochon Report) (­1988), p. 651 [para. 223].

Québec, Report of the Commission of Inquiry on Health and Social Welfare (Castonguay-Nepveu Report) (1970), vol. 1, p. 34 [para. 172].

Roach, Kent, Dialogic Judicial Review and its Critics (2004), 23 Sup. Ct. L.R.(2d) 49, pp. 69 to 71 [para. 89].

Rochon Report - see Québec, Rapport de la Commission d'enquête sur les services de santé et les services sociaux.

Romanow Report - see Canada, Final Report of the Commission on the Future of Health Care in Canada, Building on Values: The Future of Health Care in Canada.

Sanmartin, Claudia, Waiting for medical services in Canada: lots of heat, but little light (2000), 162 C.M.A.J. 1305, generally [para. 212].

Tribe, Laurence H., American Constitu­tional Law (3rd. Ed. 200), vol. 1, p. 1318 [para. 201].

Tuohy, Carolyn Hughes, Flood, Colleen M., and Stabile, Mark, How Does Private Finance Affect Public Health Care Systems? Marshaling the Evidence from OECD Nations (2004), 29 J. Health Pol. 359, generally [para. 79]; pp. 363, 374 [para. 80].

Turcotte, Fernand, Le temps d'attente comme instrument de gestion du ra­tionnement dans les services de santé du Canada (1998), pp. 4 [paras. 56, 223]; 10 [para. 223]; 11 [para. 255]; 12 [para. 223]; 13, 14 [para. 243].

World Health Organization, The World Health Report 1999: Making a Dif­fer­ence (1999), generally [para. 252].

Wright, Charles J., Waiting Lists in Canada and the Potential Effects of Private Access to Health Care Services (1998), pp. 2 [para. 252]; 6 [para. 222]; 7, 8 [paras. 217, 219]; 14 [para. 254]; 15 [paras. 245, 247]; 16 [para. 246]; 17 [paras. 244, 249]; 18 [para. 250]; 19 [para. 247]; 22 [para. 247].

Counsel:

Jacques Chaoulli, on his own behalf;

Bruce W. Johnston and Philippe H. Trudel, for the appellant George Zeliotis;

Patrice Claude, Robert Monette, Domini­que A. Jobin, Ariel G. Boileau and Manon Des Ormeaux, for the respondent the Attorney General of Quebec;

Jean-Marc Aubry, Q.C., and René Le­Blanc, for the respondent the Attorney General of Canada;

Janet E. Minor, Shaun Nakatsuru and Laurel Montrose, for the intervener the Attorney General of Ontario;

Written submissions only by Gabriel Bour­geois, Q.C., for the intervener the Attor­ney General of New Brunswick;

Written submissions only by Graeme G. Mitchell, Q.C., for the intervener the Attorney General for Saskatchewan;

Written submissions only by Augustin Roy;

Earl A. Cherniak, Q.C., Stanley H. Hartt, Q.C., Patrick J. Monahan and Valerie D. Wise, for the interveners Senator Michael Kirby, Senator Marjory Lebreton, Sena­tor Catherine Callbeck, Senator Joan Cook, Senator Jane Cordy, Senator Joyce Fairbairn, Senator Wilbert Keon, Senator Lucie Pépin, Senator Brenda Robertson and Senator Douglas Roche;

Guy J. Pratte, Freya Kristjanson, Carole Lucock and Jean Nelson, for the interveners the Canadian Medical Asso­ciation and the Canadian Orthopaedic Association;

Written submissions only by Steven Bar­rett, Steven Shrybman, Ethan Poskanzer and Vanessa Payne, for the intervener the Canadian Labour Congress;

Martha Jackman, for the interveners the Charter Committee on Poverty Issues and the Canadian Health Coalition;

Marvin R. V. Storrow, Q.C., and Peter W. Hogg, Q.C., for the interveners Cambie Surgeries Corp., False Creek Surgical Centre Inc., Delbrook Surgical Centre Inc., Okanagan Plastic Surgery Centre Inc., Specialty MRI Clinics Inc., Fraser Valley MRI Ltd., Image One MRI Clinic Inc., McCallum Surgical Centre Ltd., 4111044 Canada Inc., South Fraser Sur­gical Centre Inc., Victoria Surgery Ltd., Kamloops Surgery Centre Ltd., Valley Cosmetic Surgery Associates Inc., Surgi­cal Centres Inc., British Columbia Ortho­paedic Association and British Columbia Anesthesiologists Society;

Solicitors of Record:

Trudel & Johnston, Montreal, Quebec, for the appellant George Zeliotis;

Bernard, Roy & Associés, Montreal, Que­bec, for the respondent the Attorney General of Quebec;

D'Auray, Aubry, LeBlanc & Associés, Ottawa, Ontario, for the respondent the Attorney General of Canada;

Attorney General of Ontario, Toronto, Ontario, for the intervener the Attorney General of Ontario;

Attorney General of New Brunswick, Fredericton, New Brunswick, for the intervener the Attorney General of New Brunswick;

Attorney General for Saskatchewan, Regina, Saskatchewan, for the intervener the Attorney General for Saskatchewan;

Augustin Roy, on his own behalf.

Lerners, Toronto, Ontario, for the in­ter­veners Senator Michael Kirby, Sena­tor Marjory Lebreton, Senator Catherine Callbeck, Senator Joan Cook, Senator Jane Cordy, Senator Joyce Fairbairn, Senator Wilbert Keon, Senator Lucie Pépin, Senator Brenda Robertson and Senator Douglas Roche;

Borden Ladner Gervais, Ottawa, Ontario, for the interveners the Canadian Medical Association and the Canadian Ortho­pae­dic Association;

Sack Goldblatt Mitchell, Toronto, Ontario, for the intervener the Canadian Labour Congress;

University of Ottawa, Ottawa, Ontario, for the interveners the Charter Committee on Poverty Issues and the Canadian Health Coalition;

Blake, Cassels & Graydon, Vancouver, British Columbia, for the interveners Cambie Surgeries Corp., False Creek Surgical Centre Inc., Delbrook Surgical Centre Inc., Okanagan Plastic Surgery Centre Inc., Specialty MRI Clinics Inc., Fraser Valley MRI Ltd., Image One MRI Clinic Inc., McCallum Surgical Centre Ltd., 4111044 Canada Inc., South Fraser Surgical Centre Inc., Victoria Surgery Ltd., Kamloops Surgery Centre Ltd., Valley Cosmetic Surgery Associates Inc., Surgical Centres Inc., British Columbia Orthopaedic Association and British Columbia Anesthesiologists Society.

This appeal was heard on June 8, 2004, by McLachlin, C.J.C., Major, Bastarache, Bin­nie, LeBel, Deschamps and Fish, JJ., of the Supreme Court of Canada.

The judgment of the Supreme Court was de­livered in both official languages on June 9, 2005, and the following reasons were filed:

Deschamps, J. - see paragraphs 1 to 101;

McLachlin, C.J.C., and Major, J. (Basta­rache, J., concurring) - see paragraphs 102 to 160;

Binnie and LeBel, JJ., dissenting (Fish, J., concurring) - see paragraphs 161 to 279.