The Standard of Care in Medical Liability: The Obligation of Means

Overview

A physician who loses a patient has not, for that reason alone, committed a (faute). Quebec law binds the physician to an (obligation de moyens): a duty to act with the prudence, diligence, and competence the profession requires, without any promise that the treatment will succeed. Whether that duty was met is decided , by comparing the defendant's conduct with that of a reasonably prudent and competent physician of the same specialty placed in the same circumstances. This second note in the Medical Liability series explains the classification of obligations by intensity, why professional obligations are ordinarily obligations of means, how an differs from a fault, and which concrete elements (specialty, experience, urgency, institutional resources) courts weigh when they build the comparison model. It closes with the unresolved question of whether a shortage of resources aggravates or mitigates liability.

Learning Objectives

Distinguish obligations of means, of result, and of warranty, and explain the consequence of each for the burden of proof.
Separate a non-actionable error of judgment from a professional fault.
Explain how specialization, experience, urgency, and resources adjust the comparison model, and describe the two lines of case law on limited resources.

The Intensity of Obligations in General

Means, Result, and Warranty

The classification of obligations by intensity is a doctrinal creation. As Paul-André Crépeau recounts in L'intensité de l'obligation juridique (1989), Demogue formulated the distinction between obligations of means and obligations of result in 1925, in the course of analyzing the link between the contractual and extra-contractual regimes and the burden of proof. Crépeau's own title names three tiers: diligence, result, and warranty.

The Supreme Court of Canada adopted the vocabulary in Roberge c. Bolduc, [1991] 1 RCS 374. An obligation of diligence is one where the debtor must show prudence and skill to reach the result the parties desired; it exists in contractual and extra-contractual matters alike. An is one where the debtor must obtain a precise, determined result, no longer merely envisaged but promised or imposed, and said to be in obligatione. The goes one step further: where the debtor of a result may escape by proving , the debtor of a warranty bears the outcome whatever its cause. The medical context rarely involves warranty obligations, but the tier clarifies the logic of the scale, which measures how much of the risk of failure the debtor has assumed.

The practical stakes lie in the burden of proof. A plaintiff facing an obligation of means must prove fault; a plaintiff facing an obligation of result need only show that the promised result did not materialize. Victims therefore plead the obligation of result, and defendants plead the obligation of means.

Criteria for Classifying an Obligation

Neither the Civil Code nor most contracts label obligations by intensity. Three indicators are used.

The agreement. The first step is always to read the contract. Analysis of a contractual relationship that imposes a determined number of prestations may itself reveal their intensity, and a physician who promises an outcome has changed the intensity by agreement.
Statute. The Code is, in Crépeau's phrase, rarely of great help. A few texts are explicit. Art. 2037 CCQ binds the carrier to bring the passenger safe and sound to destination, subject only to proof of superior force, the passenger's state of health, or the passenger's fault. Art. 2100 CCQ requires the contractor and provider of services to act in the best interests of the client with prudence and diligence and in accordance with the rules of their art, adding that where they are bound to a result they may escape only by proving superior force. Art. 2138 CCQ requires the mandatary to act with prudence and diligence. These provisions confirm that service obligations are, by default, obligations of diligence.
The . The decisive criterion is uncertainty of outcome: the more uncertain the result, the more clearly the obligation is one of means. Crépeau asks whether the debtor holds all the elements of the situation in hand. Where some elements escape the debtor's control, such as the reactions of the human organism in medical care, performance is uncertain, and since a debtor does not normally undertake to obtain a result known to be uncertain, the obligation is one of diligence. Where the debtor controls the elements of performance, as in an obligation not to do something or the delivery of a specific thing, the obligation is one of result. The Superior Court applied the test in Jauvin c. Ski Bromont.com, 2019 QCCS 3984 (appeal dismissed, 2021 QCCA 1070), holding that the presence of an aléa is what distinguishes the two obligations and that the operator's duty to ensure a cyclist reached the unloading platform and was not forgotten on the chairlift involved no aléa and was therefore an obligation of result.

Professional ethics reinforce the physician's place on the scale. Art. 83 of the Code de déontologie des médecins requires the physician to refrain from guaranteeing, expressly or impliedly, the effectiveness of an examination, investigation, or treatment or the cure of a disease.

The Obligation of Means Assessed In Abstracto

The Principle

The professional's obligation of means is settled. In Roberge c. Bolduc, the Supreme Court noted the unanimity of doctrine and case law on the intensity of professional obligations, the lawyer, for instance, assuming only obligations of means. For physicians, Justice Vallerand wrote in Côté c. Drolet, 1986 CanLII 3637 (QC CA), [1986] R.L. 236, that it is now settled, without any need to recall the texts, that the physician has an obligation of means and not of result. Lapointe c. Hôpital Le Gardeur, [1992] 1 RCS 351, confirmed that physicians generally have an obligation of means and that their conduct must be assessed against that of a prudent and diligent physician placed in the same circumstances.

The comparison model is objective. As Pierre Deschamps explains in his 1991 study, courts transposed to medicine the general model of the bon père de famille, now the reasonable person. The criterion of the normally prudent and diligent physician became the preferred yardstick. This "objective" norm excludes a "subjective" norm that would be the practice of the defendant physician: the reference is not the conduct the defendant normally adopts but the conduct a would have adopted.

Three features follow. First, the model is drawn from the defendant's own category. Crépeau insists that the reasonable person must be taken from the class to which the debtor belongs and placed in similar circumstances; one cannot judge in the same manner a country doctor and a neurosurgeon in a specialized centre. Second, the model is situated in time: the are those recognized when the act was performed. Third, the model is proven, not assumed. The plaintiff must establish, on a balance of probabilities and usually through expert evidence, that the defendant departed from what the model physician would have done (art. 2803 CCQ).

Error of Judgment Versus Fault

A bad outcome, and even a wrong decision, is not enough. In Lapointe, the Supreme Court stated that health professionals should not be held liable for mere errors of judgment, which are distinct from professional fault. The case arose from the death of a young girl who had suffered a deep cut to the elbow and was transferred to Sainte-Justine; she died on arrival, having lost almost all her blood. Even on such facts, the question remains whether the physician acted as a prudent and diligent physician would have acted in the same circumstances. The Court of Appeal applied the same objective test in P.L. c. Benchetrit, 2010 QCCA 1505, a liposuction and facelift case in which too much fat was removed, a fault the physician admitted.

The distinction should not become a semantic escape hatch. In Lacroix c. Léonard, [1992] R.R.A. 799 (C.S.), the court cautioned that the word "error" is to be avoided. The question is never whether the physician erred, since medicine is uncertain and reasonable physicians err, but whether the decision fell outside the range a reasonably competent physician could have made with the information then available.

The stakes of the classification appeared in a radiology matter. At trial, in L.S. c. Centre hospitalier affilié universitaire de Québec, Hôpital de l'Enfant-Jésus, 2009 QCCS 1622, the Superior Court held that both physician and technician owed an obligation of result as to the product injected into the patient (para. 193) and condemned the physician along with the hospital, the latter for the fault of its employee (préposé). The judgment caused a stir: it suggested that physicians could carry obligations of result and seemed to revive the abandoned theory, under which the surgeon answers for everything in the operating room. In Hébert c. Centre hospitalier affilié universitaire de Québec, Hôpital de l'Enfant-Jésus, 2011 QCCA 1521, the Court of Appeal restored the orthodox position: the physician had behaved as a prudent and diligent physician, was entitled to rely on the technician's training, and owed an obligation of means, not of result (paras. 26 ff.). Only the technician, bound to an obligation of result, was liable.

Departing From the Obligation of Means

Four situations displace the rule.

The promise. A physician who promises a result intensifies the obligation and also breaches art. 83 of the Code de déontologie. In Fiset c. St-Hilaire, [1976] C.S. 994, the physician had promised that the operation would be perfect; the court held that the obligation of means could not apply because the defendant had guaranteed the results, and he answered for the failure of the operation. Laferrière v. Neal Institute of Canada (1914) is an early example. In Roy c. Pellerin, 2001 CanLII 25177 (QC CS), a leukemia patient alleged that the practitioner had abused his naivety and distress by falsely representing that the "treatments" administered would cure his cancer, with a claimed success rate of 99.999 per cent. The Canadian Medical Protective Association warns in the same spirit that encouragement about the prospects of good results must not create the impression that results are guaranteed.

The prescription and the record. Some medical acts carry no aléa. Art. 7 of the Règlement sur les normes relatives aux ordonnances faites par un médecin requires an individual prescription to be legible, with the unused portion of the sheet struck through. In Jauvin (para. 70), the Superior Court used the physician as its example: the obligation of care is one of means, since a complication is always possible despite impeccable care, but writing a prescription legibly or correctly compiling medical data presents no aléa, and in such cases the obligation may be one of result.

Situations requiring particular protection. In Roussy c. Agence de garde Sous le bon toit inc., [2001] R.R.A. 522 (C.Q.), the daycare operator owed an obligation of result to watch over the safety of the child entrusted to it. In Rizk c. Hôpital du Sacré-Coeur de Montréal, 1998 CanLII 9202 (QC CQ), the court treated as an obligation of result the nurse's duty in relation to a vagal shock after a blood draw, a risk the nurse must know and anticipate. Each such judgment lengthens the list of exceptions.

Acts of pure technique. Crépeau asked whether the obligations of physician or institution that involve not the exercise of an art but the execution of a technique carrying no serious aléa should be analyzed as obligations of result, where technique prevails over art and mechanics over therapeutics: identifying the patient, verifying the intervention to be performed, preparing or distributing a diet or a pharmaceutical product, routine laboratory analyses such as blood typing. In Richard c. Hôtel-Dieu de Québec, [1975] C.S. 223, a patient was burned by an overheated heating mattress during surgery; the hospital was liable under its hospital contract, and its obligation was characterized as one of result as regards the functioning of equipment used for hospital care.

Rescue and the Immunity of Article 1471 CCQ

Intensity also changes when a physician acts outside the professional setting. Art. 1471 CCQ exonerates a person who comes to the assistance of another from liability for the resulting injury unless it is due to intentional or (faute lourde). Quebec, unlike the common-law provinces, imposes a duty to rescue: s. 2 of the Charter of Human Rights and Freedoms requires every person to come to the aid of anyone whose life is in peril, personally or by calling for help, absent danger or another reasonable excuse. The Ontario court in Matthews v. MacLaren (1969, ON SC) restated the contrary common-law rule of no general duty to rescue, while Ontario's Good Samaritan Act, 2001 and Manitoba's equivalent shield volunteer health professionals from liability short of gross negligence. Art. 38 of the Code de déontologie des médecins adds a professional duty to aid any patient, a term read broadly enough to include a person the physician has never seen, who presents a condition likely to entail serious consequences without immediate care.

The immunity is unavailable to a physician acting within the scope of paid or assigned work; the case law is clear that once there is profit or salary, the good-samaritan logic no longer applies. The CMPA's examples mark the line. Coaching a child's baseball game, dining in a restaurant, volunteering at a marathon first-aid station, or responding on an aircraft: immunity applies. A colleague who faints at the hospital, or a call to lend a hand in a colleague's operating room: within the scope of work. A patient who collapses at the clinic door is borderline. Whether the criterion is remuneration or context remains open; the resident, assigned rather than paid in the ordinary sense, suggests that assigned service is the better test. The CMPA adds that such claims are extremely rare and that the physician should record the intervention afterwards.

The Concrete Elements Courts Take Into Account

Degree of Specialization

The comparison model shares the defendant's specialty. In ter Neuzen c. Korn, [1995] 3 R.C.S. 674, the Supreme Court held that every physician must practise as a prudent and diligent physician in the same circumstances, and that a specialist such as an obstetrician-gynaecologist is measured against other specialists possessing the reasonable degree of knowledge, competence, and skill expected in that specialty in Canada. A specialist who holds himself out as having a certain skill must display the skill of the average specialist in his field.

Topliceanu c. Bojanowski, 2018 QCCS 658, restated the rule (para. 18): a general practitioner is not held to the standards of a specialist, and the specialist is judged by the norms of his specialty. The judgment also fixes the ceiling of the model. One expert testified that he would personally have "acted like a Jesuit" and made sure the plaintiff had a follow-up appointment. The court answered (para. 142) that the defendant's conduct must be measured against the normal standards of his specialty, not against a neurosurgeon exceeding the usual norms of practice. Common-law courts reason similarly: in Fleury v. Woolgar, 1996 CanLII 10348 (AB QB), the defendant was required to use the skill of a family practitioner with a significant obstetrical practice in a well-equipped Calgary hospital.

Specialization interacts with the duty to refer. Art. 42 of the Code de déontologie requires the physician to take account of his abilities, limits, and available means, and to consult or refer where the patient's interest so requires. A specialist is judged as a specialist and a family physician as a family physician, but exceptionally the general practitioner who keeps a case beyond his competence is judged as the specialist who would have been appropriate. The standard rises, and the fault lies in the failure to refer.

Experience and Inexperience

Should inexperience count as a "particular circumstance" that lowers the standard? Lacroix c. Léonard raised the question (para. 46), and the prevailing answer is no. If experience can raise the standard, inexperience should not lower it; the standards of medicine are not scaled to the practitioner's seniority. The civil standard remains that of the reasonably competent physician of the same category.

The Circumstances of Practice

The phrase "placed in the same circumstances" does substantial work. Circumstances include the setting, the urgency, the information available, and the resources at hand.

Resources raise the standard. In Brochu c. Camden-Bourgault, 2001 CanLII 39630 (QC CA), an emergency physician sent a patient home; on return, a leg had to be amputated. The Court of Appeal held (para. 35) that, given his specialized emergency practice within an institution with high-level capacities and resources, the physician was to be assessed by the standards of a specialized emergency physician having the means of a large hospital institution.

Urgency lowers expectations. In Béliveau c. Ciricillo, 1997 CanLII 6923 (QC CQ), a patient rushed to hospital in acute respiratory failure had two teeth broken during intubation and sued for the $700 repair, calling no expert. The court recalled that the plaintiff had to prove that the physician had not acted according to the data of science (art. 2803 CCQ); the defence expert concluded that, given the urgency, intubation was indicated despite its risks. A possibly broken tooth was preferable to the loss of a life.

The setting fixes the available means. In Lacroix c. Léonard, an asthmatic patient arrived at a clinic in Saint-Jovite suffocating and losing consciousness in his vehicle. Resuscitation in a clinic is not measured against resuscitation in a hospital, and the physician had behaved as a prudent and diligent physician in the same circumstances (para. 42).

A university hospital is not the provincial norm. In S.T. c. Dubois, 2008 QCCS 1431, a child was born with trisomy and the parents sued over prenatal tests, relying on the practice at Sainte-Justine. The court observed (para. 138) that the experts, all from Sainte-Justine, worked with a concern for scientific progress and with resources found only in large university hospitals, unlike most obstetricians practising elsewhere, and that the weight given to documentation had evolved differently inside and outside university hospitals (para. 156). The question was what a prudent physician placed in the same circumstances, in Chicoutimi, would have ordered.

Philips-Nootens and Kouri summarize (Éléments de responsabilité civile médicale, 5th ed., 2021, no. 64): the relevant circumstances are external to the physician. One who practises in an urban setting near university facilities is judged more severely than one in a remote region with fewer resources at hand; courts also weigh workload and will increasingly face questions of resource allocation.

Worked example: the rural chest pain case

Dr. Roy is a family physician in a rural clinic three hours from the nearest tertiary hospital. A 58-year-old patient presents with chest discomfort. Dr. Roy examines him, reads an electrocardiogram on the clinic's older machine, finds it non-diagnostic, judges the presentation atypical, and sends the patient home with instructions to return if symptoms worsen. The patient suffers a myocardial infarction that night.

The analysis proceeds in abstracto. Dr. Roy is compared not with a cardiologist in a Montreal university hospital but with a reasonably prudent and competent family physician practising in a rural clinic with the same equipment and the same distance from specialized care. The questions are whether such a physician would have read the tracing the same way, would have ordered the blood tests available locally, and would have arranged transfer or consultation under art. 42 of the Code de déontologie. If the expert evidence shows that a prudent rural family physician would have kept the patient under observation or arranged transfer, the decision was a fault, not an error of judgment, and the limited setting will not excuse it. If the presentation was genuinely equivocal and reasonable colleagues in the same setting would have made the same call, the outcome, however serious, is the materialization of an aléa, and the obligation of means was met.

Limited Resources as an Aggravating or Mitigating Circumstance

The problem is chronic: emergency departments above capacity, patients waiting many hours on stretchers, surgical backlogs, mandatory overtime for nurses, pandemic-era protocols for rationing intensive care. The textbook example is the anaesthetist who, under accepted norms, should have charge of one patient at a time but, because of shortages, monitors three. The dilemma is whether to operate on more patients at the expense of safety or on fewer patients in light of limited resources.

The legislative context. The Act respecting health services and social services grants the right to be informed of available services (s. 4), to receive adequate, continuous, and safe services (s. 5), and to choose one's professional or institution (s. 6), but s. 13 provides that these rights are exercised taking into account the institution's organization and its human, material, and financial resources. The legislature has protected itself, which reads as a mitigating factor. Section 100 nonetheless assigns institutions the function of providing continuous, accessible, and safe services and of managing resources efficiently. Professional codes add individual duties: the physician must use health-care resources judiciously (art. 12) and refrain from practising in circumstances likely to compromise the quality of his acts (art. 43); the nurse (art. 16) and the respiratory therapist (art. 8) are under similar duties. The nurses' order reminds members that only the nurse can assess her own capacity and that ensuring continuity of care does not oblige her to find her own replacement.

The well-equipped are held higher. In Harewood-Greene c. Spanier, J.E. 95-428 (C.S.), affirmed J.E. 2000-2162 (C.A.), the court held that while the physician always owes an obligation of means, the specialist's responsibility is greater than that of the general practitioner who lacks the support of a university hospital (para. 73); because the case involved leading specialists in a university hospital with full investigative equipment, the requirement was greater for them (paras. 160 and 170).

The mitigating line. In Hôpital général de la région de l'Amiante Inc. c. Perron (C.A., 1979), two anaesthetists covered up to five operating rooms plus obstetrics because of a shortage (para. 11); an anaesthesia went wrong and a child suffered lasting harm. The Court of Appeal stated (para. 87) that the ideal is one patient per anaesthetist, but that the constraints of the shortage permit otherwise, within an admissible safety margin, and that the multiple assignments were not determinative of the accident (para. 88). Professor Tôth criticized the dictum as establishing an absence of norm justified by administrative efficiency, in anaesthesia, where the patient's life is at stake, without saying who decides what margin is admissible. Later decisions follow the same logic. In Benoît c. Hôpital de la Cité-de-la-Santé, 2013 QCCQ 15991, an ENT consultation recommended within 48 to 72 hours could not be obtained for a week, and the court found no fault given the congestion of the system and the measures taken to address it. In Bureau c. Dupuis, 1997 CanLII 8105 (QC CS), a hospital could not be blamed for lacking a hyperbaric chamber, since only one hospital in Quebec had one. In J.G. c. Nadeau, 2013 QCCS 410, affirmed 2016 QCCA 167, a foreign expert's view that an anaesthetist should be present around the clock was rejected because no Quebec hospital, including tertiary centres, was so organized. In Noël-Voizard c. CSSS de Lasalle et du Vieux-Lachine, 2007 QCCQ 5118, a patient triaged at level 3 (assessment within 30 minutes under Quebec norms) was not seen in time, and limited resources supported a finding of no liability (para. 43). In Institut St-Georges c. Laurentienne générale (C.A., 1993), a youth centre was found to have supervised adequately considering the duties imposed on it and the resources placed at its disposal (para. 24).

The aggravating line. About a decade after Perron, in Houde c. Côté, [1987] R.J.Q. 723 (C.A.), an anaesthetist covering three operating rooms administered an epidural and the patient was left paralyzed from the lower back down. The trial judge held the hospital liable for imposing an excessive workload (para. 10), and the Court of Appeal agreed (para. 45): the overload and the failure to provide appropriate monitoring staff were consequences of the material organization of the anaesthetist's work, decided by the head of department, a hospital employee. Both hospital and physician were condemned. Tôth draws the lesson that accepting an overload is not a fault in itself but does not reduce the care owed to each patient; the overloaded physician risks a situation of physical impossibility for which he will answer, and the hospital answers for the specific faults of understaffing and excessive workload. This line has since predominated. In Collins c. Centre hospitalier de Sept-Îles, REJB 2000-20110 (C.Q.), a patient with a triple wrist fracture was transferred to Quebec City without the escort her transfer prescription required, by taxi and commercial flight; the court held (para. 46) that an overflowing emergency department on Easter Monday was no defence to treating a prescription lightly, and that excessive workloads and staff shortages engage the hospital's liability. In Lafontaine c. Institut universitaire de cardiologie et de pneumologie de Québec, 2018 QCCQ 206, a chest X-ray that ministerial norms required to be read and reported within fourteen days was read four weeks later; the court characterized the deadline as an obligation of result (para. 17), held that workload, staff shortages, and even the unavailability of radiologists are not defences (para. 19), and found that the hospital should at least have told the patient of the delay so she could seek the service elsewhere (para. 20), although causation of her financial losses failed. In Landry c. Hôpital St-François d'Assise (C.S., 1995), a haemodialysis patient suffered aluminum intoxication at the only Quebec hospital without a water purifier; the economic choice was no defence. In Caron c. CHUQ, 2006 QCCS 3293, the plaintiff sued the hospital for its organization after a nurse worked 24 hours within a continuous 32-hour period. In Cilinger c. Centre hospitalier de Chicoutimi, 2004 CanLII 9657 (QC CS), affirmed on this point 2004 CanLII 39136 (QC CA), a class action by women unable to obtain radiotherapy within the six to eight weeks medicine requires was authorized over the hospitals' plea of limited resources; the Court of Appeal confirmed only that the government could not be sued.

Taking stock. Two contradictory approaches coexist, both predating the pandemic, and a decisive Court of Appeal ruling is still awaited. One view accepts that the system must sacrifice some quality of care while everyone does their best; the other holds that limited resources are no excuse. The strong tendency of the case law is to treat limited resources as aggravating for hospitals, which manage the system and pay for having tolerated unacceptable resource levels, while remaining more indulgent toward the individual physician caught in the shortage.

Practice Checklist

Classifying the obligation

Read the agreement or the record of what was said: did the physician promise a result?
Check for a statutory or regulatory text fixing the intensity of the obligation (prescription regulation, ministerial deadline).
Ask whether the act carried an aléa. Therapeutic acts do; identification, labelling, legible prescriptions, routine analyses, and equipment maintenance generally do not.
Consider whether the situation is one requiring particular protection.

Building the comparison model

Identify the defendant's specialty and confirm that the expert evidence addresses that specialty, not a higher one.
Fix the relevant date and the rules of the art recognized at that time.
Describe the setting: clinic or hospital, regional or university, available equipment and specialists.
Account for urgency and for the information available when the decision was made.
Do not lower the standard for inexperience; raise it where the physician retained a case that should have been referred.

Resources and rescue

Where the defence invokes shortages or workload, distinguish the physician's conduct from the institution's organizational choices, and locate the case within the Perron or Houde c. Côté line.
Where the physician acted outside paid or assigned work, consider the art. 1471 CCQ immunity and the gross-fault threshold.

Glossary

Aléaaléa: The uncertainty affecting the outcome of a performance; its presence signals an obligation of means, its absence an obligation of result.
Captain of the shipcapitaine du navire: The abandoned theory under which the surgeon answers for everything that occurs in the operating room.
Error of judgmenterreur de jugement: A mistaken decision that a prudent physician could also have made; it is not a fault.
Faultfaute: A departure from the conduct of the reasonably prudent, diligent, and competent person of the same category in the same circumstances (art. 1457 CCQ).
Gross faultfaute lourde: A fault showing gross recklessness or carelessness; the threshold for a rescuer's liability under art. 1471 CCQ.
In abstractoin abstracto: Comparison of the defendant's conduct with an abstract model of the same category in similar circumstances, rather than with the defendant's own habits.
Intensity of obligationsintensité des obligations: The degree of commitment assumed by a debtor, from a duty of diligence to a guarantee of outcome.
Obligation of meansobligation de moyens: The debtor must show prudence and skill in pursuing the result the parties hoped for, without promising it; the creditor must prove fault.
Obligation of resultobligation de résultat: The debtor must deliver a determined result, said to be in obligatione; failure raises a presumption of fault rebuttable only by superior force.
Obligation of warrantyobligation de garantie: The strictest tier, under which the debtor answers for the outcome even where superior force intervenes.
Reasonably prudent, diligent, and competent physicianmédecin raisonnablement prudent, diligent et compétent: The comparison model in medical liability.
Rules of the artrègles de l'art: The recognized standards of practice at the relevant time.
Superior forceforce majeure: An unforeseeable and irresistible event that exonerates the debtor of an obligation of result (art. 1470 CCQ).

References and Further Reading

Civil Code of Quebec: arts. 1457, 1470, 1471, 2037, 2100, 2138, 2803.
Charter of Human Rights and Freedoms (Charte des droits et libertés de la personne): s. 2.
Act respecting health services and social services (Loi sur les services de santé et les services sociaux): ss. 4, 5, 6, 13, 100.
Code de déontologie des médecins: arts. 12, 38, 42, 43, 83. Code de déontologie des infirmières et infirmiers: art. 16. Code de déontologie des inhalothérapeutes du Québec: art. 8. Règlement sur les normes relatives aux ordonnances faites par un médecin: art. 7.
Good Samaritan Act, 2001 (Ontario); Good Samaritan Protection Act (Manitoba).
Supreme Court of Canada: Roberge c. Bolduc, [1991] 1 RCS 374; Lapointe c. Hôpital Le Gardeur, [1992] 1 RCS 351; ter Neuzen c. Korn, [1995] 3 R.C.S. 674.
Quebec Court of Appeal: Côté c. Drolet, 1986 CanLII 3637 (QC CA); Hôpital général de la région de l'Amiante Inc. c. Perron (1979); Houde c. Côté, [1987] R.J.Q. 723; Institut St-Georges c. Laurentienne générale cie d'assurance-vie (1993); Brochu c. Camden-Bourgault, 2001 CanLII 39630 (QC CA); P.L. c. Benchetrit, 2010 QCCA 1505; Hébert c. Centre hospitalier affilié universitaire de Québec, 2011 QCCA 1521; Jauvin c. Ski Bromont.com, 2021 QCCA 1070; J.G. c. Nadeau, 2016 QCCA 167.
Superior Court and Court of Quebec: Richard c. Hôtel-Dieu de Québec, [1975] C.S. 223; Fiset c. St-Hilaire, [1976] C.S. 994; Lacroix c. Léonard, [1992] R.R.A. 799 (C.S.); Harewood-Greene c. Spanier, J.E. 95-428 (C.S.); Landry c. Hôpital St-François d'Assise (C.S., 1995); Béliveau c. Ciricillo, 1997 CanLII 6923 (QC CQ); Bureau c. Dupuis, 1997 CanLII 8105 (QC CS); Rizk c. Hôpital du Sacré-Coeur de Montréal, 1998 CanLII 9202 (QC CQ); Collins c. Centre hospitalier de Sept-Îles, REJB 2000-20110 (C.Q.); Roussy c. Agence de garde Sous le bon toit inc., [2001] R.R.A. 522 (C.Q.); Roy c. Pellerin, 2001 CanLII 25177 (QC CS); Cilinger c. Centre hospitalier de Chicoutimi, 2004 CanLII 9657 (QC CS); Caron c. Centre hospitalier universitaire de Québec, 2006 QCCS 3293; Noël-Voizard c. CSSS de Lasalle et du Vieux-Lachine, 2007 QCCQ 5118; S.T. c. Dubois, 2008 QCCS 1431; L.S. c. Centre hospitalier affilié universitaire de Québec, 2009 QCCS 1622; Benoît c. Hôpital de la Cité-de-la-Santé, 2013 QCCQ 15991; J.G. c. Nadeau, 2013 QCCS 410; Topliceanu c. Bojanowski, 2018 QCCS 658; Lafontaine c. Institut universitaire de cardiologie et de pneumologie de Québec, 2018 QCCQ 206; Jauvin c. Ski Bromont.com, 2019 QCCS 3984.
Other jurisdictions: Matthews v. MacLaren (1969, ON SC); Fleury v. Woolgar, 1996 CanLII 10348 (AB QB); Laferrière v. Neal Institute of Canada (1914).
Doctrine: Paul-André Crépeau, L'intensité de l'obligation juridique, ou, Des obligations de diligence, de résultat et de garantie (1989); Pierre Deschamps, "L'obligation de moyens en matière de responsabilité médicale" (1991) 4 Assurances 575; Suzanne Philips-Nootens and Robert P. Kouri, Éléments de responsabilité civile médicale, 5th ed. (2021), no. 64; François Tôth, "Contrat hospitalier moderne et ressources limitées : conséquences sur la responsabilité civile" (1990) 20 R.D.U.S. 313; R.J. Gray and G.S. Sharpe, "Doctors, Samaritans and the Accident Victim" (1973) 11 Osgoode Hall L.J. 1; CMPA (ACPM), Considérations pratiques sur le consentement éclairé (2006, rev. 2021) and Agir en bon samaritain : Quels sont les risques? (2015, rev. 2021).

Disclaimer

This article is for informational purposes only and does not constitute legal advice. Quebec civil law may evolve through legislation and judicial interpretation. For advice on a specific situation, consult a qualified Quebec lawyer or notary.