La Régulation de la Réutilisation du Matériel Médical à Usage Unique au Québec (The Regulation of the Reuse of Single-Use Medical Instruments in Quebec)
Bibliographic record
Abstract
French Abstract: La reutilisation du materiel medical a usage unique, comme les dialyseurs, les cardiostimulateurs ainsi que les catheters, est un chapitre de l’histoire du systeme de sante quebecois qui demeure meconnu par un grand nombre de juristes et de citoyens. Or, cette pratique, jamais explicitement interdite par une regle de droit au Quebec, a neanmoins fait l’objet d’une regulation par le biais de normes diverses, dont une directive quasi reglementaire, des enonces politiques du ministere de la Sante et des Services sociaux, et plusieurs rapports d’organismes consultatifs comme le Conseil d’evaluation des technologies de la sante du Quebec (devenu maintenant l’Institut national d’excellence en sante et en services sociaux), l’Association des hopitaux du Quebec, et le Centre provincial de reference en sterilisation. Cet article examine en detail le portrait normatif de la regulation de la reutilisation des instruments jetables au Quebec depuis 1976 et conclut que l’Etat quebecois sembleavoir fait le choix d’encadrer cette pratique grâce a un mode de regulation par processus de deliberation qui vise a obtenir le consensus des acteurs effectuant la reutilisation, c’est-a-dire les soignants et les etablissements de sante.English Abstract: The reuse of single-use devices, such as dialyzers, pacemakers, and catheters, is a chapter of Quebec history that remains unknown to many in the legal community, as well as a large number of citizens. This practice was never formally prohibited through regulations or legislation in Quebec, but a certain type of normative framework emerged over the years, composed of a quasi-regulatory directive from the Ministry of Health and Social Services, as well as several reports from consultative agencies such as the Conseil d’evaluation des technologies de la sante du Quebec (now the Institut national d’excellence en sante et en services sociaux), the Association des hopitaux du Quebec, and the Centre provincial de reference en sterilisation. This article examines in detail the informal regulation of the reuse of single-use devices in Quebec since 1976 and concludes that Quebec seems to have purposely chosen to adopt a model of regulation through deliberation that aimedin reuse, that is, health care professionals and hospitals.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.007 | 0.012 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.001 |
| Bibliometrics | 0.002 | 0.002 |
| Science and technology studies | 0.006 | 0.005 |
| Scholarly communication | 0.005 | 0.001 |
| Open science | 0.002 | 0.001 |
| Research integrity | 0.002 | 0.002 |
| Insufficient payload (model declined to judge) | 0.006 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".