Victims’ Rights and Health Care Workers

by GS

Violence against health care workers has become an increasingly serious concern within Canada’s health care and criminal justice systems, a trend that has been exacerbated by the heightened pressures and public tensions associated with the COVID-19 pandemic. Health care professionals occupy a unique and essential role in society, delivering critical services in high-stress environments while routinely interacting with individuals experiencing fear, crisis, or emotional distress. Despite the indispensable nature of their work, health care workers have faced rising levels of harassment, intimidation, and physical violence. This escalation has prompted questions about whether existing legal frameworks sufficiently recognize their vulnerability and adequately respond to harms committed against them.

In response to these concerns, Parliament enacted Bill C-3, which received Royal Assent on December 16, 2021.[i] Among its key provisions, the bill amended the Criminal Code to require sentencing judges to treat offences committed against health care professionals and first responders, while they are engaged in the performance of their duties, as aggravating factors at sentencing.[ii] This legislative reform reflects a broader shift toward victim-centered approaches in Canadian criminal law and emphasizes sentencing as a mechanism for denunciation, deterrence, and acknowledgment of harm.[iii] At the same time, it raises important legal and policy questions regarding the scope and implications of profession-specific protections within the criminal justice system.

The use of aggravating factors is a well-established feature of Canadian sentencing law. Section 718.2 of the Criminal Code directs judges to consider factors that increase the gravity of an offence or the moral blameworthiness of the offender, while remaining guided by fundamental sentencing principles such as proportionality, denunciation, deterrence, and rehabilitation.[iv] Aggravating factors do not create new offences or impose mandatory minimum penalties; rather, they structure judicial discretion by highlighting circumstances Parliament considers to be particularly serious.[v] By explicitly identifying violence against health care workers as an aggravating factor, Bill C-3 signals a legislative judgment that such offences warrant heightened denunciation due to both the vulnerability of the victims and the essential public services they provide.

This amendment aligns with existing sentencing provisions that afford enhanced protection to particular categories of victims. For example, offences motivated by bias, prejudice, or hate, as well as offences committed against law enforcement officers, are already recognized as aggravating factors.[vi] In this context, the inclusion of health care professionals reflects a consistent legislative approach to addressing occupations exposed to heightened risks of harm. It also demonstrates the capacity of the criminal law to adapt to evolving social realities and emerging patterns of victimization.

Although abuse against health care workers pre-dated the COVID-19 pandemic, incidents of violence and harassment escalated significantly during and after the public health crisis.[vii] Factors such as the spread of misinformation, increased mistrust of medical professionals, and systemic strain within the health care system have contributed to heightened tensions between patients and health service providers.[viii] A 2021 National Physician Health Survey conducted by the Canadian Medical Association found that approximately eight out of ten physicians had experienced intimidation, bullying, harassment, or microaggressions in the workplace over the course of their careers.[ix] Forty percent of these respondents also reported that such conduct occurred “frequently” or “often,” with female professionals significantly more likely to experience weekly incidents of harassment or abuse.[x] Comparable trends have been similarly documented among nurses. A January 2025 survey by the Canadian Federation of Nurses Unions (CFNU) reported that 60% of nurses had either witnessed or experienced abuse or harassment in the last year.[xi] The CFNU also reported that in Manitoba alone, there were 812 workers’ compensation claims in 2024 related to assault or other violent acts against nurses and nursing supervisors, compared to 298 claims in 2015.[xii]

These findings reflect broader trends across the health care sector, including among paramedics and emergency department staff, who often work in high-risk environments with limited security measures.[xiii] Workplace violence in health care settings is frequently underreported due to the normalization of abuse, fear of retaliation, or skepticism about whether reporting will lead to meaningful consequences.[xiv] Research has linked such violence to burnout, psychological harm, increased staff turnover, diminished patient safety, and higher rates of medical error.[xv] These impacts extend beyond individual workers and threaten the overall functioning and sustainability of the health care system.[xvi]

Canadian courts have long acknowledged the seriousness of offences committed against individuals performing public-facing or protective roles. Sentencing decisions involving assaults on police officers, correctional staff, and transit operators frequently emphasize deterrence and denunciation, given the broader societal implications of such conduct.[xvii] Although jurisprudence interpreting Bill C-3 remains limited due to its relatively recent enactment, courts have historically recognized that aggravating factors serve both a symbolic and practical purpose, by expressing societal condemnation while shaping sentencing outcomes within the bounds of judicial discretion.

Notably, even prior to the enactment of Bill C-3, some courts treated the fact that a victim was a nurse as an aggravating factor. This suggests that judicial awareness of the vulnerability of health care workers was already emerging, prior to the bill’s official enactment.[xviii] In R v. Van Horlick, for example, the court emphasized that nurses are entitled to a safe working environment and that a clear and unequivocal message must be sent that violence against health care workers is unacceptable.[xix] These early applications are promising and suggest that the even prior to the amendment the judiciary was establishing a precedent to consider and acknowledge these harms in sentencing.

When significant societal challenges arise within a critical sector, it is appropriate for the law to respond. Health care workers interact directly with the public in emotionally charged and unpredictable circumstances, and the growing risk of violence further compounds the inherent stress of their profession. Given the essential role health care plays in Canadian society, addressing violence against those who provide these services through enhanced legal protections represents one means of affirming their value and importance.

At the same time, Bill C-3 raises broader policy questions regarding equality before the law and the limits of profession-specific sentencing protections. Some critics of the law’s application in this capacity may argue that criminal law should focus on conduct rather than occupational status, or that expanding aggravating factors risks leading to over-criminalization. Others may question whether criminal sanctions alone are sufficient to address these issues of systemic workplace violence, pointing to the need for additional measures such as labour protections, occupational health and safety regulations, and institutional reform.

Nevertheless, where systemic conditions place members of a particular profession at a heightened risk of violence, a targeted legal response is both reasonable and consistent with established sentencing principles. The criminal justice system has long recognized that certain roles entail unique vulnerabilities and responsibilities that justify enhanced protection. In light of the essential and high-stakes nature of health care, strengthened legal protections for health care workers serve not only individual victims but the broader public interest. Viewed in this context, I believe that Bill C-3 represents a measured and justified legislative response to a pressing social problem and an expansion of victims’ rights within the Canadian justice system.

Endnotes

[i] Bill C-3, An Act to amend the Criminal Code and the Canada Labour Code, 1^st Sess, 44^th Parl, 2021, (as passed by the House of Commons 16 December 2021).

[ii] Ibid.

[iii] Ibid.

[iv] Criminal Code, RSC 1985, c C-46, s 718.2 (a).

[v] Ibid.

[vi] Ibid.

[vii] Canadian Medical Association, “How Bill C-3 can work for you: What the anti-harassment law means for doctors” 6 February 2025 online: <cma.ca/latest-stories/how-bill-c-3-can-work-you-what-anti-harassment-law-means-doctors>.

[viii] Ibid.

[ix] Ibid.

[x] Ibid.

[xi] Canadian Federation of Nurses Unions, Violence Against Nurses in Canada: An Urgent Call to Action (Canadian Federation of Nurses Unions, 2025) at 5.

[xii] Ibid at 6.

[xiii] Nelson et al, “Workplace Violence Against Nurses in Canada: A Legal Analysis” (2023) 24:4 Policy, Politics, & Nursing Practice 239 at 239.

[xiv] Ibid.

[xv] Ibid at 241.

[xvi] Ibid.

[xvii] Ibid at 243.

[xviii] Ibid at 246.

[xix] Ibid.