Trozzi v CPSO: The Doré Framework and the Limits of Physician Speech

The COVID-19 era produced a substantial body of professional discipline jurisprudence in Ontario. Several physicians who used the period to advocate against vaccination, against masking, against public health guidance, and in some cases against the regulator’s authority to police their conduct found themselves on the receiving end of CPSO discipline proceedings. The published decisions from those proceedings now form a recognized sub-cluster of Canadian administrative law on physician speech, the duty of regulatory cooperation, and the proportionality of disciplinary sanctions during public health emergencies. Trozzi v College of Physicians and Surgeons of Ontario, 2024 ONSC 6096, is the Divisional Court of the Superior Court of Justice of Ontario’s appellate review of one of the most prominent of those proceedings. The unanimous panel (Newton RSJ, Myers J, and Shore J) dismissed Dr. Mark Trozzi’s appeal on every ground advanced and ordered costs against him.

The decision is doctrinally significant for several reasons. It is one of the most thoroughly reasoned Ontario appellate applications of the Doré v Barreau du Québec, 2012 SCC 12, framework for balancing Charter freedom of expression against regulatory objectives in professional discipline. It confirms that the Ontario Physicians and Surgeons Discipline Tribunal (the “OPSDT”) was entitled to find that a physician’s public statements during the COVID-19 pandemic — including statements encouraging unproven treatments and statements challenging the safety and efficacy of approved vaccines — could constitute professional misconduct where they engaged a meaningful risk of public harm. It rejects the argument that CPSO policies during a public health emergency are merely non-binding recommendations that do not inform the standard of care. It clarifies that the threshold for opening a regulatory investigation is the regulatory threshold, not the criminal “reasonable and probable grounds” standard. And it confirms a doctrinally important point that connects directly to the production-of-records framework I covered in CPSO v Kilian: reliance on legal advice does not excuse the statutory duty of cooperation with a regulator.

The decision is also part of the broader procedural arc of the Trozzi matter, which is itself the most prominent of the COVID-era physician discipline cases. The OPSDT findings of misconduct were released in November 2023. The penalty decision imposing revocation of his certificate of registration was released in January 2024 and was the subject of my earlier post on the OPSDT revocation and the broader COVID-era cluster. This decision is the next stage: the Divisional Court’s appellate affirmation of both the misconduct findings and the revocation penalty. The decision now stands as the operative appellate authority in Ontario on the proportionality of physician speech regulation in a public health emergency context.

A note on framing before going further. Dr. Trozzi remains a public advocate for his position and has continued to characterize the proceedings against him as persecution. The substantive analysis below proceeds on the legal record before the Divisional Court and the Court’s reasons for decision. I am not in a position to assess the underlying scientific debates that were raised before the OPSDT or to evaluate the views of any individual physician on the COVID-19 vaccines. The legal analysis turns on what the Tribunal was entitled to find and what the Divisional Court was required to affirm under the applicable standards of review. Those are the framework questions this comment addresses.

The procedural arc

The factual and procedural history of the Trozzi matter spans four years and is itself the operating context for the Divisional Court decision.

The original CPSO investigation (October 2021). The CPSO opened an investigation into Dr. Trozzi after receiving complaints about his public statements on COVID-19 vaccines, his promotion of unproven treatments including ivermectin, and his issuance of medical exemptions from COVID-19 vaccination requirements. The CPSO investigators identified specific public statements made by Dr. Trozzi in interviews, on his website, and on social media, and identified specific exemption documents he had issued. The investigation included demands for patient records and other documents that he initially declined to produce.

The s. 87 Superior Court application. The CPSO applied to the Ontario Superior Court of Justice under section 87 of the Health Professions Procedural Code (the “HPPC”) for an order compelling Dr. Trozzi and several other physicians to produce records and cooperate with the College’s investigations. The application was granted. The Ontario Court of Appeal subsequently addressed aspects of the s. 87 framework in the parallel Kilian v College of Physicians and Surgeons of Ontario, 2024 ONCA 52, decision, holding that constitutional arguments belong before the Discipline Tribunal at first instance, not before the courts on a s. 87 application.

Interim orders. The Inquiries, Complaints and Reports Committee (the “ICRC”) imposed interim orders under section 25.4 of the HPPC restricting Dr. Trozzi’s ability to issue COVID-19-related exemptions and ultimately suspending his certificate of registration during the investigation.

The OPSDT hearing on the merits (June 2023). The OPSDT held its hearing on the merits over multiple days in mid-2023. The CPSO led expert evidence from Dr. Andrew Gardam (a public health and infectious disease expert) on the standard of practice for physician communications during the COVID-19 pandemic. Dr. Trozzi led his own evidence including written submissions and scientific reports challenging the consensus public health position on COVID-19 vaccines. Cross-examinations included extensive engagement with the underlying scientific evidence.

The OPSDT findings on the merits (November 2023). The OPSDT found Dr. Trozzi:

• Engaged in professional misconduct by failing to maintain the standard of practice of the profession
• Engaged in disgraceful, dishonourable or unprofessional conduct
• Was incompetent in the practice of medicine

The misconduct findings included specific conduct: promoting ivermectin as a COVID-19 treatment without adequate scientific basis; making public statements asserting the COVID-19 vaccines had not met appropriate safety and efficacy standards; issuing medical exemptions from COVID-19 vaccination requirements without adequate clinical basis; failing to cooperate with the CPSO investigation; and engaging in uncivil discourse with the regulator and others.

The OPSDT penalty decision (January 2024). The OPSDT imposed the most severe sanction available under the Health Professions Procedural Code: revocation of Dr. Trozzi’s certificate of registration. Costs were ordered against him. The penalty reasons reflected both the gravity of the underlying conduct and the additional weight of the non-cooperation findings. The penalty decision is the subject of my earlier post on the COVID-era cluster, Trozzi and Luchkiw: CPSO Revocation and Suspension for COVID Misconduct.

The Divisional Court appeal (October 2024 hearing). Dr. Trozzi exercised his statutory right of appeal under section 70(1) of the HPPC to the Divisional Court of the Superior Court of Justice of Ontario. The appeal was heard on October 8, 2024 before a three-judge panel (Newton RSJ, Myers J, and Shore J). The Divisional Court’s reasons for decision were released on November 1, 2024 — somewhat earlier than the typical Divisional Court timeline, which itself signalled the Court’s confidence in the outcome.

The current decision — 2024 ONSC 6096. The appeal was dismissed on every ground. Costs were ordered against Dr. Trozzi. The OPSDT’s findings of misconduct and the penalty of revocation now stand as the final disposition. Subsequent communications from Dr. Trozzi’s counsel have indicated an intention to seek leave to appeal to the Ontario Court of Appeal; as at the date of this post, no such leave has been reported as granted.

The standard of review framework

Statutory appeals from administrative tribunals are governed by the framework articulated by the Supreme Court of Canada in Canada (Minister of Citizenship and Immigration) v Vavilov, 2019 SCC 65. The framework distinguishes between:

• Questions of law — reviewed on the standard of correctness
• Questions of fact and mixed fact and law — reviewed on the standard of palpable and overriding error

In the discipline context, the further wrinkle is that the appellate court must defer to the specialized tribunal’s findings on matters within its area of statutory expertise — including the assessment of standards of practice and the calibration of disciplinary sanctions. The deference is not unlimited; the tribunal must apply the correct legal framework, and where it does not, the appellate court will intervene.

The Divisional Court in Trozzi v CPSO applied the Vavilov framework to Dr. Trozzi’s appeal. The grounds raised mostly engaged questions of fact or mixed fact and law (the application of the legal standard to the specific evidence), where the palpable and overriding error standard applies. The legal questions on which correctness applied — the proper interpretation of the Doré v Barreau du Québec framework, the threshold for CPSO investigation, the effect of legal advice on the duty of cooperation — were addressed on correctness review and decided against Dr. Trozzi.

The standard of review framework matters for any prospective appeal. Where the tribunal’s reasons engage its specialized expertise, the appellate court will defer absent palpable and overriding error. Where the tribunal applies a wrong legal framework, the appellate court will intervene. The Divisional Court found neither error in Trozzi.

The Doré framework

The Supreme Court of Canada’s decision in Doré v Barreau du Québec, 2012 SCC 12, is the operative framework for assessing whether a regulator’s disciplinary decision that engages a Charter right is consistent with the Charter. The framework is calibrated to the administrative law context. Rather than applying the formal Oakes v R, [1986] 1 SCR 103, proportionality test (which applies to legislative limits on Charter rights), Doré requires an administrative decision-maker to:

1. Consider the statutory objectives engaged by the decision
2. Consider the Charter values at stake
3. Balance the two proportionately
4. Reach a decision that gives effect to the statutory objectives while limiting the Charter value no more than necessary

The framework has been developed in subsequent cases including Loyola High School v Quebec (Attorney General), 2015 SCC 12 (religious freedom and school regulation); Law Society of British Columbia v Trinity Western University, 2018 SCC 32 (religious freedom and law society accreditation); Groia v Law Society of Upper Canada, 2018 SCC 27 (freedom of expression and incivility in court); and Law Society of Saskatchewan v Abrametz, 2022 SCC 29 (procedural rights and discipline delay).

In Trozzi, the Charter value at stake was freedom of expression under section 2(b) of the Canadian Charter of Rights and Freedoms. Dr. Trozzi was disciplined in part for his public statements about COVID-19 vaccines and public health policies. The framework requires the OPSDT to weigh the statutory objectives of physician discipline (public protection, the integrity of the profession, accurate clinical information for patients and the public) against Dr. Trozzi’s freedom to express views including views that depart from accepted public health guidance.

The Divisional Court’s analysis affirmed the OPSDT’s application of the Doré framework. The reasoning, distilled:

• The public protection objective of physician discipline is substantial, particularly during a public health emergency
• Physician statements carry weight with the public because of the physician’s professional standing
• Statements that promote unproven treatments or that contradict accepted public health guidance during a pandemic engage a meaningful risk of public harm
• The regulator’s response (discipline up to and including revocation in serious cases) is proportionate to the harm risk
• The Charter value of freedom of expression is respected — physicians retain the right to engage in legitimate scientific debate and to express disagreement through professionally appropriate channels — but the regulator can limit speech that engages public protection concerns

The framework is not a free hand for the regulator. It requires the OPSDT to actually engage in the balancing analysis and to articulate the reasons. Where the OPSDT does so within a range of reasonable outcomes, the Divisional Court will defer. Where it does not, the appellate court will intervene. The Court in Trozzi found the analysis was done; the appellate intervention point was not engaged.

The “non-binding policies as evidence of standard of care” principle

One of Dr. Trozzi’s substantive arguments was that the CPSO’s COVID-19 statements and policies were non-binding recommendations rather than binding rules or regulations. He argued the OPSDT therefore erred in applying them as standards against which his conduct could be measured.

The Divisional Court rejected the argument. The reasoning has implications well beyond the COVID-19 context:

• The standard of practice of the profession is assessed against the totality of relevant evidence
• Published clinical guidelines, regulatory policy statements, professional society recommendations, and consensus public health guidance are all relevant evidence of accepted practice
• The non-binding character of such guidance does not deprive it of evidentiary value in assessing the standard
• A physician departing significantly from such guidance must be prepared to defend the departure on the available evidence
• The departure does not automatically constitute misconduct; the question is whether the departure was reasonable in the circumstances

The principle parallels longstanding common law on the use of clinical guidelines in malpractice litigation. Guidelines are evidence, not law. They are not dispositive but they are highly probative. The same analytical framework operates in the discipline context.

For physicians, the operational implication is that compliance with published guidance is not just a clinical question but an evidentiary one. Departure from guidance is permissible but the departure needs to be reasoned, documented, and defensible. For regulators, the implication is that the framework allows for principled departure from guidance while still maintaining accountability where the departure is unreasonable.

The investigation threshold

A further argument raised by Dr. Trozzi was that the CPSO needed “reasonable and probable grounds” — the criminal investigation threshold — before commencing a regulatory investigation. The Divisional Court rejected this.

The HPPC framework for investigation initiation is different from the criminal investigation framework. Under section 75 of the HPPC, the CPSO Registrar may appoint an investigator where the Registrar has reasonable grounds to believe that the member has committed an act of professional misconduct or is incompetent. The threshold is regulatory, not criminal. The “reasonable and probable grounds” formulation that applies in criminal law (and that requires both reasonable belief and the additional probability dimension) does not apply.

The reasoning is grounded in the protective purpose of regulatory investigation. The regulator’s role is preventive — protecting the public from potential harm before the harm crystallizes. A criminal-standard threshold would frustrate the protective purpose by requiring near-certainty before the regulator could even look into a matter. The regulatory standard is calibrated to allow the investigation to occur where reasonable grounds to believe exist, with the substantive determination of misconduct following the investigation.

The principle has implications beyond the Trozzi case. Any physician facing a CPSO investigation should be aware that the threshold for opening the investigation is lower than the threshold for finding misconduct. The investigation can proceed on the basis of reasonable grounds; the substantive finding requires evidence on the balance of probabilities (a higher standard).

The non-cooperation duty and the legal advice defence

The doctrinal centerpiece of the Divisional Court’s analysis — and the point most likely to be cited in future cases — is the rejection of reliance on legal advice as a defence to non-cooperation with regulatory investigation.

Dr. Trozzi’s argument was that his refusal to cooperate with the CPSO investigation was based on legal advice from counsel. The argument was structured as a kind of equitable defence: he had acted reasonably by relying on professional advice, and the consequences of that advice should not fall on him personally. The Divisional Court rejected the argument:

• The duty of cooperation under sections 75-76 of the HPPC is a statutory duty
• The statutory duty applies to the physician personally; she cannot delegate the obligation to counsel
• Where counsel advises a physician to refuse to cooperate, the physician faces a choice: follow the advice and risk the consequence, or comply with the statutory duty
• Reliance on legal advice does not transfer the consequence to counsel
• The physician remains accountable for the failure to comply

The principle connects directly to CPSO v Kilian, where the OPSDT addressed the production-of-records dimension of the same issue. The two cases together stand for the proposition that the duty of cooperation is foundational, that constitutional and other legal arguments can be raised through the proper procedural channels, but that refusal to cooperate while those arguments are being developed is itself professional misconduct.

The framework has practical implications for any physician facing a regulatory investigation. The advice that “you don’t have to cooperate until you’ve challenged the legality of the investigation” is, at best, advice to incur an additional layer of professional discipline exposure on top of whatever the underlying investigation is about. The cost of refusal can substantially exceed the cost of compliance even where the underlying conduct under investigation might have produced a less severe sanction on its own.

The expert evidence analysis

A significant portion of Dr. Trozzi’s appeal challenged the OPSDT’s handling of expert evidence. The argument: the Tribunal had failed to consider his own scientific reports (which his counsel asserted contained over 160 peer-reviewed citations); it had failed to engage with his cross-examination of the CPSO’s expert (Dr. Andrew Gardam), during which his counsel asserted Dr. Gardam had made concessions favourable to Dr. Trozzi; and it had improperly preferred the CPSO’s expert evidence over Dr. Trozzi’s.

The Divisional Court applied the deferential standard appropriate to a tribunal’s findings on expert evidence. The Tribunal is the trier of fact and is entitled to assess credibility, weight, and the relative persuasiveness of competing expert evidence. The appellate court intervenes only where there is palpable and overriding error.

The Court found no such error. The Tribunal had:

• Heard both experts
• Considered the underlying scientific evidence presented through both
• Made findings about the standard of practice based on the evidence as a whole
• Articulated its reasons in a way that demonstrated engagement with the evidence

The Court was not required, on appellate review, to retry the underlying scientific debates. Whether ivermectin is or is not an effective treatment for COVID-19 was not a question the Divisional Court needed to decide. The question was whether the OPSDT had properly applied the standard of care framework to the evidence before it, and the Court found that it had.

The principle is broadly applicable to expert evidence in regulatory proceedings. The tribunal’s job is to apply the standard of care framework, not to act as an arbiter of contested scientific debates. The tribunal is entitled to rely on the consensus expert evidence in determining the standard; physicians who depart from consensus carry the evidentiary burden of justifying the departure.

The “ungovernable physician” framework on appeal

The Trozzi case is part of the broader “ungovernable physician” framework that I addressed in detail in CPSO v Kilian. The framework holds that a physician who refuses to engage with the regulatory process — who refuses to produce records, who refuses to attend interviews, who refuses to acknowledge the regulator’s jurisdiction — engages in professional misconduct on that basis alone, independent of any clinical conduct findings.

The Divisional Court’s affirmation of the OPSDT findings against Dr. Trozzi gives the framework further appellate-level support. The Court accepted that:

• The OPSDT was entitled to find professional misconduct based on the non-cooperation findings even apart from the clinical conduct findings
• The combined effect of the clinical misconduct findings and the non-cooperation findings supported the most severe available penalty (revocation)
• The proportionality of revocation was within the range of reasonable outcomes for the combined misconduct

The framework now operates across the cluster:

• Trozzi — OPSDT revocation, Divisional Court affirmation (the principal articulation)
• Luchkiw — OPSDT substantial suspension
• Kilian — OPSDT 12-month suspension, the production-of-records dimension
• Kustka — OPSDT penalty (June 2025)

Together these cases form what is now a substantial body of Ontario administrative law on the duty of regulatory cooperation in the discipline context. The doctrine is not specific to COVID-19; it applies to any context in which a regulated professional refuses to engage with the regulator.

What about freedom of expression?

A question that any reader will have at this point: doesn’t physician speech enjoy the protection of section 2(b) of the Charter? The short answer is that it does — but the Doré framework explicitly contemplates that the protection is not absolute and that regulators may limit physician speech where the limit is proportionate to a legitimate regulatory purpose.

The longer answer requires distinguishing several scenarios:

Pure scientific debate. A physician who engages in legitimate scientific debate about the safety or efficacy of a particular intervention, through peer-reviewed publication, conference presentation, or other professionally appropriate channels, is engaging in protected speech that the regulator cannot ordinarily restrict. The framework supports robust scientific debate within the profession.

Public commentary on policy. A physician who engages in public commentary on health policy — supporting or criticizing public health measures, advocating for particular approaches, contributing to public deliberation — is engaging in expression that the regulator can restrict only where the regulatory interest is substantial and the restriction is proportionate. The framework supports physician participation in public discourse but recognizes the regulator’s role in calibrating the boundaries.

Statements that engage clinical care. A physician who makes public statements that affect patient clinical decisions — encouraging patients to refuse evidence-based treatment, promoting unproven treatments, issuing medical advice not grounded in accepted practice — engages a much stronger regulatory interest. The framework permits substantial regulatory intervention in this context.

Statements that constitute clinical misconduct. Where a physician’s public statements amount to the provision of substandard care to identifiable patients (for example, by issuing unjustified medical exemptions or by making clinical recommendations that depart materially from accepted practice), the regulator can treat the statements as direct evidence of clinical misconduct. This was a substantial part of the OPSDT’s analysis in Trozzi.

The Doré framework operates across all four scenarios but calibrates differently in each. The Trozzi case engaged the third and fourth scenarios most directly; the regulator’s response was proportionate to the public protection concern those scenarios engaged.

Costs

A practical feature of the Divisional Court decision that is worth noting: the Court ordered costs against Dr. Trozzi. Costs in Divisional Court appeals can be substantial, particularly where the appeal raised constitutional and other complex legal arguments that required extensive responding submissions from the College’s counsel.

The costs order is a meaningful additional consequence of the appeal. Beyond the loss of the licence, the physician now faces a costs liability potentially in the tens of thousands of dollars (or more, depending on the assessment). The combined consequences of OPSDT costs, Divisional Court costs, and the loss of practice income over years are substantial.

For any physician considering whether to pursue an appeal of a discipline decision, the costs framework is part of the strategic calculus. An unsuccessful appeal compounds the financial consequences. A successful appeal can produce a costs award in the physician’s favour, but the path to a successful appeal in the COVID-era cases has been narrow.

The doctrinal lessons

The case stands for several propositions.

The Doré framework operates in physician discipline. Physician speech is protected by section 2(b) of the Charter but is subject to proportionate regulatory limits where the limits are calibrated to legitimate regulatory purposes. The framework requires the regulator to engage in proportionality analysis; where the regulator does so within a range of reasonable outcomes, the appellate court defers.

Public health emergency context supports robust regulatory intervention. During a public health emergency, the regulatory interest in accurate clinical information and public protection is heightened. The proportionality calculus accordingly permits more robust intervention than would apply in non-emergency contexts.

Non-binding policies inform the standard of care. Published clinical guidelines, regulatory policy statements, and consensus public health guidance are all evidence of accepted practice. Their non-binding character does not deprive them of evidentiary value. Physicians who depart from such guidance carry the evidentiary burden of justifying the departure.

The regulatory investigation threshold is regulatory, not criminal. The CPSO can open an investigation on reasonable grounds to believe that misconduct has occurred. The criminal “reasonable and probable grounds” standard does not apply.

Reliance on legal advice does not excuse non-cooperation. The statutory duty of cooperation under sections 75-76 of the HPPC applies to the physician personally. Counsel advising refusal to cooperate produces an additional layer of professional discipline exposure for the physician.

Expert evidence is for the tribunal to assess. The appellate court does not re-try the underlying expert debates. Where the tribunal has properly applied the standard of care framework to the evidence, the appellate court defers.

Costs follow the unsuccessful appeal. The costs framework in Divisional Court appeals is a meaningful additional consequence. Physicians considering appeals should incorporate the costs risk into their strategic calculus.

The “ungovernable physician” framework now has appellate support. The Divisional Court’s affirmation of the OPSDT findings against Dr. Trozzi confirms the framework at the appellate level. Future cases involving non-cooperation will be analyzed within this established framework.

Why this case matters

For physicians. The boundaries of physician speech under the regulatory framework are now substantially clarified. Engagement in legitimate scientific debate through professionally appropriate channels remains protected. Public statements that engage a meaningful risk of public harm — by promoting unproven treatments, by contradicting accepted public health guidance on matters affecting clinical care, by issuing unjustified medical exemptions — are within the regulator’s reach. The framework is not asymmetric; the regulator must engage in proportionality analysis and must articulate its reasons. But the proportionality analysis has been performed thoroughly in Trozzi and the result was upheld on appeal.

For regulatory counsel. The case provides a comprehensive appellate authority on the application of Doré to physician discipline involving public statements. Future discipline proceedings involving similar issues will have a clearer doctrinal foundation. The case also reinforces the framework for opening regulatory investigations, the use of non-binding policies as evidence of standard of care, the duty of cooperation, and the management of expert evidence.

For counsel advising physicians. The case clarifies the legal advice defence to non-cooperation: it does not exist. Counsel advising a physician to refuse to cooperate with a regulator must understand that the consequences fall on the physician, not on counsel. The strategic calculation needs to incorporate that reality.

For prospective patients and the broader public. The case confirms that the regulatory framework in Ontario is robust enough to address physician conduct that exposes the public to risk. The framework operates with appropriate procedural protections (the right to a hearing, the right to expert evidence, the right to appeal) but the substantive boundaries are real. Physicians who depart materially from accepted practice during a public health emergency face meaningful regulatory consequences.

For more on the patient-facing side of regulatory complaints, see A Patient’s Guide to Making Complaints About Health Care in Ontario. For the broader COVID-era discipline cluster, see Trozzi and Luchkiw: CPSO Revocation and Suspension for COVID Misconduct and CPSO v Kilian.

Cluster integration

The COVID-era physician discipline cluster (four cases at the OPSDT level, two at the appellate level):

• Trozzi — OPSDT revocation; Divisional Court affirmance (this post)
• Luchkiw — OPSDT substantial suspension
• Kilian — OPSDT 12-month suspension; Kilian v CPSO, 2024 ONCA 52 (Court of Appeal on s. 87 framework)
• Kustka — OPSDT penalty (June 2025)

The “ungovernable physician” framework:

• Trozzi (principal articulation, now with Divisional Court appellate support)
• Kilian (production-of-records application)

The Doré framework in physician discipline (new appellate authority):

• Trozzi v CPSO — the principal Ontario appellate articulation

The non-cooperation framework:

• Trozzi (legal advice defence rejected on appeal)
• Kilian (production motion dismissed at OPSDT level)

The regulatory framework cluster:

• A Patient’s Guide to Making Complaints About Health Care in Ontario (patient-facing)
• Trozzi and Kilian (physician-facing discipline)

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Decision Date: November 1, 2024

Jurisdiction: Divisional Court of the Superior Court of Justice of Ontario (statutory appeal from the Ontario Physicians and Surgeons Discipline Tribunal)

Panel: Newton RSJ, Myers J, and Shore J

Citation: Trozzi v College of Physicians and Surgeons of Ontario, 2024 ONSC 6096 (CanLII)

Outcome: Appeal dismissed on every ground. The OPSDT’s findings of professional misconduct, dishonourable conduct, and incompetence affirmed. The penalty of revocation affirmed. Costs ordered against Dr. Trozzi.

Key authorities: Doré v Barreau du Québec, 2012 SCC 12 (proportionality framework for administrative decisions engaging Charter values); Loyola High School v Quebec (Attorney General), 2015 SCC 12; Law Society of British Columbia v Trinity Western University, 2018 SCC 32; Groia v Law Society of Upper Canada, 2018 SCC 27; Law Society of Saskatchewan v Abrametz, 2022 SCC 29 (development of the Doré framework); Canada (Minister of Citizenship and Immigration) v Vavilov, 2019 SCC 65 (statutory appeal standard of review framework); Health Professions Procedural Code, ss 25.4, 70(1), 75-76, 87 (statutory framework); Canadian Charter of Rights and Freedoms, ss 1, 2(b).

Related citations: Kilian v College of Physicians and Surgeons of Ontario, 2024 ONCA 52 (Court of Appeal on s. 87 framework); College of Physicians and Surgeons of Ontario v Kilian, 2024 ONPSDT 23 (OPSDT motion ruling on production of records); Kilian v College of Physicians and Surgeons of Ontario, 2025 ONSC 2829 (interim order patient harm framework).