Life or Limb
A collaborative policy that ensures accountability for the most vulnerable patients
The Ministry of Health and Critical Care Services Ontario (CCSO) developed the Life or Limb Policy (2013) in response to recommendations from the Office of the Chief Coroner for a provincial “no refusal” policy when critical injuries or conditions of threatened life or limb are involved. The purpose of the Life or Limb Policy is to facilitate timely access and transfer of patients who have an episode of time-sensitive, treatable, and critical illness (i.e., are life or limb threatened), to an appropriate level of acute care services for interventions that would improve patient outcomes (loss of life or limb is certain if transfer does not occur within 4 hours).
In 2025, following extensive engagement with health system providers, clinicians and patient and family advisors from each region of the province, CCSO, now a part of Ontario Health, has updated the Life or Limb Policy. The Life or Limb Policy ensures accountability for access to care for the sickest, most vulnerable critically ill patients, and promotes the patient’s clinical condition as a priority. No patient with a life or limb threatening condition who might benefit from transfer to a centre capable of providing an appropriate intervention will be refused care.