What is the standard of review for the second issue in a medical malpractice case?

The standard of review for the second issue must be determined by the pragmatic and functional approach. This involves consideration of four factors: the presence or absence of a privative clause or statutory right of appeal; the expertise of the tribunal relative to that of the reviewing court on the issue in question; the purpose of the legislation in question, as well as the purpose of the particular provision in question; and the nature of the question (Dr. Q v. College of Physicians and Surgeons of British Columbia, 2003 SCC 19).