The above cited article appeared in the paper on the above date and it outlined some of the inequities in the health system in Ontario. In one sentence: a man was told, after deciding against care for his cancer-stricken 91 year old mother, that he had “...five business days...” to pick from five long-term-care homes for his mother.
So this man is in crisis: his mother will likely not survive her cancer, and he now has to navigate the system. Then he was “...stunned to discover, he says, that he had been misinformed and given inadequate information about how to select a home by a hospital social worker and a case manager from one of the province’s 14 community care access centres...” In other words, he was lied to, and that by hospital staff.
“Cohen discovered he did not have to choose as many as five homes, including three with short waits. Nor did he have only five days to make a decision. Nor was he limited to choosing only from the list of homes he was given at the hospital.” This was from his own research into the Long-Term Care Homes Act, according to the article. So, again, he was lied to. Cohen says, “I felt pressured, there is no question about it, in trying to make a decision...” Cohen is a doctor himself.
The spokes representative for North York General Hospital “...says privacy laws prevent him from discussing individual patients.” So the hospital has the information, but they are hiding it – a public lie by omission. However, he calls this pressure “...a process in place to “encourage” patients to temporarily move to Long Term Care homes...” So the encouragement described is experienced as pressure and coercion, and this is on top of lies and inadequate information given to the family.
As Jane Meadus, “...a lawyer with the Advocacy Centre for the Elderly” says,
“The rules are being broken. People are being lied to, no question. They are being told they have to do things that are not in accordance with the law, in order for hospitals to get them out of beds.”
The probable reason is to save money. According to Janice Gross Stein in her book The Cult of Efficiency, patients are now considered statistics and if they go over the prescribed limit, they are negative statistics. [Stein, 2002:2] This means that money rules the care people are given, which is the incentive for hospitals to lie as part of their standard operating procedure. That probably won’t stop generous administrative bonuses from being paid out. According to the Star article, “...many ailing seniors are wrongly told they must go home from hospital before they can even apply to a nursing home...”
Cohen also had a conflict when he chose a care home with a long wait; the same hospital staff who initially gave him his options resisted until he apparently showed them his data from research. There are issues with access to long-term care, but most patients in long term care homes die after three years, according to the Star report. As well, according to this Star report, Cohen’s mother is still waiting for a bed – a year later.
I would like to know, since lies and misinformation are standard in this story, why it is that people think medically provided death is a good idea. If this is what happens to patients like Cohen’s mother – with dementia and complicated health concerns – what would happen to ‘simpler’ cases? What would happen if cases are considered according to if they are negative or positive statistics?
Remember, this is a man in crisis who is himself a doctor. He was lied to, despite being part of the medical profession. He had to do his own research to discover the lie and use that research to defend his dying mother. Yes, the woman could have gone to another home with a shorter wait list, but her ailments probably precluded it. However, remember a few things:
· Cohen was lied to at the outset
· He was not told his options
· He spoke to staff at the hospital where is mother is to this day
· He had to navigate all this new information while in a crisis situation
If this is the case in Cohen’s situation, what would it be like if we had medically provided death? Likely, this would become the only option and other options would be ignored, refused or downplayed, taking advantage of family members in crisis. And doctors are not required to tell patients the whole truth according to Tim Falconer in his book That Good Night: “I think that many Canadians have been surprised to learn that a doctor can make a ‘do not resuscitate’ order without the consent of a patient or his or her family, yet that appears to be the current state of the law in Canada, Britain and the United States.” [Falconer, 2011:44]
And by the way, North York General rates a ‘B’ according to the CBC website “rate my hospital.”
That good mark is surprising, given what we just learned. Yet sadly, this story highlights the power imbalance between patient, family and the medical profession. The rules exist to assist and protect those who break them, not those who are victimized by them. Our system needs a sensitive, democratic overhaul wherein those most impacted – the ailing and disabled – get the primary say in care – something not likely to happen if Ontario adopts something akin to Quebec’s proposed Bill 52. But we won’t talk about that, either, will we? And we should be talking...loudly and in defense of the sick and weak. Time to speak up.