It's been a turbulent year for the Canadian medical system: debates over physician-assisted suicide, efforts to improve trans health care and abortion access, and the uncovering of bunk supplements and prescriptions are just a few of the highlights that made the last twelve months so notable. With so much news to clear through, we broke down some of the major issues for health care in Canada in 2015.
Earlier this year, the Supreme Court ruled that terminally ill patients have the right to ask a doctor to help them die. It's a decision that marked the end of a battle that started over two decades ago with the case of Sue Rodriguez, a woman suffering from amyotrophic lateral sclerosis—also known as Lou Gehrig's disease—who asked to have her life ended with the help of her doctor. At the time, she lost the case with a ruling of 5-4 and ultimately ended up defying the court by having a physician and friend—former NDP politician Svend Robinson—help her commit suicide in 1994.
In February of this year, 22 years after the original ruling, the Supreme Court came to a unanimous decision to allow physician-assisted suicide, and they have given the government until February 2016 to formulate a precise strategy as to how they'll legislate the matter. The court cited "sanctity of life" as guaranteed by the charter as what was being violated by forcing someone to live in pain.
"A person facing this prospect has two options: she can take her own life prematurely, often by violent or dangerous means, or she can suffer until she dies from natural causes. The choice is cruel," the opening statement on their decision reads.
Since the word came down, debate over how physician-assisted suicide should be handled has been fervent. For one, the Council of Canadians with Disabilities and the Canadian Association for Community Living, two organizations that have generally advocated for a ruling in favor of physician-assisted death, criticized the ruling for having language that allowed the new law to be too broad.
"As we each near the end of our lives, at the time when we are likely to be most vulnerable to despair and fear, we have now lost the protection of the Criminal Code. Where shall we now find that protection? CCD and CACL caution that our collective response to this question must go far beyond the technical exercise of so-called "safeguards," a joint statement read.
While it's unclear exactly how the new Trudeau government will form legislation following the decision, the Liberals have asked for a six-month extension on the February 6, 2016 date ordered by the Supreme Court due to what the federal government says is a "very high level of legal uncertainty" created by the original ruling. Despite the wait on the federal level, Quebec has passed law that legalizes physician-assisted dying in the province, putting it at odds with the current Liberal government. The law, which went into action December 10, is unlikely to go unimpeded, considering it is already being challenged by the courts.
Trans Health Care
2015 was also a big year for trans health care, even if much of the time was spent on a battle for awareness surrounding the issues facing the trans community. One of the most pressing issues was access to sex reassignment surgery. In Ontario, this access has been notoriously bottlenecked. Currently, prospective patients looking to have OHIP-funded surgery done need to go through a mental and physical assessment, and the only mandated place that can do so is CAMH in Toronto.
Not only is this a problem geographically—as those in remote areas have to travel a very long distance just to get a check-up—but the wait list to get greenlit for the treatment is absurdly long, sometimes stretching up to three years. In many cases, this forces trans individuals to have to pay for the expensive surgery themselves through a private clinic. In other, more worrying cases, there is data to support that self-surgeries have been performed out of a desperate need for treatment.
In November, Ontario Health Minister Dr. Eric Hoskins pledged to expand the number of facilities that will be able to greenlight reassignment surgery, with the possibilities of hundreds of facilities getting referral capabilities by some point next year.
"One of the most vulnerable times for trans people is when they are ready for surgery, but face a prolonged wait," said Hoskins. "This change would reduce wait times by allowing many trans clients to get surgical approvals from their own local primary care teams."
VICE looked into the issue of access to surgery earlier this year in the documentary On Hold, which examines the state of trans health care in Canada. Outside of access to reassignment surgery, the doc explored issues such as trans individuals having poor access to transitional hormones and the lack of publicly-funded procedures in New Brunswick. The new Liberal government hasn't yet proposed anything solid when it comes to addressing trans health care at a federal level.
In July, a VICE documentary highlighted the severe restrictions for women trying to access abortions in the Maritimes. The restrictions have lead many women to performing their own DIY abortions, or having under-the-table physicians perform makeshift abortions for them, and more recently, PEI women have been redirected to Moncton, NB,via a toll-free hotline in order to have abortions performed.
This situation unfortunately hasn't changed. To this date, PEI offers no route for women to get safe and legal abortions. But the new federal Minister of Health told CBC News in November that abortion access needs to be expanded, and the the Liberal government will look at ways of expanding access. The minister didn't go into detail as to how this would be achieved (not to mention the fact that health care is handled on a provincial level.)
Medical Record Snooping
After reports over the last year showed that Canadian hospitals were not only failing to protect the medical records of patients, but had employees who were actively digging into said records—the most notable of which being those of crack-smoking former Toronto mayor Rob Ford—red flags began to pop up all over the medical system. The Toronto Star found that records were not only being stolen en masse, but that certain employees were actually selling the personal information of patients for profit.
The case of Shaida Bandali, a 61-year-old clerk from Rogue Valley Hospital, ended with the hospital worker pleading guilty for forking over thousands of medical record to financial brokers over 12 years. Bandali was selling the records for $1 to $2.75 a piece and netted at least $12,000 [$8,000 USD] in the 22 months she was investigated, although it's unclear how much she made over more than decade-long period she was running the scheme. Bandali plead guilty in August, was fined $36,000 [$25,000 USD] and was placed on two-year probation.
More notably is the legal battle started by a Peterborough resident who sued for an unauthorized access of their medical records. They won the case, and the Ontario Court of Appeal ruled that future class action lawsuits against hospitals that fail to protect the information of their patients are fair game. This could spell trouble for hospitals in other provinces that have been caught of the same thing—see Alberta, which has hit a "record" number of breaches, according to a privacy watchdog.
Bunk Supplements and Dirty Prescriptions
There's also been the issue of scandals involving drugs and supplements. An investigation released by CBC News in November found that most health supplements on the market—including things like omega-3 fish oil, Vitamin C, and protein powdered—were oftentimes marketed with greatly exaggerated claims or contained amounts that didn't match their label. Health Canada later confirmed that the process for verifying new supplements entering the market is "weak" and that improvement is needed.
In another case of Health Canada fucking up hard, one of the country's largest suppliers of prescription medications was caught for not only packaging possibly-unsafe drugs, but also that the facilities used for producing the drugs—in particular, two that were located in India—were not properly inspected by Health Canada and often allowed for improper use of ingredients. Health Canada was tangled in a legal battle with the drug company until recently, when a judge said that former Minister of Health Rona Ambrose had acted too quickly when she decided to ban importation of any drugs from the company.
Shitty Law Coming to An End
Finally, the blood ban on gay men—which has prevented them from donating blood to the Canadian Blood Services (CBS) for a really long time—was promised to be lifted by the new Trudeau government as soon as possible, and thank fucking god for that. Maybe next will be banning nurses from questioning how old my tattoos are or if I have an infectious disease because of them.
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