Sometimes an injustice is perpetrated that is so venal, that it demands an extra effort of resolve just to overcome the initial despair. That is the case with our front page exclusive this week on the possible Quebec Ministerial Decree that would order cutting Critical Care to our most vulnerable. And the news that at least one major hospital may be going along with it without challenging it’s legality.
If implemented, Quebec would be the first western democratic jurisdiction that would — in effect — have state enforced euthanasia. Not euthanasia in the sense of “Right to Die” laws. Euthanasia in its other legal definition of withdrawing medical care and terminating life. This Decree now under discussion at the highest levels must be stopped in its tracks. If not, let political and medical authorities be warned that there will be blood on their hands. Hundreds will die in the first 60 days.
Last December 5th The Suburban broke the story on a Health Ministry protocol that would limit intensive and emergency care as well as surgeries in cases where ICUs and ERs reach 150% capacity during the pandemic. The protocol called for hospitals to form three-person committees whose mandate is to review and reject extending intensive care and emergency room intensive care to anyone who did not meet a 70% “survivability” threshold. The quantification of that 70% was left undefined and subjective. It also had provisions on terminating intensive and emergency intensive care of exiting patients. A separate protocol is included even for infants and newborns.
Concerns were raised at the time that the protocol would discriminate against seniors, survivors of cancer and other serious illnesses and people with existing cardiac and other chronic conditions because age and health would be used by the committees against potential patients reaching the percentage threshold. The protocol itself includes a paragraph that states that, “..no decision under this protocol may be taken if it violates Charter protections against discrimination based on race, colour, creed, religion, gender, physical handicap or age.” Section 7 of the Charter of Rights and Freedoms guarantees the protection of the “right to life.” However next to the word age there was a bracketed phrase that read “unless a law or regulation allows it.” At the time many legal experts warned that the “survivability” percentage though not an overt discrimination based on age amounted to the same thing because with age come infirmities that would inevitability hold seniors below the required threshold and the Protocol was a covert age-based discriminatory document.
But as long as the Protocol retained its status as a guideline document leaving final decisions to attending physicians, health care accessibility was unaffected. All that changed last Wednesday. After press time, The Suburban received a call from a reliable and senior source in the Montreal medical community about a virtual meeting that had been held at the MUHC. The meeting included doctors representing from the various constituent hospitals of the MUHC and was reportedly directed by the MUHC’s assistant director-general and its director of professional services. They informed the assembled that the MUHC had begun implementing some of the Protocol including training the three person committees and doing simulation triage on patient admissions and exclusions. The attendees were also informed that the MUHC expected the other hospitals to follow suit. The Suburban source reported that objections were raised immediately both on grounds of conscience and lack of necessity. The MUHC representatives’ answer was that preparation was necessary because the Protocol may soon be mandatory through the force of Ministerial Decree to be signed possibly in the next few weeks by the Quebec Minister of Justice.
We encourage all of you to contact your MNAs, your doctors and the Users Committees of your hospitals and let them know in no uncertain terms that this must not pass. We at this newspaper leapt into action when we heard the news and we have not stopped. We have contacted government officials, hospital administrators, doctors and some of the leading legal experts in this field. We have encouraged the lawyers and doctors to make their views public. Going on the record through overt opposition to this will make the government reject the Decree. We have dedicated our oped page this week — and will continue — to some of the boldest and bravest professional voices in this province. We have encouraged hospitals to seek injunctive relief in the Courts from this Decree if it is signed.
But all the eloquence and knowledge alone will not stop this. It is you who must engage. For your voices represent votes to the politicians. Only your force can break through the bodyguard of lies the bureaucrats who wrote the original Protocol are using to push the idea of a Decree. It’s about saving money for the government. Nothing more noble than that. In speaking with a half dozen major hospitals, they have all told us there is no shortage of beds, nor equipment, nor capacity nor even lack of nurses. It is true that nurses are not coming into work in full complement, but only by about 5%.
It is beyond comprehension why Premier Legault acted to ensure full staffing for seniors residences last spring by doubling salaries and calling in the Canadian Forces but has been so lax on the nursing situation in hospitals. Mr. Premier, while you are negotiating with the nurses, call in the medical staff from the Forces again. You don’t need this Decree. Hospitalizations and deaths are down 90% from last spring in relation to positive tests. Hospital stays now average 96 hours not two weeks due to greater understanding of the virus and effective therapeutics. And positive tests themselves have dropped almost 50% from last Wednesday to today going from 2600 to 1400 as we were told they would by one hospital director who has not been afraid to challenge “accepted wisdom.” There is no excuse for a Decree unless it is a fabricated one.
Let our legacy from this horrible period be one of compassion and courage as symbolized by the words and actions of Dr. François Marquis, Director of Intensive Care at Maisonneuve-Rosemont, the first to speak out against this when he boldly said, “I was not raised for this nor trained for this. I will not be someone who will pull out a breathing tube.”