Medical Issues

LawNewsPolitics

UPDATE: The Quebec Court of Appeal ruled today that Bill 52 can go ahead

In 2013, Bill 52 – An Act respecting end-of-life care was introduced to the Quebec National Assembly. The purpose of the bill is to recognize the primacy of a person’s right to choose what kind of care he receives from health professionals including the right to end his suffering through medically assisted suicide. The Bill was adopted by the National Assembly which voted 94 in favor, 22 against. It came into force this month.

Under the new law, any adult capable of consenting to care can withdraw their consent or refuse to receive life-sustaining treatments or procedures and this refusal or withdrawal can be expressed by any means. The attending physician has to provide the person with all the information required particularly with regards to therapies and palliative care in order to allow them to make an informed decision and ensure that said decision is made freely.

Medical aid in dying can only be provided to adults in Quebec who qualify for medicare, suffer from a serious illness, are in an advanced state of irreversible decline, and suffer from “constant and unbearable physical or psychological pain which cannot be relieved in a manner the person deems tolerable.” The consent can only be provided by the person suffering in a free and informed manner and has to be done via a form that will be prescribed by the Quebec Health Minister. It has to be signed in the presence of a health or social service professional who also has to sign it.

Before the doctor administers the aid in dying, he has to agree that the person meets all the medical requirements and has to make sure that the request was made “freely and without any external pressure” and that the decision is an informed one. The doctor doesn’t have to discuss the patient’s decision with his close relatives unless the patient asks him to. If the physician decides all those criteria are met, he must then consult with a second doctor who is independent of the patient and himself in order to make sure the patient meets the medical requirements for assisted suicide.

If all this checks out, the doctor must then administer the aid personally and take care of the patient until death. The patient can withdraw their request at any time, and doctors are allowed to opt out of administering said aid, in which case the director of professional services must find another doctor to do it.

Though the Act has passed the legislature and received royal assent, the law is facing legal challenges by opponents concerned about the ramifications of medically assisted suicide. Though the law affects only Quebec, the issue has become a national one. In February 2015 the Supreme Court of Canada in Carter v. Canada (Attorney General) ruled the articles in the Criminal Code prohibiting medically assisted suicide unconstitutional and struck them down.

The Criminal Code states that no one can “consent to having death inflicted on him” and that such consent does not negate the criminal responsibility of the person who killed the consenting individual. Killing a person even with their consent would be considered a homicide and would result in a prison sentence of up to 14 years.

While the Supreme Court agreed that the purpose of the ban on medically assisted suicide – to prevent the abuse of vulnerable people, namely, the ill and weak – is a noble one, the ban also unfairly punished those of sound mind who suffer unbearably and want to end their pain. It leaves the latter in an awkward position of having to take their own lives by their own means, or suffer the debilitating agony of their illness.

The court gave the Federal Government one year to come up with new legislation. That delay expires February 6, 2016 and the Federal Government has since requested a six month extension. In the meantime, the articles in the Criminal Code remain in effect, though Quebec Justice Minister Stéphane Vallée has assured physicians that instructions would be given to prosecutors not to go after doctors offering end of life care.

The most vocal opponents of Bill 52 are Paul Saba, head of the Coalition of Physicians for Social Justice, and Lisa D’Amico, a woman with life threatening disabilities. Together, they went to the courts to prevent the law from going into effect.

A Superior Court ruling on December 1, 2015 suspended certain aspects of Bill 52 stating that they can’t come into effect so long as the Criminal Code articles are still in force. According to Saba, the law places undue emphasis on medically assisted suicide and not on palliative care.

Palliative care is the process by which medical and social service professionals make a patient as comfortable as possible in light of terminal illness and prepare the patient’s family for the impending loss.

Saba’s argument seems to be based on the notion that if palliative care was better, fewer patients would want to die. It unfortunately displays a remarkable lack of sensitivity towards the dying who value their dignity, are exhausted by their illness, sick of the side effects of pain medicines, and feel humiliated by the assistance they need for tasks as basic as wiping one’s ass.

D’Amico’s argument is as simple as calling medically assisted suicide murder. On December 9, 2015 she told CBC that “(M)urder should remain a murder. There’s no reason why a physician could be allowed to kill a person that is sick.”

Unfortunately for D’Amico, the Supreme Court of Canada said that medically assisted suicide isn’t murder, and that proper safeguards such as those that exist in countries like the Netherlands would be effective in order to prevent the abuse of the very people D’Amico is fighting to protect.

Most Canadians support medically assisted suicide, and that includes many of our terminally ill. It comes down to the issue of whether one can really choose to die. As history has proven countless times, people can, so why deny them the choice?

Culture

People are passionate about Movember and fighting cancer. Few things these days bring people together under a common cause. Our strong, natural solidarity to fight for good causes has been  undermined and perverted by greedy jerks. We need to take back our movement.

The Movember movement tries to create a better, more healthy world. Supporters have the purest intentions. It is beautiful when good people come together for a good cause. And us Canadians do it very well.  But, like many good movements, it has been spoiled by greed. Some big business types and their buddies don’t care about us or our movement, they only care about our money.

Our movement has been hijacked by big business. They turned love and solidarity into marketable CancerCure™ campaigns. It’s all corporate. The big shots took it over. These big business big shots brandish CancerCure™ ribbons and slogans on their products and then throw pennies at the cause. They mark CancerCure™ on make-up, ointments, foods with dangerous additives and hormones proven to cause cancer or contain cancer causing carcinogens. People die and they lie. Someone’s making dough.

And what about Big Pharma?

Big Pharma get trucks loads of CancerCure™ money and then they have the nerve to charge an arm and a leg for their lifesaving drugs. Their large profits are criminal. We run marathons, they get obscenely rich, poor Canadians get poorer into debt to treat tumors. Why don’t the Cancercure™ big shots  say anything about that?

Well, they’re in bed with Big Pharma. If they weren’t so obsessed with getting rich and having fancy fundraising festivals we could save millions of lives around the world. Simple diseases could be eradicated if not for the giant inaccessible costs of their drugs and Big Pharma’s greedy lust for profits.

Let’s look at AIDS and Malaria. Poor folks in the third world are dying in droves. If Big Pharma wanted, they could produce enough HIV/AIDs and Malaria medicine to eradicate the disease and end related deaths once in for all. But they don’t. It isn’t profitable. The dead and dying are a lucrative market. Canadians are going into poverty, people in the third world die. Whose winning?

Movember and similar CancerCure™ campaigns have the real potential to change the world, but first the movement needs to stand up for Canadians and people around the world. Big shot Stephen Harper is pushing a new free trade deal with Europe down the throats of Canadians. Patent protection will be increased. Expensive drug treatments will become explosively expensive for longer periods of time. Cancer will cause poverty.

The Movember big shots and their CancerCure™ buddies haven’t said a word.

Whose side are they on?

News

The MUHC (McGill University Health Centre) intends to sell several major properties, including the Montreal Children’s Hospital, the Montreal Thoracic Institute and Royal Victoria Hospital, as a means to offset the cost of constructing the new super-hospital. This strikes me as an unfortunately negligent action on the part of a once well- respected public healthcare organization.

It’s a terrible irony that a hospital gifted specifically to improve public healthcare and foster institutional collaboration would be sold off to the highest bidder to pay for an obsolete super-hospital, itself a testament to illogical centralization and public-sector graft.

The super-hospital is a step in the wrong direction. Experts knew this to be the case twenty years ago when the concept was first discussed – better overall healthcare requires multiple facilities, spread throughout the city.

Specialist hospitals more often than not require specialized design and geographic considerations in order to maximize efficiency. Facilities under construction at the Glen Yards, though large and impressive to look at, will be unable to fully replace the current number of beds. Moreover, the Vic’s widely praised and well-respected maternity ward will likely only be half its current size in the new hospital.

How many more hints do we need? Shuttering the Children’s and Royal Victoria Hospital completely is a bad idea.

While many of us are resigned to thinking that what happens with the Vic is well outside our control, I believe quite the opposite is true. The Vic belongs to the people of Montreal; the land was donated in perpetuity to be used as a hospital and the documents attesting to this still exist.

The Government of Québec has made it clear they have every intention on pressing ahead with this ill-conceived super-hospital project. In my eyes, since the provincial government has been so insistent that we consolidate medical operations in a single site, they can pay for it from general revenue. Selling the Vic to offset the immense cost of the Glen Yards facility is quite simply unethical.

The right of first refusal should therefore be granted to the citizens of Montreal, and I would hope the Anglophone community would lead the charge to prevent the large-scale regression in public healthcare that will come with these closures. After all – Anglo hospitals serve all Montrealers and these closures will affect everyone negatively.

The Vic should therefore be repurposed. Another piece of crucial institutional space, the Children’s, is also in need of major renovations for any future re-purposing, but it’s location, size, space and facilities all make it, much like the Vic, ideally suited to continue on in an institutional role.

Dawson College is nearby and currently renting space in the Forum to deal with over-crowding. The Children’s could provide an ideal location for a Dawson satellite campus and its easternmost pavilion could be re-purposed as a downtown 24-hour clinic and overflow emergency room.

Either way the point remains the same – the community has to at least be given the opportunity to try and auto-finance what the government no longer wants to pay for.

In terms of what ought to become of the Vic I suggest we look at what led to its creation for inspiration.

royal_victoria_hospital_winter_-e1357268720318

As originally conceived, the Royal Victoria Hospital was designed to offer better healthcare for the wealthy elites of the Square Mile. Providing better healthcare to the city’s rich elites facilitated philanthropic and political efforts to improve public health citywide well before the advent of free public healthcare.

It further served to solidify the relationship between the Vic and McGill University, a partnership that has driven medical innovation in our city for most of our modern history. It’s location, set as it is jutting from the side of Mount Royal, was deemed ideal for the rehabilitative process, as proximity to nature was considered during the late Victorian Era to have a universal curative effect. Though I’m glad they no longer perform surgery by open windows (as was the practice about a century ago), one can’t deny the sanctuary aesthetic of the Vic.

I strongly believe it is for this reason that so many local women choose to have their children there – it looks like a castle, set high upon the mountain, with inspiring views of the city and all its potential unfolding before you. It’s safe, secure. Since so many of us were born there over the years a natural trust developed and strong bonds were forged between the hospital, university and the community.

The Royal Victoria Hospital, as its namesake and the affiliated nursing order might imply, has had a particularly strong bond with middle and upper class women of the city. During the hospital’s early days there were concurrent civic improvement, public hygiene and public health initiatives principally driven by local women’s clubs.

Efforts to provide green space, hospital services, school lunches, parks and playgrounds, public vaccination campaigns and the like were nearly universally championed by socially-minded philanthropic clubs organized by the ladies of local high society. It opened a unique nurses’ residence in 1905 and a women’s pavilion in 1920, from where the Vic’s role as birthplace to so many Montreal Anglos originates.

So why not go back to the roots?

Montreal does not have a specialist women’s hospital and I truly believe we’re lacking as a result. In a day and age in which there are renewed efforts at limiting women’s access to birth control both at home and abroad, not to mention the horrors of sexual abuse, rape and mutilations we see from all corners of the globe, I believe we should go against this backwards tide by providing a sanctuary for the women of our city in one of its safest places – atop the mountain in a Scottish Baronial castle.

Royal_Victoria_Hospital_06

This new community-run women’s hospital could focus on providing obstetrics and birth control, gynecological, neonatal and early pediatric care, though if space permitted it would be worth investigating whether a shelter could be fitted into the design as we’re lacking in that department as well. As a public service for the citizens of Montreal the hospital would be naturally bilingual in operation, whether it remains part of the MUHC network is another issue. These facilities should be developed as a means to ease over-crowding at the new super-hospital by providing a more specialized alternative.

This is just one possible solution to help keep the Vic alive. It’s possible the MUHC and provincial government may instead decide to repurpose the Vic as a medical tourism hospital – a potentially lucrative venture that could serve the broader interest by heavily offsetting the cost of public healthcare. Or they’ll be sold off for residential re-development, the exact opposite of what we both want and need in this city.

These are possible outcomes only as long as we don’t make our case to have our say. If we believe that a community ought to have the right to determine how we collectively utilize institutional space, then we need to make our voices heard. We need to stake our claim to that which belongs to us.

* Top image by Jason C. McLean, other images courtesy TaylorNoakes.com and WikiMedia Commons

Culture

It’s 5am.  You haven’t slept all night and yesterday’s news is slowing sinking in.

You’ve been diagnosed with a chronic disease.

Your life is about to change dramatically. You are justifiably overwhelmed. But there is hope.

The next day you run into an old friend from high school who also happens to have suffered the same fate yet she seems rather happy. She has been reading up on an alternative medicine called homeopathy; a safe, gentle medicine that can work well for chronic conditions.

Later that day you walk home in high spirits and immediately run over to your computer and Google homeopathy, but something weird happens. Just two spots under the first article is “Homeopathy: The Ultimate Fake.”

Click. 4000 words later you’re feeling like you just had the wind knocked out of you.

It’s not that your friend meant to deceive you. It’s the fact that she’s been Scammed. Hustled. Bamboozled. You’ve just learned the cold hard truth about homeopathy: it’s just placebo effect.

You  have no doubt this article was written in the name of science. It sounds like a scientific report; the writing is cool, calm and collected. If that wasn’t enough, then there’s the fact that it’s written by a very articulate doctor who quoted many scientific studies and statistics.

You throw in the towel…It’s been a roller-coaster of a day. Time to rest. And the next day you decide to call up your friend. You need to give her the bad news as gently as possible.

“Oh Quackwatch! Oh ya, know ALL about them,” she says with sheer enthusiasm.

Confusion on your part.

“Oh you don’t know?” she asks playfully.

“That website is mostly just one guy’s opinion on different alternative health products. These happen to cost a fraction of the price of modern pharmaceuticals and they’ve been getting more and more popular. As a consequence, they are taking away a nice chunk of business from the big pharmaceuticals.”

“I did a search on Quackwatch for antidepressants but I didn’t find anything. This is weird. I figured if this guy was legit he would mention them because a lot of what Quackwatch claims about homeopathy is actually true of antidepressants.”

Say again?

She goes on to inform you how no one really knows how antidepressants work. No research exists which explain how they work. And researchers discovered many studies were hidden from the public that suggest antidepressants are no better than placebos.

“Look, I’m not against antidepressants whatsoever. But when I read that, I wondered why is Quackwatch not talking about the $11billion we consumers spend each year on something that research is saying to be no better than a placebo?”

Good question.

“There was a big research study published in the Lancet a few years back. This is one of the world’s most respected scientific journals where other researchers double check and triple check any published study to make sure they are done properly, also known as Peer Reviewed. This makes sure the studies meet the highest scientific standards in the world.”

“The researchers found that homeopathy was no better than a placebo. But then something happened.”

“Other researchers started finding huge problems in the study. They discovered 110 studies that proved homeopathy works were “accidentally” excluded. Long story short, six months later, four letters get published letting everyone know that the placebo theory is 100% not true.”

Your friend makes a good point. But you aren’t convinced. Now you need to find out for yourself .

You hop on to Google. After a lot of head scratching and time wading through a sea of info you find out that:

Meta-analysis is when scientists look at many different studies and see if a theory can be proven right or wrong. Randomized controlled trial is when the researchers randomly decide who will get a placebo and who will get the real medication.

A blind study means that the patients trying the medications don’t know if they are in the group getting the real medicine or if they are getting the sugar pill. Double Blind means even the researchers don’t know.

And then comes the silver bullet:

The 2005 peer reviewed meta-analysis of over 100 double blind randomized controlled trials on homeopathy offers crystal clear scientific evidence that the placebo theory is 100% false and that homeopathy can work for certain (not all) chronic conditions. Period.

You feel Scammed. Hustled. Bamboozled. This “consumer watchdog” maintains that homeopathic research is unimpressive and that homeopathy is just a placebo.

But you also feel thankful that your friend tipped you off. You’re excited to find out all about this new medicine that could be life changing for you.

Google Search: “homeopathy” Yes! I’m feeling lucky!

Here we go! Homeopathy – Wikipedia The Free Encyclopedia

Click. Add to Favorites

16,000 words later…. “What?  I thought wikipedia was legit!”

You scroll back up to the first paragraph, and read it again with utter disbelief: “Scientific research has found homeopathic remedies ineffective and their postulated mechanisms of action implausible…homeopathy is generally considered quackery”

The implications are scary:  1,500,000 people look up the word “homeopathy” every MONTH. The FIRST article those 1.5 million people see is “Homeopathy – Wikipedia The Free Encyclopedia”  from a popular website with a reputation for objectivity. Presenting false information. And using derogatory emotionally loaded words like quackery.

You wonder how many of those million and a half people have chronic diseases and are looking for hope…

Back Click. Remove Bookmark. Clear History. (yes, I know anyone can edit Wikipedia, but this one’s already the subject of an edit war.)

Google “Copeland’s Cure: Homeopathy and the War Between Conventional and Alternative Medicine”

No Google. I don’t want to “feel lucky”. I just want the truth.

Click.

NewsSex

Do you or a significant other rely on contraceptive pills for your sexy peace of mind? Depending on the type of pill taken, I’d rethink doing that. A popular birth control pill called Yasmine and its contraceptive cousin Yaz are the subject of lawsuits between several thousand consumers and the manufacturer, Bayer Pharmaceuticals.

The lawsuit against Bayer involves thousands of American plaintiffs and a separate class-action lawsuit has also been initiated in Canada. Matthew Baer, a lawyer with the firm representing the plaintiffs in the Yasmine/Yaz lawsuit in Canada, explains that Bayer did not adequately warn consumers about the very serious risks specifically associated with Yasmine and Yaz.

Image courtesy of www.thesenatorsfirm.com/

How do these two contraceptives and their side-effects stand out from the rest? Women using them are four times more likely than women on other types of contraceptives to experience blood clots, stroke and gallbladder disease. Plaintiffs have reported severe chest and abdominal pain, digestion issues, and gallbladder problems. The pills can lead to life-threatening conditions such as cardiac arrest and   pulmonary embolisms, or blood clots in the pulmonary artery leading to the lungs.

Baer says that these risks should have been “clearly stated [in the product packaging] so that individuals and their doctors could have made informed decisions about what product to use”. Sounds like a pharmaceutical giant has been withholding information from the public. I don’t think anyone’s surprised. Beyond this, the Yaz and Yasmine lawsuits have made it clear that lives are at stake and that corporations like Bayer must be held accountable for their lack of transparency.

“We believe that [through these lawsuits] Bayer will be required to explain to Canadian consumers what it knew about the risks associated with using Yasmin and Yaz and when it first became aware of those risks”… which, by the way, was more than a couple of years ago.

Being a woman that’s equal parts skeptic and paranoid, I had to find out what makes this product different from others such as Alesse (brand name for Aviane), Tricyclen, or Diane-35. Like several others of its kind, Yasmin and Yaz are combination oral contraceptives, containing both an estrogen and a progestin component. The estrogen component used in these pills is common to other combination oral contraceptives. It’s the progestin component, called drospirenone, that is the unique ingredient linked to a   sixfold increase in the risk of experiencing those Yazerrific side-effects mentioned earlier.

 

What’s in that pill? Courtesy of kansascity.injuryboard.com

Oh wait, about Diane-35… If you or a significant other are on it, I’d read about the Diane-35 consumer advisory on the Government of Canada website.

At this point, Miss Paranoid Skeptic perks up again. How did these contraceptives get approved by our dearest Health Canada, most recently in 2008, if the products’ warning labels weren’t properly informing consumers? Apparently Health Canada relies on the materials provided to it by drug manufacturers when approving drugs for the Canadian public. The responsibility lies in the hands of the drug company, which Baer states has “an ongoing responsibility to collect adverse event reports and continue to update the label as necessary”.

This is when Bayer Pharmaceuticals shrugs its shoulders and gives its cutesy ooops. The brand name and generic form (Ocella) contraceptives continue to be available on the market, despite studies that have revealed a heightened risk of potentially life-threatening side-effects. Bayer pharmaceuticals maintains that sufficient warnings about blood clots and other side effects are reflected on product labels.

So, what’d ya say we order an extra large widespread-controversy, a product recall, and an extra dose of corporate responsibility on the side? Siskinds law firm and a website dedicated to the Yasmine/Yaz lawsuits have already gotten the ball rolling on that.

If you’re a Yasmine or Yaz user, get informed about getting off these birth control pills and join the “Take Your Body Back” Facebook group.You can also watch Siskinds law firm’s YouTube video produced by Matthew Baer (matthew.baer@siskinds.com) for more information.

Laurence Rants

Good Monday morning. It is the middle of the month, the ides of November. My Roommate, band mate and brother by choice turns 45 today, so, Happy Birthday to Steve   P. Frasier!

Now, on with the rant…

Es tu, snow?

Is it just me or is it starting to get cold and wet outside and why does it seem to be getting dark a lot earlier than it should be? The reason is because at this time of year, the earth’s axis points away from the sun, so we get less radiation. Precipitation begins to get colder until it starts to freeze. Then the truly evil season comes upon us. Things begin to die off, many go into hibernation and my car gets a constant salt bath, causing rust.

The cold makes pains harsher and causes shrinkage in places like the bladder. It is now very heavily taxing on the system of most people here and as a result, diseases begin to manifest themselves with a much stronger level of severity. It’s no coincidence that more people die from natural causes at the beginning of winter than at any other time of year.

Winter is a harsh season. It is also an expensive season, seeing as we need to spend much fuel and electric power simply to heat our homes and businesses. We also must spend money and labour to winterize our homes and vehicles. Winter is a time of greater pollution as well, for various reasons.

I know, it’s still autumn. Retailers are only just beginning to put the deliberately annoying annual forced feed and suppository showcasing of their greed and   avarice into play. I will, no doubt, have the same annoyed rant about it that I do every year.

Maybe if I was a skier, but I’m not one. I was soured on skiing in elementary school. If I skated, but my ankles can’t take the pressure of skates without causing me pain. I don’t like pain. I also don’t like shoveling snow, scraping windows, or slippery sidewalks.

Of course, I was born in the middle of winter. I’m told I was born during a very severe snowstorm, one that other later snowstorms have been compared to.

Enough about that for now.

I have noticed that in sometimes laying bare my insecurities, I make myself appear weak and a sorry excuse for a human being. I find that I sometimes use the internet and my rant column on Forget The Box as a sort of psychologist’s couch, except without any kind of confidentiality agreement. In fact, I sometimes slander myself and not always with positive return.

It’s true   that I can be quite pessimistic at times, but when the glass is empty, don’t tell me that you think it’s full. It’s full all right. Full of nothing but the air in the room. Life is like that sometimes. Sometimes one is forced to sacrifice the things that are most meaningful in favour of something frivolous and superficial, benefiting someone else exclusively.

I almost forgot to mention that the box is empty, so Forget the Box.   Forget the Box is having a fundraiser party on November 20th at club Vegas in the Plateau Mont-Royal. Come, donate, buy beer and donate some more. Forget the Box needs your support, as do all of the people involved who do this as a labour of love, on a voluntary basis. For those of you in the Montreal area, please support local alternative and new media, particularly grass roots organizations such as Forget the Box (you can also donate using PayPal). Thank you for your continued support.