There was an article in the Winnipeg Sun on Wednesday this past week, and I don't know a single person that's read it that didn't finish it with a fairly strong opinion. It was written by Floyd Perras, the director of Siloam Mission here in Winnipeg. In it he refers to a situation that took place at the Health Sciences Centre in 2008, where a homeless, double amputee named Brian Sinclair died waiting for longer than 30 hours in the Emergency department. Mr. Sinclair was sent alone by taxi from a community health centre to present himself at HSC concerning a blocked catheter that required changing. On arrival he may or may not have presented himself to triage, as he was never registered as a patient waiting for medical attention. After more than a day, unable to void his bladder, he died in his wheelchair in the ER waiting room of a bladder infection that spread to his bloodstream. The resulting furor has been going on nearly 4 years. His family has brought legal action against the Health Sciences Centre, the Winnipeg Regional Health Authority, and the province of Manitoba, going so far as attempting to have the HSC ER declared a "public nuisance" and suggesting in their lawsuit it should be shut down (a move I felt stole an enormous amount of credibility from their grievance). No final legal decisions have been made, but the province in now seeking to dismiss the lawsuit after paying Sinclair's family approximately $110,000 for "loss of care, guidance and companionship for his wrongful death." They are still seeking $1.6 million.
There is no question that this incident warranted investigation and corrective measures. As the only hospital in the core area of Winnipeg, HSC is presented with unique challenges and opportunities in its delivery of care, and must remain vigilant and consistent in providing it. I am given to understand in the wake of Mr. Sinclair's death that the ER has taken measures to ensure this kind of oversight doesn't occur again, and has improved their triage process to ensure all who are waiting for care are accounted for.
Many including myself, have found it somewhat baffling that his family have appeared to be such tireless champions for Mr. Sinclair and his cause following his death, given that he was homeless in life, and spent over a day in ER all alone. Where were any of them when he was alive and really needed an advocate? There's no way I would allow any of my loved ones to sit in an emergency room alone, and certainly not for anywhere near that length of time without exploring other options. His family suggests that he had a speech impediment that made communication difficult. Why was he put in a taxi alone from the community health centre then? If they suspected he was incapable of triaging himself, they had no business sending him alone, without at least a telephoned report to the ER prior to his arrival. The ball was dropped by many people in Mr. Sinclair's life it would seem, far before he turned up at the hospital. Mr. Sinclair's family claim they persist in their legal efforts to "find out the truth about what happened to him" and that "he's going to leave something behind to this city, and that's a better health system". I would ask how them getting a substantial pay day provides them with any further details about Mr. Sinclair's death than were provided to them by the medical examiner, or improves the health system by taking money out of it. How does shutting down the only ER in the core area make for a "better health system"? With many accessing ER for routine medical care, where does the family expect people to go instead? Do they plan to donate the proceeds of the lawsuit (should they be awarded them) to aboriginal or homeless causes that would improve the health of these demographics? If they do, they certainly haven't mentioned it publicly. If changes have been made and processes improved, what more are they really hoping for in terms of "ensuring this never happens again"?
The article written by Mr. Perras was an incredibly glib, underinformed, and self-satisfied interpretation of these complex events, and attempts to lay blame solely at the feet of racism and discrimination. While this would be an easy explanation, it in no way represents the truth. Mr. Perras claims that "ER staff prioritize homeless people to the bottom of the list. If they are aboriginal, they can be put even lower on the list. They've learned that if you make a person wait and wait, they will eventually go away." Firstly, anyone who has so much as walked past the ER waiting room at HSC would find it easy to see that the majority of the people being served there are aboriginal, and many would appear to be homeless, or at least from less than ideal living situations. It's a fair assumption that HSC provides care to more people of these demographics than any other hospital in Winnipeg. Mr. Perras also takes issue with wait times. "A simple data base could remind intake staff of how long people have waited for help. Perhaps after 6-8 hours, they automatically go to the front of the line." Well Mr. Perras, HSC is designated as the trauma centre for Manitoba, northwestern Ontario and Nunavut. This means that ER staff there deal with life-threatening injuries on a daily basis and prioritize their slate based on the seriousness of cases, not race or socioeconomic status. This means that if you utilize the ER as a family doctor or walk-in clinic, you can expect to wait behind those who have been hit by cars, who've been stabbed, shot, assulted, or who have suffered major burns. This is how it should be. Imagine the hospital trying to explain to a family that their loved one bled to death while the staff tended to a headache simply because that headache waited longer. Staff know how long people have been waiting, and they don't like it any better than the patients. The goal of ER staff is to see an empty waiting room, and patients receiving timely attention, not just outwaiting sick people in the hopes they'll "go away". This is not why those who take on the massively stressful task of ER work do what they do. They aren't in the back room drinking coffee and watching daytime TV thinking "20 more minutes and I'm sure they'll all give up." They are on their feet for hours and hours, saving lives, and dealing with untenable situations every day that the rest of us couldn't even begin to imagine.
If Mr. Perras would like to take issue with how he believes aboriginals and homeless people are discriminated against by the health system, I say people in glass houses shouldn't throw stones. His own organization categorically refuses shelter to those who appear intoxicated or who may be under the influence of drugs. As substance abuse and addiction are understood to be a prevalent issue amongst homeless and/or aboriginal people, and addiction undoubtedly makes them even more vulnerable, I would ask Mr. Perras who's really deprioritizing the homeless? And according to the Siloam Mission website, every single one of their beliefs and values centres heavily on the Christian faith and emphasizes that "without a faith commitment to Jesus Christ, the future is one of eternal separation from God and all that is good", which I am given to understand is not a philosophy in line with traditional aboriginal spirituality. If Siloam Mission disapproves of how one of the resources utilized by the aboriginal homeless is treating them, perhaps they as a resource should be making greater efforts to pick up the perceived slack and be more inclusive. I certainly respect Siloam Mission's right to operate their organization as they see fit, but in doing so, they are alienating or outrightly barring a large percentage of those that need help, while criticizing HSC for allegedly the same thing. Perhaps a little self-reflection and fact checking would have done Mr. Perras some good prior to writing his article, as it certainly wasn't a good vehicle for organizational promotion published as it was.
Thank you for reading and have a well-informed week :)
*none of the preceding represents the views or opinions of HSC, the WRHA or the province of Manitoba*
No comments:
Post a Comment