We would like to thank our healthcare workers who have worked tirelessly to test, diagnose, and care for patients during this pandemic. This pandemic shaped the way our society looks, interacts and operates. While many are staying home, healthcare workers are risking their own safety for our wellbeing. But what about those individuals who choose not to abide by the rules of social distancing, wearing masks or isolating when returning from travel? The issue that arises is whether doctors have the right to refuse treatment to COVID patients that have been contributorily negligent. That is, patients who have voluntarily failed to follow public health guidelines. There are individuals who don’t believe that the pandemic is even real, whether it be because of the conspiracy theories, the lack of physical symptoms unlike the bubonic plague or the privilege of not knowing anyone who is battling with the disease. Some of these individuals engage in self-destructive habits. It can be seen through protests on the TTC where individuals have proclaimed they do not want their body to be regulated by the state and that masks hinders their freedom of expression. I ask these same individuals who went to school here, dress codes were also enforced – where was this energy when children weren’t allowed to wear spaghetti straps to class? Another example is Bill 21 in Quebec, banning religious symbols such as the hijab, niqab and turbans. The freedom of expression argument is an interesting take, is it more important than the right to life, liberty and security of the person? Wearing a mask has a utilitarian purpose, protecting individuals from spreading the virus to one another. If healthcare workers can wear it for hours a day, we can wear them for limited time periods, when leaving our homes to run errands or going to work. The way COVID-19 impacts individuals differ greatly based on their immunity levels. While some can overcome it without knowing they even had it, others require ventilators to breathe and have reduced lung capacity once treated. Since there is no one cure fits all approach, the spectrum of treatment varies in costs, treatment time and resources. Labour boards across Canada have outlined a four step test to justify refusal to work because of unsafe or dangerous conditions:
However, the situation is different for healthcare professionals given the nature of their work. Doctors have a mandate to help the ill. Healthcare professionals cannot dictate how patients live their lives, nor can they withhold treatment based on the disparity in standards of morality. Physicians are not in the position to determine when self-destructive behaviours warrant treatment. If this were the case, healthcare professionals could refuse cases related to smoking, eating disorders or sports injuries since it could be argued that is “self-destructive” behaviour. Doctors are expected to provide equal treatment for all, without their biased judgment and projected complications. The difference between those cases, and COVID-19 is the risk of contracting the virus. Healthcare professionals are putting themselves, their families and others in close proximity at a heightened risk of infection because it is unknown how this disease is spread. Regardless, the code of ethics highlights that the patients’ welfare be placed above their own self-interest. How can it be monitored if a patient was negligent? Would specific measures need to be in place to assess if they broke by-laws such as congregating with more than 10 individuals? Went shopping without a mask? Should it be that people need to surrender their health card if they break a law to say that they are willing to risk everything, their health included to live a lifestyle that cannot be supported at this moment in time? As a member country for the World Health Organization (“WHO”), Canada is committed to providing healthcare for every human being without distinction of race, religion, political belief, economic or social condition. Therefore, physicians in Canada owe a legal duty of care to patients and there is a limited right to refuse the work based on the four step test identified by the labour board. By: Karen Randhawa |
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