Man files a law suit; opinions

[Friendlyapplicant]

What are some of your thoughts on this?

https://www.ctvnews.ca/mobile/health/the-solution-is-assisted-life-offered-death-terminally-ill-ont-man-files-lawsuit-1.3845190#_gus&_gucid=&_gup=Facebook&_gsc=oSjpnmH

[NeuroD]

I just finished a Neuro rotation at that hospital.... Didn't hear or see anything related to this guy oddly enough.

[rmorelan]

2 hours ago, PhD2MD said:

I just finished a Neuro rotation at that hospital.... Didn't hear or see anything related to this guy oddly enough.

ha it is surprising how often that happens. Hospitals are big places

[ralk]

Obviously too few details to say much definitively about this case in particular. The notion of MAID especially is a landmine not worth stepping on because there's so much left to interpretation in the way this case is described, which could have been anywhere from a provider inappropriately pushing MAID to the patient indicating wishing they were dead and a provider very appropriately exploring the option for MAID in response. Plenty of room here for a miscommunication to spiral out of control here.

One aspect that does deserve some attention is the role of home care, which has expanded rapidly in recent years, for good reason, but has had difficulties meeting expectations and has been hampered by inconsistent quality. It would not surprise me in the slightest if the patient's account of poor care from the LHIN's home care services was accurate, or at least clearly sub-par. These days, publicly home care staff are definitely over-worked, usually poorly coordinated, and generally under-trained. That they often work for private groups that are subcontracted by the LHIN doesn't help things as the companies often push these workers to see large patient volumes in a minimum of time, a situation LHINs are often happily oblivious to. These groups are also often short on workers, so bad employees stick around longer than they should, even if there are complaints against them, and there are often quite a number of new graduates around just learning how to get on their feet.

When it all works as intended, it's a great service - I've had many patients with good qualities of life made possible only because of home care, and countless occasions when more intensive care (hospital or LTC) was avoided due to home care being an option. More often than not, I still receive generally positive feedback from those receiving home care. However, I have heard often enough about problems with the service. There are absolutely holes and flaws in our home care system.

Bringing it briefly back to this case, the crux seems to be that the patient is unsatisfied with their home care and does not feel safe leaving the hospital with the LHIN as his main caretakers. That's a fair concern, but there are limits to how far that concern goes in allowing him to demand changes. Unless he pays privately, or receives funding from a non-governmental charitable organization, the LHIN is pretty much the only option for home care services. Persistently inadequate care from the LHIN certainly would give him legal recourse against them to change their actions and/or compensate him for harms, but that's about as far as it goes. It's not the hospital's responsibility, or the hospital physicians' responsibility, to ensure the LHIN does its job perfectly. That he's refusing to accept their care does not alter the hospital's responsibilities. He does not get the right to a hospital bed if he's been medically cleared to be discharged. Discharge from hospital does not require patient consent and if he refuses to leave he can be charged money on a daily basis for taking up the bed.

In short, he has a right to a certain level of care under our current laws, but what he seems to be demanding goes beyond what he is legally entitled to. If everyone who had an issue with the LHIN's home care services could demand public funding for non-LHIN private home care, or for a hospital bed, our system would fall apart very quickly.