12 April 2015

Health care among single, older women – a case of discrimination for OHRT

Added April 23, 2015: transcript of short 6 minute excerpt of audio recording of Dr’s appointment April 28, 2014.

This week, on April 10, I submitted an application to the Human Rights Tribunal of Ontario (OHRT), alleging discrimination by my family doctor on the grounds of sex; family and marital status; and age.  The general area of discrimination I filed it under was ‘Goods, Services and Facilities,’ specifically, ‘Medical/health services’.

I had already tried to resolve the matter, or various aspects of it, through LDAM, the London and District Academy of Medicine, with no success, then filed a complaint with the College of Physicians and Surgeons of Ontario (CPSO), in June, 2014. I have received very little feedback on that, except that it is still in progress, I am told. While the CPSO complaint is directed largely towards a lack of professionalism in general in the behaviour, attitude, and practices of the doctor, the application for the HRT is about specific incidents and situations that reflect discriminatory attitudes as well as practices that discriminate on grounds covered by the Code.

The CPSO form was quite vague in the way it asks for information, and even though I included headings under which I thought the behaviour or attitudes would fall, the first investigator immediately changed it to what she saw as the problem. Having the “investigator” be the one who decides what will be told to the Committee is hardly reassuring. While they may claim to be unbiased, even the fact they claim to be suggests they aren’t. If a person cannot acknowledge normal human frailties, but think they are superhuman in their ability to be objective, how can we have faith in their decisions?  I especially did not like the CPSO’s decision to file my complaint under the heading “Communication and termination” as it seemed to minimize what happened, and to clinically sanitize, as it were, what was really going on – the biases the doctor held and the actual incidents of bullying, harassment, and unprofessional behaviour.

I decided to go forward with the application with the Human Rights Tribunal, based on grounds covered by the Human Rights Code. What this means is that, in this case, I have stated in the application that my HRT complaint is on the grounds of sex (meaning male or female); family and marital status; and age. I have focused on two incidents only (and their ramifications), and gone into greater detail on these two incidents than I did in the original CPSO complaint. One incident was an ultrasound test I was sent for, which not only created much discomfort and risk but seemed to be altogether unnecessary. The other event was an appointment with the doctor which turned into a scenario of outright hostility and the outrageous and uncalled for demand that I submit to a urine test for what he called “street drugs” (see excerpt of transcript of 6 min audio recording of April 28, 2014 appointment).

The human rights tribunal application is a more structured form than the CPSO complaints form, although perhaps it also makes a difference that over this last year my thoughts on this period in my life have become clearer, in terms of their significance, so I am better able to express them, and more concisely.

Below are the headings for my responses to the questions on the two incidents and for their effect on me, and why I believe it was discrimination, for the Human Rights Tribunal. To read, follow the links to the pages. The information is the same as what appears in the application itself, though I have not disclosed the name of the doctor who is the subject of the complaint.

The two events are described in terms of what, who, when and where. Following that is an explanation of the effect it had on me.

1. Pelvic renal ultrasound incident   and Effect on me of Pelvic renal ultrasound incident

2. Urine sample, “street drugs” and termination
    Effect on me of Urine sample, “street drugs” and termination

The last part directly addresses the matter of discrimination, and why I believe I was discriminated against.  For this part, the starting point is the type of discrimination. And the three types of discrimination are 1. sex,  2.family and marital status, and 3. age. For each of these, I explained why I believed I was discriminated against, eg., starting with ‘sex,’ I told how I was discriminated against on the basis of being female. For ‘family and marital status’ my focus was on not having family close by, nor a husband, and how that can affect quality of health care.  And finally, age, the one factor that seems to have everyone concerned about the burden older people are presumably putting on the health care system – or some of us, at least.

These are the three areas I wrote about, on the HRT application, explaining why I believe I was discriminated against:

3. Discrimination on the grounds of sex
    Pelvic renal ultrasound test
    Urine sample, “street drugs,” and termination

4.  Discrimination on the grounds of family and marital status
     Pelvic renal ultrasound incident
     Urine sample, “street drugs,” and termination

5.  Discrimination on the grounds of age
     Pelvic renal ultrasound incident
     Urine sample, “street drugs,” and termination

There were other questions asked on the application form. See links following for my responses:

6. Remedy I am asking for

7. Why the other proceeding (LDAM) could not deal with my complaint

8. Other important information the tribunal should know

9. Practices and policies complained about

In my responses, I have quoted from other sources, though I had virtually no advice on how to go about this HRT process and am not sure I did this the way they wanted me to. I can only hope it will be taken seriously. It certainly was serious for me.  Regardless of what happens, I want it to be known that this is what I experienced. Whether it was a unique kind of situation, or one that others have experienced, I do not know, although I do know that discrimination on the grounds of sex, as well as on the grounds of family and marital status, and age, exists in various ways within the healthcare system.

List of References used in the application form questions on discrimination for the HRTO

Ageism: Concepts and Theories, Law Commission of Ontario, 2009. Retr Jan 20, 2015

Code Definitions (I), Code Protections for Relationships (III), POLICY AND GUIDELINES ON DISCRIMINATION BECAUSE OF FAMILY STATUS, OHRC. March 28,  2007. Retr March 22, 2015.  http://www.ohrc.on.ca

Collaborating with Patients and Others,  Duties: To the Patient. Principles of Practice and Duties of Physicians. CPSO Policies and Publications. Retrieved March 26, 2015.

Defining Discrimination Based on Family Status, OHRC Policies etc on family status. Retr Jan 25, 2015 http://www.ohrc.on.ca/sites/default/files/attachments/Policy_and_guidelines_on_discrimination_because_of_family_status.pdf

Ending the Physician Patient Relationship, CPSO Policies and Publications, Sept 2008.
Retrieved March 26, 2015.

Incontinence: The Canadian Perspective, Cameron Institute, Canadian Continence Foundation, Dec 2014. Retr Mar 25/15.

‘Physicians and the Ontario Human Rights Code’, Policy Number:#5-08.  Policy Category: Practice, Publication Date: December 2008, Introduction. Retrieved Feb 22, 2015.

‘Principles of Practice and Duties of Physicians,’ Policies and Publications, CPSO website. Retr March 24, 2015. http://www.cpso.on.ca/Policies-Publications/The-Practice-Guide-Medical-Professionalism-and-Col/Principles-of-Practice-and-Duties-of-Physicians