29 December 2017

Why and how I was discriminated against – explaining to HRTO’s Dr Fthenos

1. On November 6, 2017, I submitted a 50-page Application to the Human Rights Tribunal of Ontario, describing how I was discriminated against by 7 individuals (naming also one organization) in a total of 9 various incidents/events over a couple of years or so. The individuals were doctors, administrative staff, and other staff at a hospital.
2. This is the second blog entry I have written on this subject of this HRTO Application. See also, Ageism in Ontario's health care and human rights (HRTO), Dec 21, 2017.
3. Brief Chronology
June 27, 2017 – CPSO complaint submitted (College of Physicians and Surgeons of Ontario)
Nov 6, 2017   –  HRTO Application submitted (Human Rights Tribunal of Ontario)
Nov 27, 2017 – email to HRT requesting status of Application
Nov 27, 2017 – email response from HRTO re status of Application – in a queue
Nov 28, 2017 – Letter by email to Dr Fthenos, Registrar, HRTO, to remind him of the CPSO
Dec 7, 2017 –   Letter to Dr S. Bodley, President, CPSO, informing him of the related HRTO
Dec 11, 2017 – Letter from Dr Fthenos, HRTO, Notice of Intent to Dismiss
Dec 18, 2017  – my letter to Dr Fthenos, HRTO Registrar, requesting extension,
                          among other things
Dec 21, 2017 – email to Dr Fthenos, Registrar, HRTO requesting response and time extension
Dec 21, 2017 – Ageism in Ontario's health care and human rights (HRTO).  Blog:
                         Sue’s Views on the News
Dec 21, 2017 – email to HRT requesting time extension on Notice of Intention to Dismiss and
Dec 21, 2017 – email to HRT requesting correction of clerical errors
Dec 29, 2017 – Why and how I was discriminated against – explaining to HRTO’s Dr Fthenos.
                         Blog: Sue’s Views on the News

One letter, then another
4.  On Monday, December 18, 2017, I wrote a letter addressed to Dr Georgios Fthenos, Registrar of HRTO, about a letter I received from his office, dated December 11, giving me a Notice of Intent to Dismiss my Application. At first I assumed their letter was in reponse to my own letter of November 28th (by email attachment), addressed to Dr Fthenos specifically, hoping to avoid the letter being taken up by someone else who had the authority to, thus not getting my concerns addressed. In response to the Dec 11 Notice of Intent to Dismiss, I sent a letter by regular mail, on Dec 18, 2017, addressed to Dr Fthenos, Registrar, HRTO, with questions and a request for an extension of time. Just before Christmas closing, on Thursday, December 21, I emailed a reminder to the Registrar at HRTO, about the request for an extension of time and about possible errors. I requested that he please send his response by Wednesday, December 27, 2017.  To explain how this works, I shall say here that emails to the HRTO are automatically addressed to the Registrar, to HRTO.Registrar@ontario.ca , but would not ordinarily go to the Registrar.  It is part of the mystique of the HRTO. I have not heard back, so I must continue to address my concerns about my Application and the way Dr Fthenos and the Tribunal are carrying out their duties.

5. In the letter dated Dec 11, 2017, containing the Notice of Intent to Dismiss, signed automatically by Dr Fthenos, the Registrar, I was informed that my Application did not identify specific acts of discrimination within the meaning of the Code, as it appeared I had explained only in general terms that I have been treated unfairly without connecting the “unfairness” to one of the grounds set out in the Code. See one example from my Application of an incident that I explain in terms of the Code that they did not see as an incident. Dr Fthenos, or the unnamed person doing the work for the Registrar, presumably has the power to dismiss my Application if I don’t write it up in the manner they expect it to be done. My Application has not yet been accepted to be processed, so there is no caseworker I can approach, only address my concerns to the Registrar, Dr Fthenos. But I don’t know if he gets to see anything I write and send to him. The concern of whoever wrote to me was not the letter I wrote to Dr Fthenos on Nov 28, however. It was how I wrote up part of the Application for the HRTO.
Ontario Human Rights Code
6.  Under the CODE, incidents that Applicants bring to the HRTO must be about discrimination on particular grounds: disability, creed, sex, sexual harassment and/or solicitation, gender, sexual orientation, family status, marital status, and age (brief version of grounds). In my Application I have named discrimination on the grounds of sex (being female) and age (being an older female), marital status (being single), and family status (being part of a family but not living together). I have tried to supply the information I was asked for, but the request did not give any details except that I must relate my claims to the CODE. The writer was presumably seeing what I have complained about as incidents of meanness, or unfairness in general, not as being related to any of the grounds mentioned in the CODE.  But people  - doctors, nurses, admin staff, etc, are not unfair in general, I wouldn‘t think. They have something going on in their heads when they treat one patient better than another, or deny adequate diagnostic treatment to some patients but not others. I doubt that the desk staff draw straws to determine which patients will get what kind of treatment on this day, as they look at them waiting patiently in the waiting room. They know, from what they see in their files, or who is accompanying them (if anyone), or from how old they look, how ill they seem, and so on, what kind of treatment they will be offered. When people are treated unjustly in hospitals, one at least hopes it isn’t because of some characteristic irrelevant to life’s journey not usually acknowledged as a stigma such as colour of hair, probable time left to live, ability to cope, style of writing, or whether one is needed by a significant other or family.
7.  I believe I do understand what I am expected to do although I question the authority of the person who has said I must, and of the necessity of stating each incident, for each respondent, and showing its meaning under the code. The person who informed me, in the Notice dated Dec 11, didn’t explain which sections needed to be rethought, and rewritten, and I was unsure what I needed to be doing. I believe that having 7 respondents makes it more difficult to connect the acts of discrimination to the different parts of the Code I am basing my claims on. It is more difficult, I think, to see the whole picture when the incidents of discrimination, and how they relate to the Code, are looked at as distinct incidents. And it is probably only when the entire situation is looked at that it can be recognized for what it is – a situation of discrimination on the grounds of sex and age, and family and marital status.

Explaining Discrimination within the Code - and an example
8.  In the Application Form, Part C, Under the heading ‘Questions about Discrimination on the Ground of Age,’ for example, the question reads: Explain why you believe you were discriminated against based on your age. I believe I have answered that. I tried to answer, “How” as well as “Why.” It is possible that when a subject such as discrimination is a familiar one, that a person tends to take for granted that the reader – the caseworker or even Dr Fthenos himself, in this case, can understand what I am saying, and how I was discriminated against. I have been studying and writing about aging and gender for many years now, at universities I have attended and on my own. But do the individuals who work at the HRTO understand the complexities of all types of discrimination? Why did the person who responded to me say:
the narrative setting out the incident of alleged discrimination fails to identify any specific acts of discrimination within the meaning of the Code” (Letter, Dec 11, 2017, signed automatically, Georgios Fthenos, Registrar).

Yet here is one such incident , one more time, that I included in Section C (Goods and Services) of my Application. It was the last one I mentioned, about the doctor who attempted to find a solution but only belittled what I had been through and how serious this matter was. Besides the letter-writer not being able to find one single incident of discrimination, I believe it is only respectful to provide a name when writing a letter that contains the possibility of a momentous decision. A person writing anonymously can say anything and not have to take responsibility for mistakes. Furthermore, that person neglected to provide details of which section or which question s/he need to have me make changes to. 
9.  In the Application, in the section about the Code, I explained how I understood the relevant parts of the Code and included them in my response – not in narrative form but in numbered paragraphs. If the comment by the person who wrote to me was about Question 8, I was simply doing what I was expected to do, according to the Applicant’s Guide to Filing an Application:
You must tell the HRTO what happened to make you believe that the respondent has discriminated against you based on one of the grounds in the Code.  .  .  . start from the beginning and end with the last incident of discrimination . . . . include what happened, who was involved, when it happened, where it happened. .  .  .  we encourage you to tell your story in chronological order” (p 19).
If it comes across as a narrative, with numbered paragraphs, describing each incident in order, it only makes me wonder if the writer understood what was expected of the Applicant, especially when there was so many incidents and respondents. It must come across as a rather long narrative, but that is what was asked for.   
10. I imagine that if a person has named only one Respondent, it is easier to say something to the effect that, This person discriminated against me by bullying me because he thought he could get me to back down and shut up because I was old and needed the health care I was getting even though it was substandard. But I would have to repeat the same sentence 6 or 7 times, for each of the respondents who bullied me. I wonder if the person writing to me has had experience doing Applications that have involved 7 individual respondents and 9 incidents/events.
Three excerpts – Ageism and Public Interest Remedies
11. As an example of how I laid out the section about “Why” in Part C, I include a link here to the first 3 paragraphs out of 13 in total, of my response in the section on Discrimination on the grounds of Age. See 2017 Dec 28 excerpt age discrimination  .  Secondly, I have included the first couple of pages from my response to the question on discrimination on the grounds of family and marital status, explaining "why" I believed I was discriminated against.  I also include the section ‘Public Interest Remedy’ also called the Remedy for Future Compliance,  that was part of the Application to the HRTO, Nov 6, 2017, on how to improve the hospital’s approach to problems of discrimination, including prevention. Although the paragraphs are not numbered, it is only one page long and is clearly specific about what I see as necessary and how to solve each problem.
Proving discrimination
12. I believe Dr Fthenos or the writer of the letter may have been mistaken in implying strongly that I need to prove my case in writing, bit by bit, before I get to the Hearing. As I have stated before to him, my case relies on circumstantial evidence, and so will become much clearer as time goes on. It may not be evident at this time that the incidents I had to put up with were due to the grounds I stated – age, sex, etc, family and marital status, but taken on the whole – each piece as part of the whole – and it will be clearer to any reasonable person that they are part of a wider situation of discrimination that I was subjected to.
Sending mail between HRTO and others  
13. The information in paragraphs 12, 13, and 14 has been included in emails I sent to the HRTO yesterday, Dec 28, in an attempt to have errors in calculation of time corrected, and to request an extension of time to respond to the Notice of Intent to Dismiss.
In the letter dated December 11, 2017, I was given a deadline – Monday, January 8, 2018 – to respond to a lack of detail in my Application for a Human Rights Tribunal, in effect allowing me only 23 days to deal with it, from December 15 to January 8.   The Rules of Procedure of the HRTO state,
Where a document is delivered by a party or sent by the Tribunal, receipt is deemed to have occurred when delivered or sent: 1. by mail, on the fifth day after the postmark date” (Rule 1.22).
If Rule 1.22 applies to the Registrar, for this document sent to me, then even if the letter was sent to me (and postmarked) on the day it was written, December 11, 2017, it would be deemed to have arrived on December 16, leaving me 23 days to respond.
'Notice of Intent to Dismiss' Rules
Under Rule 13 of the Rules of Procedure, DISMISSAL OF AN APPLICATION OUTSIDE THE TRIBUNAL'S JURISDICTION, it is stated that
“Where it appears to the Tribunal that an Application is outside the jurisdiction of the Tribunal, the Tribunal shall, prior to sending the Application to the Respondent(s), issue a Notice of Intention to Dismiss the Application. The Notice will:
a) be sent to the Applicant only;
b) set out reasons for the intended dismissal; and,
c) require the Applicant to file written submissions within 30 days
” (Rule 13.2 ) 
14.  The Registrar Dr Fthenos could have given me 30 days to respond to his notice, but he only allowed me 23. The writer/Dr Fthenos seemed not to have taken into account the extra 5 days for getting through Canada Post (Rule 1.22). And it still wouldn’t add up to 30 days. Neither was I granted the full 30 days mentioned in Rule 13.2, after receiving Notice of Intent to Dismiss.
15.  Even if the Rule 13.2 had said I was to be given 30 days to respond, I understand he has the power to lengthen or shorten any time limit in these rules (Rule 1.7, Rules of Procedure). In that case, one would have thought the Registrar or his secretary would have mentioned what rule they were using to decide how much time to give me to respond.
16.  There is another aspect to this problem of the possibility of having my Application dismissed. Under Rule 13 of the Rules of Procedure, DISMISSAL OF AN APPLICATION OUTSIDE THE TRIBUNAL'S JURISDICTION, it is stated,
The Tribunal may, on its own initiative or at the request of a Respondent, filed under Rule 19, dismiss part or all of an Application that is outside the jurisdiction of the Tribunal” (Rule 13.1, Rules of Procedure).
In other words, if Dr Fthenos decides one part or all of the Application isn’t within the jurisdiction of the HRTO, because he is reading my Application in a certain way, or for some other reason,  is it possible that he can dismiss not only that one part but the entire Application? He has already stated (or the reviewer/caseworker has) that he cannot identify a single act of discrimination within the meaning of the Code in the Application I wrote.  It seems almost as if I am expected to prove in my Application that I was discriminated against, rather than have a Hearing at which to discuss the incidents and alleged discrimination. 
Making Changes to Section C
17.  Nevertheless, I will attempt to make changes in the format of that part of the Application that deals with the Code, linking specific incidents with the applicable Code. I thought I had done that, to some extent, but presumably not enough to be recognized as such. And I can only hope that I am granted additional time to complete the changes. The power of the Registrar, or his staff who write letters in his name, to dismiss my Application when I have myself have found what appear to be errors in calculation of time, a lack of detail in the reasons given to me for the Notice of Intent to Dismiss, no acknowledgment of any specific acts of discrimination in my Application, and scant information on which sections in my Application need changes, leaves me hoping that when it comes to the more important decision, of whether I can continue on with the Application for a Tribunal or not, special attention will be paid to handling it fairly and with social justice in mind. The Rules of the Social Justice Tribunals of Ontario (SJTO) state:
The rules and procedures of the tribunal shall be liberally and purposively interpreted and applied to:
a) promote the fair, just and expeditious resolution of disputes,
b) allow parties to participate effectively in the process, whether or not they have a representative,
c) ensure that procedures, orders and directions are proportionate to the importance and complexity of the issues in the proceeding
My HRTO Application
18.  As it stands currently, the Application I have submitted to the HRTO has not yet been processed, having only been looked at by an unnamed person at the HRTO office in Toronto and/or the Registrar, Dr Georgios Fthenos, and declared that
a review of the Application and the narrative setting out the incidents of alleged discrimination fails to identify any specific acts of discrimination within the meaning of the Code allegedly committed by the respondents” (Dr Georgios Fthenos, Dec 11, 2017).
My Application is 50 pages long. I have described each of the nine incidents. I have described how each of these affected me. And I have described how each relates to the Code of the HRTO – how they were acts of discrimination  under the Code.  I have described how family and marital status and the intersecting grounds of age and sex are understood within the Code, and stated this is how I was discriminated against.  I have included here excerpts from both the beginning of the section in my Application on age and sex discrimination, and on family status and marital status. But I will make changes to that section.
Initial emails with HRTO
19.  Following is the initial sequence of emails and letters back and forth between the HRTO and myself. My HRTO Application had been received by them on November 6, 2017, and given a File Number, but at no time did I receive notification that my Application was being worked on – being processed. When I emailed for the status of my Application, on Nov 27, 2017, I was informed the same day by email that it was in a queue. I did finally contact the HRTO (also called the Tribunal and/or the Registrar) on November 28, by email plus attachment, to inform the Registrar that my Application included information about a related investigation under way, at the CPSO (College of Physicians and Surgeons of Ontario). That complaint was about another doctor, whose attitude and behaviour towards me was due, in part, to his knowledge of the negative reports written by the specialist/surgeon I had named in my Application to the HRTO. These two investigations are connected, and I wanted to ensure that the CPSO was aware of this Application. When I had attempted to inform the investigator at the CPSO of the HRTO Application, she simply said that each investigation was confidential so the CPSO would not know about the HRTO Application. As it happens, they are not confidential. I was required to include details of the CPSO complaint, including the original complaint form (dated June 27, 2017), in my Application to the HRTO.
20.  After I wrote that email to Dr Fthenos, on November 28, 2017, explaining about the CPSO investigation, in return I got a letter in the mail, containing no mention of my concerns, but informing me of his 2017 Dec 11 Notice of Intent to Dismiss  .
Human Rights Legal Support Centre and the Summary Hearing
21. On speaking with the Human Rights Legal Support Centre they told me that the HRTO didn’t deal with incidents involving medical decisions.  I didn’t know that, but I still have 6 or 7 other incidents the Tribunal could investigate. The person at the Legal Centre did not want to discuss anything more with me with me when I said to her the medical decisions were just just the start of it. I know I must have made mistakes in the Application, and I would appreciate the opportunity of correcting them, and giving evidence, rather than see the entire Application dismissed.  I gather, ordinarily, that this decision of the Notice to Dismiss would be made at a Summary Hearing, where the Applicant would be able to defend their position, but the Tribunal has not requested a Summary Hearing, although the Respondent apparently could, but I thought not until my Application had been processed, which would mean that the Respondents named in my Application receive notice from the HRTO that this matter was being investigated. I am unsure whether a Summary Hearing would be of greater benefit at this point.
22.  I submitted my Application to the HRTO on Nov 6, 2017. I received confirmation but for several weeks it was in a queue, I was told on November 27 when I inquired. Then, on Dec 11, I was sent by mail a Notice of Intent to Dismiss my Application and given until January  8 to respond. The way Dr Fthenos, Registrar and human being, or his assistant, unnamed, has left it (intentionally or not) is that I am subject only to the decision made by him or the assistant, whether or not to dismiss my Application. See Paragraphs 5, 7, 11, and 16. 

23. At best, I am at risk of having the Registrar, Dr Fthenos, dismiss my Application on his own ability to reason, and his own knowledge of discrimination on the grounds I  have mentioned (has he read through the 50 pages?).  Worse, it could be someone – unnamed – who is just learning how to process HRTO Applications.  I do have concerns. It’s one thing to have respect for someone in authority, and to show respect, but quite another to trust the outcome, especially when mistakes have been made already, and comprehension of discrimination on the basis of age and sex has not been demonstrated to me in the letter I received (2017 Dec 11 HRTO Notice of Intent to Dismiss), signed automatically 'Georgios Fthenos'.

21 December 2017

Ageism in Ontario's health care and human rights (HRTO)

In November, 2016, I was subjected to false accusations and lies (which amounts not only to harassment/verbal abuse but also to discrimination under the Human Rights Code) in reports written by a specialist/consultant at LHSC (London Health Sciences Centre), and other employees.  I identified that incident, among others, as discrimination on the grounds of sex and age, and marital and family status, separating it into nine distinct incidents, and submitted an Application form on those grounds to the HRTO (Human Rights Tribunal of Ontario).  I named eight Respondents, one of them being the organization LHSC, the rest being individual Respondents.

Writing up this Application was complex enough. It was impossible to make all the connections that would enable a caseworker to understand at one reading what it was all about. But this was only the Application, not the hearing. And nothing stands still. Even since submitting my Application, on November 6, 2017, there have been other interactions, not in person but by mail, or email, or telephone.  The distortions of truth coming from those interactions have been more than simply frustrating. They’re enough to make a person lose faith completely not just in the human race but in the  safety or value of speaking in person to someone who might then tell lies and manipulate one. There was also the doctor who wrote to me, copying his letter, sent by standard mail, to several of his colleagues. I don’t have that option, to start sending so many letters off to people, and so am limited to using mainly email, a means of making contact that is not reliable or proof of anything except that one may be a nuisance, probably, something that may not apply so easily to a letter writer.  Then it came to be that emails themselves – not mine but other individuals - were likely being manipulated, but I had no power to stop that from happening.

It is difficult to be an older person in Ontario and not have the resources or support to fight the battle, not just against the original source of discrimination and ageism as a patient, but then with the HRTO. I don’t qualify for Legal Aid and don’t have the funds to get a lawyer or even a paralegal otherwise, as far as I know. Despite seeking the more reasonable alternative in the London area I didn’t find a paralegal who appeared to have knowledge of the complex system of human rights in Ontario. That’s different from human rights abuses that happen abroad. Here, it’s about discrimination on grounds that are listed in the Human Rights Code, such as age, sex, race, marital status, etc, that occur in education, or employment, or in areas such as goods and services.  

The woman at the HRTO Legal Centre will only say to me now, after hearing the first part of my Application (about this being about a doctor) that they don’t deal with cases about doctors’ medical decisions. That is how this situation started – regarding a medical decision made by the doctor, but it has gone way beyond that. In fact, looking back at it more objectively, I believe the main incident for the HRTO (since he has been absolved of responsibility of  treating me inadequately and carelessly) must then at least be about the damning reports the doctor wrote about me, no doubt egged on by his loyal staff.  This will get sorted out, as time goes on. It is just difficult to pull it all together when others say that’s not allowed, or that’s not the problem.

I wonder if the participants in this in entire situation were knowledgeable enough to realize that the larger they make it – the more complex and involving more people than just the doctor – the less likely it becomes that the HRTO or any other complaints system I went to would see as an issue they can resolve – or was it simply that they figured if they ganged up on me, I would give up and go away. According to the doctor’s reports, not just one or two, but all his admin staff accused me of being rude. I only recall seeing two of them – the front desk clerk and the person who showed me to my appointment, but then there was the audio clerk too. And the appointment-taker, so named because she was only the voice on the other end of the telephone, there to make – and break – appointments.

I tried to explain that at one point, probably in the Application, that part of that problem, the one with the front desk clerk, could have been a matter of perception (with discrimination as its basis).  If she, as secretary of the doctor, saw herself as above the patients – or above some patients – they may consider it rude even if the patient speaks to attempt to understand something. Treating patients as children is one form of ageism – as people not competent, or on the other hand as not worthy, being only patients in the hierarchy. Besides that, the front-desk clerk may also have had poor self-esteem, and thought I was being critical of her, which I wasn’t. I just thought that, 2 years down the road, I could try to make sure that my reports didn’t keep going to the original referring doctor. On the other hand, her behaviour (which wasn’t immediate, only coming to light weeks later) may have been done to me to turn the tables, as it were, knowing that I realized I was being shortchanged on the diagnostic test that had been offered me. Thus, accusing me of being rude, in effect, treating me like a child, was to do the opposite of what I was about to bring into the open, the fact that the doctor saw it okay to treat me, an older female, having no family close by and no husband, the way he did. Thus, by the doctor accusing me of being rude, the real reason behind my attempts to get answers about the test I was being offered, when I had already been dismissed so quickly by the doctor at the appointment, was at risk of being ignored completely.

I have been put in a situation of trying to understand why this or that happened to me, and whether it was legitimately a case of discrimination on the grounds of one or more of sex and age, and marital and family status.  And I have had to do it for every incident, of which there were nine in the Application I made – 9 incidents, 7 individuals. If the HRO believes in social justice, I hope they would make it as bearable as possible for me to engage with them in achieving a just solution.  

At this time, there is a delay in processing new Applications, I have been informed, which are taken in the order they are received.  So, meanwhile, no caseworker has been assigned to my Application, made on November 6, 2017.