Showing posts with label Human Rights Tribunal. Show all posts
Showing posts with label Human Rights Tribunal. Show all posts

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
                         complaint
Dec 7, 2017 –   Letter to Dr S. Bodley, President, CPSO, informing him of the related HRTO
                         Application
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
                         corrections
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
 "(A3.1).
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'.

29 January 2017

The Women’s March, social injustice, and personal experience

About a week ago a piece was written for the Washington Post that I found to be out of place in the Opinions section. I hesitate to provide the title of it, as it might automatically turn readers against me, for not viewing it with the sensitivity it requires, at least on one level. But here it is - the title 'My wife died just after Election Day. I'm attending the Women's March for her'. 

Death so often does necessitate the offering of condolences, ignoring errors in judgement or in practice, and just generally thinking of uplifting things to say. But then why would anyone choose to publish an obituary in the Opinions section of a newspaper?  Perhaps the reason was that it wasn’t an obituary in the usual sense. It was as much about the husband of the person who had died as about the deceased. And yet, scores of comments in the Comments section following the article were written in a manner that resembled condolences more than comments.

One might ask, was the article telling us the opinion of the writer on some social or political  - or economic  - issue? Not exactly, no, the writer appeared to be questioning his own sense of masculinity, in preparing to march in place of his deceased wife in the Saturday’s Women’s March, held in Washington and in places around the world, on Jan 21, 2017. Those who marched did so for a variety of reasons, many of the marchers no doubt being personally motivated, others marching for the rights of women who are marginalized in society, some having specific interests, such as abortion rights for women, violence against women, etc.

Mr Ikins’s wife suffered a tragic death, a fall down stairs, a coma, and finally, release through death. I can relate to that experience of having a fall. A year ago today I suffered a slip and fall, through which I broke my femur. Luckily  - I think – I survived, not having severed an artery and having a fast-acting, thoughtful neighbour, paramedics ready to do their bit, and an expert surgeon to care for my injury. Since then I have had to walk using a walker, but in a few days I will have the nails removed from the knee – nails that held the rod in place while the leg healed. So I am hoping for the best outcome. But by chance, my equilibrium – my sense of balance, experienced as a kind of giddiness, has affected my ability to walk normally too. Mr Ikins says that Nov 8 was the worst day of his life.  It was not a great day for me, either.

On November 8, 2016, I attended an appointment with an ENT (ear, nose and throat) specialist, to tell him about the symptoms I had been having, but found my concerns being dismissed by a specialist who was overbooked, overworked that day, no doubt, and who was not expecting this new set of symptoms. For some reason, he was also defensive, and spent far too much time explaining to me why he sent the last report to my old family doctor, the one I had laid a complaint against with the CPSO, and filed an application against with the Human Rights Tribunal.  I had realized the report went to that doctor, despite my requesting from his appointment taker/secretary that it not be, but it was anyway, in order to abide by the regulations. 

On my way in, I had asked the girl at his clinic front desk if the report could be sent to a different doctor this time, and she said she thought so, but to ask the doctor when I saw him, which I did. All this took precious time away from my concerns – of the balance issue – disequilibrium.  Finally, he offered me a partial VNG test (look it up). I agreed, and later, at home, looked up the test on google. I saw that I had been offered only a piece of the set of 4 tests, and so decided to try to get the tests I needed. To skip to the end of this story, the appointment-taker/secretary and the staff at the ENT clinic lied about me, and the ENT specialist cancelled the appointment I had with him. I am now left with no suitable options for a proper diagnosis nor for treatment options, nor to repair the damage to my reputation.  The only possible option I have, which won’t help my vestibular/vertigo problems, is to lay a complaint against this doctor too.

Returning to the article written by Charles Ikins, I have to say I question whether Charles Ikins’s perception of the reasons for the march were rather limited. He saw it as being for women who experience indignities of the kind Trump had presumably committed, the very reason his wife was protesting.  And he decided that it would not be unmasculine for him to march in place of his wife, to honour her beliefs and commitment.

For the most part, I believe the women’s march was about fighting for the rights of women, and especially marginalized women, women who do not get the same kinds of opportunities and treatment that other women do – some of them single women, poor women, women without husbands, black women, old women, and so on. The maintaining of rights of women – abortion, sexual rights, and so on, were also reasons women marched.

I thought that the Washington Post had used a grieving husband’s thoughts and piece honouring his wife as a political manoeuvering – publishing it on Trump’s Inauguration Day, the day before the women’s march. Taken on its own, as a piece intended for friends and family, the article could be seen as having merit. But published in the Washington Post, for the public to read, it came across as something very different.

Part way through the article, Mr Ikins mentions the admonition for participants to “check your privilege.” He says he thinks he knows the meaning of the phrase, and yet the article itself is an example of what the privileged should try not to do. Instead of seeing things through their own eyes only, and taking for granted the things they have, the material advantages in life, and seeing their own cause as the one most worthy, they might try to see what others experience in life.

It is part of the human condition for tragedy to strike families – all of us - tragedies that are not anyone's fault. That's not going to help the writer of the article talked about here, but it needs to be said. Furthermore, some people in life – women among them – struggle in ways the privileged might not even be able to imagine – and it is not always men who are responsible for the injustices.  Finally, I have reservations about the value of a Women’s March if President Trump is chosen to be the most recent scapegoat for feminists seeking to unite women over a cause - any cause – to enhance interest in the feminist movement.


By Michael Alison Chandler
Washington Post - Opinions
Jan 12, 2017

By Charles Ikins
Washington Post – Opinions
Jan 20, 2017
https://www.washingtonpost.com/opinions/my-wife-died-on-election-day-im-attending-the-womens-march-for-her/2017/01/20/e83c8092-df2d-11e6-ad42-f3375f271c9c_story.html?utm_term=.52db5f512fff&wpisrc=nl_opinionsA&wpmm

26 January 2016

The Human Rights Tribunal process is a farce

Having been involved in Ontario’s Human Rights Tribunal process since the summer of 2015, I can now say for certain the Human Rights process  - at least the way it was conducted in my case - is a farce. It may work for some people, of course, but I hasn’t worked for me.

One of the reasons I say this is that, while attempting to get one of the main issues of contention between the Respondent and myself, the Applicant, resolved, I can see how the process has worked in his favour. And if the process itself hasn’t, while running its natural course, then the people working in it have enabled it to benefit him.

One


The Application I made to the HRT was to declare that the Respondent – my family doctor at the time – had discriminated against me on the grounds of sex, marital and family status, and age. I followed the rules and submitted 5 ‘important documents’ and one audio recording that I would be using at the hearing, as well as providing a list of them, stating the importance of each, as required in that section of the form. As the Applicant, I also had to provide a thorough description of the two incidents of discrimination and how they affected me, and what remedies I was seeking, which did not include a monetary remedy only ones directed to the Respondent himself and recommendations within society. See Remedies sought from the HRT.

Then it was up to the Respondent to write an official Response, using an HRT form for that, which he did in July, 2015. On it he wrote the name of only one document – The Medical Chart of McMcPherson – giving the reason it was important as “describes the care provided to Ms McPherson.”  It was at about this time that I inquired from the Legal Support Centre what was menat by the term ‘Document.’ I got no answer on that.

This was the first of the three times in all that the Respondent and the Applicant (myself) were required to declare what documents we were bringing to the hearing – or relying on, or might be using.

I did respond the Respondent’s official response, but the Form 3 I used said only respond to new issues, so that matter of the one bundle of documents – being my Medical Chart – remained unaddressed.

Two


The second time we were required to declare the documents  - in a formal Disclosure of “Arguably relevant Documents” - was by September 1, 2015, which I did, submitting my by then 7 documents plus 2 audio recordings by the deadline, but receiving nothing in return from the Respondent.

I contacted the Respondent and the HRT via an official form and was hastily sent the bundle of items previously mentioned by the Respondent – the Medical Chart. There were no dates on them, not in chronological order, no description of each page or their importance, nor their relevance, as was stated to be the new requirement – that they be arguably relevant.

I was concerned about the bundle being passed off as a single ‘Document’ but was advised by HRT to wait as a third deadline would soon be approaching, and perhaps all would be resolved by then.

Three


The third and last deadline was Dec 29, 2015, by which time the Applicant and Respondent were to have submitted all the documents they were going to “rely on” at the hearing in February.  By this time the Respondent had put numbers and titles on each of the items in the 103-page Medical Chart. But nowhere was the importance of the ‘Document’ or it relevance included, except meant to be as a “description of the care provided to Ms McPherson.”

I objected strenuously. And the Respondent’s lawyer objected in return, and in two Interim Decisions and one Case Direction, decisionmakers at the HRT sided with the doctor – the Respondent.  I get to use my 7 pages, and he gets to use 103 – if he needs to.

If I need to defend myself against anything that is raised by the documents he produces in self-defence, I don’t have anything. We both submitted documents starting in April, his in July, 2015, me providing insight as to why mine were important, the doctor providing nothing, except to say they described the care provided to me.

Negotiations and arguments


Forms 10 and 11 abounded then, between the Respondent’s lawyer and myself and the HRT, as we attempted to persuade the Interim Decisionmakers, Laurie Letheren and Dawn Kershaw, of the merits of our requests – me for adjournment to allow the Respondent time to provide the relevance of each of the 103 pages, his lawyer to plead that he had the right to a speedy hearing.

As time went on, his lawyer made the argument once again that I had placed the care provided to me at the centre of this matter, while I argued that no, like Evan Solomon, Mike Duffy, Jian Ghomeshi and Joe Fontana, when accusations are made against them it isn’t the good they have done that is at the heart of the matter. It is when mistakes are made, or discrimination carried out, that it ends up at a Tribunal and these are the matters to be looked at, not the good these people did. The lawyer’s Form 11 saying what she did, there, was ignored by the Interim Decisionmaker, Dawn Kershaw, in her Jan 15, 2016 Interim Decision, as were my remarks about what this case should be about.

Each time, the Interim Decisionmakers argued that this matter of the adjournment and the relevance of the items in the Medical Chart should be left to be decided at the hearing.  And then I realized that this was not going to happen. It couldn’t happen. It was an illogical decision the Interim Decisionmakers had been making every time they said it.

It would take time, if the Respondent were ordered to write down the relevance or importance of each of the items in the 103-page Medical Chart. There’s not a hope that could happen at the hearing, while we are all sitting there. It would seem that they  - the HRT Registrar, Richard Hennessy, or the adjudicator, Dawn Kershaw - had no intention of deciding in my favour, that the doctor would have to provide the relevance of each of the documents.

What that means, in terms of the hearing, is that if I produce a document or an example of ill-treatment or disrespect he wishes to dispute, he can produce a document from the 103 pages to prove his argument. However, having only 7 documents and 2 audio recordings, I am limited in how I can make a point or defend myself against his accusations. I can speak, but I have not been granted credibility. So it is the harsh words and distortions in documents written by the Doctor and his receptionist that will be believed.

What’s worse is that, during this whole process, I was led to believe that the process would be fair, yet I was not given the option of seeking documents to contradict the 103 pages he decided to rely on.  In fact, how could I? How could I begin to guess what he was going to produce, at the hearing, from his array of documents that he first mentioned back in July?

Three times the doctor produced that Medical Chart as his Document of importance, relevance, to rely on. And each time he not obliged to prove that the items in it were.

Discontinuity between the lead-up and the hearing


Late in the process it also sinks in that everything that happens during the initial process has nothing to do with the hearing. All that happens during these months of preparation, the HRT sending directions as to what should be submitted and when, and how they should be described, is forgotten once the hearing starts. What that means is that all the talk, all the arguments, all the lack of description regarding importance, relevance of the pages, etc. in the Medical Chart mean nothing once the hearing starts. It means that I can request that the doctor provide the relevance, right there, at the hearing, but that the adjudicator, Dawn Kershaw, can simply say No. Or, she can say, This should have been dealt with before the hearing started. There is no time now.

All those submissions I made, beforehand, about my position, mean nothing, unless they are included in the documents I submitted to the HRT to be used at the hearing. That means that the medical research I provided links to on why older women who have had given birth and have had hysterectomies ought not and do not need to be sent off for an ultrasound on their bladders will not be there as evidence. Only my word will count, though the colleague witness of the doctor has said in writing that the treatment I received – including the pelvic ultrasound on my bladder, was within the standard of care limits. What that means to me is that I would not want him as my doctor. And secondly, that giving the patient the chance to ask questions beforehand and to find out what would be expected from her doesn’t matter to either of them. As for the request by the doctor for a urine sample from me to test for “street drugs,” it is still my view that he needs to take a course or two on how to communicate in respectful ways. See details of the incidents of discrimination:
Statement on Pelvic Renal ultrasound incident 
Statement on drugs, urine termination incident 


Just as importantly, the doctor needs to consider the differences between  women who are young and those who are growing older, and how that may affect their diagnosis and treatment in matters such as kidney disease.

What is the purpose of such a lengthy process of requests for documents from the Applicant and the Respondent?  Is it to wear out the Applicant through repeated failed attempts to achieve fairness at the hearing?  See SJTO and HRT Rules of Procedure p 2

p 2 of the Rules

A3 INTERPRETATION

A3.1 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.





20 September 2015

Human Rights Tribunals: privacy and transparency

Added Nov 15, 2015: An Interim Decision was made on October 8, 2015.  See more in the note below, at the end.

The purpose of this is to explain part of the process of the Human Rights Tribunal, using one aspect of my own experience and how that relates to privacy laws in health care, and accountability of physicians and other health care workers, and the accountability and transparency of those organizations meant to resolve problems that occur. The example I am using is of my own Application to the Human Rights Tribunal, April 14, 2015, of discrimination on the grounds of my sex, family and marital status, and age (for more details, see Health care among single, older women – a case of discrimination for OHRT).

On Aug 26, 2015, I made a Disclosure to the lawyer of the Respondent. The Disclosure was required according to the Rules of Procedure, providing him with copies of the documents I would be relying on at the hearing, as “arguably relevant” documents.

I received nothing from the other side by the deadline (September 1, 2015) given by the HRT, in the Rules as being three weeks after they notified us (on August 11) of the dates of the hearing (February 10 & 11, 2016). September 1st  was the date by which both sides were to have sent to the other a list and copies of documents they thought may be relevant to the issues raised in the case.

Backing up for a moment, I must say here that only one item had been listed in the Important Documents section of the Respondent’s Response to my Application (received July 27, 2015).  That one item was my Medical Chart, for all the time I was with the doctor in question, from September 2012 until spring of 2014. I submitted my Form 3 reply to the new points raised in the Response on Aug 12 (having had an extension, due to the original due date, August 7, being less than 2 weeks away from when I received the Response) though not responding to the idea of having his entire Medical Chart about me being available for him to pick and choose from at the hearing, or for it to possibly influence the adjudicator. Since no items – appointment dates, specialist reports, etc – were listed, I had no idea whether what was included was a complete set, or whether what would be sent to me, finally, was complete. And at the same time, more or less, received the notice from the HRT about the dates of the hearing, requiring me to then send a Disclosure to the Respondent by Sept 1, which I did, as noted in the previous paragraph.

But now, having not received a Disclosure of arguably relevant documents from the Respondent by September 1, and not agreeing anyway with the idea of my privacy into my medical records being made available in that manner, I discovered that I could complete a request for an Order on a Form 10 and submit it to the HRT, using the Production of Documents part to request a copy of the document - my Medical Chart. To me, the chart wasn’t “arguably relevant,” at least not in its entirety, but I decided to submit Form 10 anyway, requesting that the Dr itemize the Medical Chart and send only those items he was planning on using at the hearing in February. Also, I requested under ‘Other’ that for privacy reasons, the entire chart not be produced at the hearing, thus, not sent to the HRT’s adjudicator (see excerpt from PHIPA, Personal Health Information Protection Act, 2004). Formally, these were the requests I made in writing, and sent to the lawyer for the Respondent and to the HRT:

Request for an Order for the Production of Documents
I am requesting, first, with conditions, that the Respondent, the Dr, produce relevant sections of the document he named in his Response (July, 2015).  I also request that he particularize those sections of the Medical Chart that he plans to use at the hearing.  

Other Request: that the Medical Chart of Ms McPherson not be used in its entirety
I am requesting that the Respondent not rely on the Medical Chart of Ms McPherson in its entirety, for this Application at the hearing, as that would be an invasion of privacy under the law, such as under PHIPA, the Personal Health Information Protection Act, 2004. I request that he selects only those items he plans to use, explains why each is important, and provides a copy of them for the Applicant. (Question 3, Form 10, September 9, 2015)

I wrote out a detailed explanation of my reasons for making these requests in Form 10, Question 4, and sent a copy of the Form 10 to both the Respondent’s lawyer and to the Human Rights Tribunal Registrar/caseworker.

About two weeks later (September 17th) I received a copy of the Medical Chart from the lawyer, obviously not itemized as there was no list, and no explanation of why the Respondent thought each entry in it was important, or arguably relevant, or whether it was complete at all, and of course, reaching me well after the due date for a Disclosure.

This wasn’t what I had hoped for. After all that explaining, the lawyer had simply sent off what appeared to be an unsorted file of my medical records, not particularized, and with no acknowledgement in the cover letter that I had sent to her a completed Form 10 with pages of info and explanations. There was a brief email discussion between the lawyer and myself, which also went to the caseworker.  But in the end, the caseworker said that the Form 10 Orders would go to a ‘decision maker’ to resolve.  Already, I can picture another person getting involved in this situation who knows nothing about the Application, and would have to start from scratch reading up on it, and being pressured to make a fair decision on whether my Medical Chart should be allowed to be taken into consideration and whether it needs to be particularized.  What’s more, the lawyer now has the opportunity to respond to my Form 10 request before the decision maker considers it, and the decision maker gets to see what she says about it, including the fact that she has sent me a copy of the Medical Chart already, by that point.

One might ask, at this point, why did the lawyer quickly send me a copy of the Medical Chart, when it was overdue by practically two weeks, and when it was not what I asked for?

I feel that her sending the ‘document’ to me – the Medical Chart – altered the dynamics of the situation, whereby a ‘decision maker’ might just as easily say, Well, it’s been sent to the Applicant now, so leave it at that. And the Applicant did make out a Form 10 request for Production of Documents . . . . .

The Rules of Procedure say the Respondent must send their ‘arguably relevant’ documents by a certain date, but don’t say what happens if they are not sent by that date, except that I can request them if I choose to, through submitting a Form 10, in this case for Production of Documents.

I don’t want this to end up being a matter later interpreted by the Respondent as me being the one to request the Medical Chart. Details are so easy to skim over, and if the fact is that I submitted a Form 10 for the Production of Documents, which I did, the assumption could well be that I considered them ‘arguably relevant’.

This Application to the Human Rights Tribunal is supposed to be about the actions and behaviour of the Respondent, not about me having to defend myself against false accusations and distortions of the truth made by the Respondent and his colleagues in documents in my Medical Chart. My response to Question 4 of the Form 10 goes into more detail about the idea of truth, and who gets to be believed in this world and who doesn’t. It also brings in the matter of the longer transcript of the April 28, 2014 office appointment, and the accusations made against me by the Respondent in his Response to my Application, that I shouted at his staff after the appointment ended.

I have presented in my Application only 2 examples of discrimination, both of which I believe I have the evidence to uphold. I could write at length, too, about the behaviours of the Respondent, but I have no proof of much of it. But when the Dr says something, and writes it down, it seeme from what I have seen elsewhere that it is taken as truth.

I might not have known about Form 10 and the right to request a production of documents and the right to request privacy of medical information, had not the Respondent failed to make a Disclosure of the ‘document’ named in the Response – the Medical Chart.  I have no access to a lawyer who can foresee such issues arising and be able to advise me. Of course, the other side of that is that no mention of the reason for the importance of the Medical Chart was mentioned in the Response, and its relevance might have been difficult to explain. I have never said the doctor did not provide some good health care towards me. If he hadn’t done something worthwhile, it wouldn’t have taken me so long to acknowledge the unprofessionalism and poor judgement in his treatment of me, and he would have been seen, at least by me, as not worthy of being a physician. Rarely is someone totally one or the other – all bad or all good.

A physician is someone who is subject to certain standards in his profession. Too many errors of judgement, incidents of rudeness, trivializing the patient’s concerns, and judging me on the basis of my sex, and family and marital status, and age is what can lead to the realization that he is discriminating against me. Saying, “The report is back. You’re fine,” isn’t serious on its own, but amongst so many other incidents, it becomes relevant, an indication that he doesn’t care, and isn’t doing his job.  When I go to him about ankle pain, or a swollen knee, and the first question he asks is How does that affect your driving,” one has to wonder. And when medications I have been taking for a number of years are questioned, and changed, for no good reason or without informing me when I go to him to have prescriptions renewed, it made me wonder. And why was I treated like a walk-in patient, having to have my prescriptions renewed by hand, with the risk of mistakes being made, and being denied having access to Tylenol 2 with codeine, 2 per day, as though that was a large amount and I might abuse the privilege of having relief from pain. Read in my blog, Health care among single, older women – a case of discrimination for OHRT, for details about that and the unnecessary pelvic renal ultrasound he sent me for. He wasn’t behaving like a family doctor should.

The HRT caseworker had assured me a while back that if the due date were approaching and I hadn’t sent a required document, that he would request it. That was in response to my requesting confirmation when he received documents I sent to him. But he didn’t request from the Respondent the ‘important document’ named by the Respondent in his Response, which surely must have been intended to be sent as an ‘arguably relevant’ document to me as a Disclosure. The caseworker accepted my Form 23, declaring I had sent my own Disclosure to the Respondent, but it didn't jog his memory to ask the Respondent for his list of arguably relevant documents in a Disclosure. And my sending my Disclosure to the Respondent didn’t lead him – or her, the lawyer – to send their own Disclosure to me.

For me to do the requesting of my Medical Chart, through a Form 10, resulting in a conglomeration of largely unexplained and unidentified items quickly being sent to me (although more than two weeks overdue, not the ‘documents’ I asked for, and not mentioning they were in response to my Form 10), would have made it appear that it was me who believed they were ‘arguably relevant,’ unless the decision maker took more time to read what I wrote than the lawyer did. It is possible the lawyer was attempting to cover up a mistake, and was hoping the ‘decision maker’ would overlook it and accept her sending of the documents, though past the deadline, without examining closely what I wrote in Question 4 of Form 10.  But the lawyer wouldn’t have realized her error of omission had I not pointed it out when I sent her the Form 10. And then what?

It’s too easy for the Human Rights Tribunal to take short cuts, to not be transparent in its process, and to simply make important decisions without the Applicant knowing what’s going on, for instance, who the decision maker is in terms of position if not by name, and his expertise, especially in the area of privacy in health care. This situation has now been left in the hands of the Respondent’s lawyer, who gets to write a response to my Form 10, and the decision maker for the HRT, who makes a judgement on the Form 10 I submitted. He could have her send a list of itemized documents from the Medical Chart, and agree with me that the privacy of my medical records is important, or he could just say, Well she has sent it now, so that’s good enough. And then she will send a copy to the HRT in December, the relevance of which the Respondent will not be obliged to explain, even if it gives a false impression of me, while falsely presenting him in a better light.

Note: Added Nov 15, 2015: 


An Interim Decision was made on October 8, 2015, granting the Respondent and lawyer their requests, regarding their Disclosure – my medical chart.  It was declared by Laurie Letheren, an adjudicator with the HRT, that my requests were premature. The material was delivered to me, although not organized properly, some of it not relevant and none of it argued to be relevant, and not itemized, no reason stated for its importance other than it demonstrated the care I received from the doctor, and it was sent a little late. But at least I got them, I think she was saying. 

If the Respondent decides to particularize the documents, s/he may do so when required to send the documents to the Tribunal (deadline December 29th) in preparation for the hearing early in February. But again, s/he may not. There has been no warning given by the adjudicator to the lawyer to itemize the documents. It’s just a collection of undecipherable documents, much of it, with no explanation of why each page of the seemingly random collection is relevant. At least, that much should have been done. Then, by the end of December, s/he would be able to decide, presumably, which documents she is going to use at the hearing. 

Also added to List of Resources, on Nov 15, ‘Health-care system in need of more transparency, report says’ (The Star, Nov 12, 2015).

Resources


Health care among single, older women – a case of discrimination for OHRT
April 12, 2015
http://suemcpherson.blogspot.ca/2015/04/health-care-among-single-older-women.html

Health-care system in need of more transparency, report says [added Nov 15, 2015]
C.D. Howe Institute says there should be more public reporting on patient experience within Canada’s health-care system.
By Theresa Boyle, Health
The Star
Nov 12, 2015
http://www.thestar.com/life/health_wellness/2015/11/12/more-transparency-needed-in-health-system-report.html

New health legislation will improve transparency
By Olivia Carville, Staff Reporter
The Star
Sept 19 2015
http://www.thestar.com/life/health_wellness/2015/09/19/new-health-legislation-will-improve-transparency.html

Personal Health Information Protection Act (PHIPA), 2004, S.O. 2004, c. 3
Government of Ontario
http://www.ontario.ca/laws/statute/04p03#BK1
retr Sept 17, 2015
see excerpt here: http://suemcpherson.blogspot.ca/p/personal-health-information-protection.html