“Quare siletis juristae in munere vestro?
[Why are you jurists silent about that which concerns you?]”
Giorgio Agamben, State of Exception
The Health Ministry is inappropriately extrapolating DNR orders to limit other life saving treatments for certain patients deemed disposable based on arbitrary criteria. In other words, a person can have a Do Not Resuscitate Order using CPR because such a rescue might be considered by the physician as futile or that it would cause more harm but that shouldn’t automatically preclude the patient from receiving other successful life-saving treatment.
My father is laid in the hospital bed in his multi-striped house robe tied at the waist with a sash over his beige hospital pajamas. His arms and legs are thin, he is frail, but his face is calm. Almost nonchalantly, he shrugs his shoulders. He blinks at me through the lenses of his gold wired eyeglasses, and he says, “I want to live, you better tell him, go on, make sure that doctor wrote it down properly.”
The day before I was present when a young doctor came to my 87-year-old father’s hospital bed. He looked at my father’s medical chart and then asked my father why he wanted to live. He asked this because my father, being of sound mind and medically stable, had opted to continue taking life-saving medication to prevent, or at least alleviate the symptoms, of his episodic illness. The young doctor who was assigned to write down my father’s wishes for what should be done by the medical professionals for my father if he should become ill again sighed in exasperation. The young doctor seemed frustrated by my father’s decision. My father felt compelled to tell the doctor why he chose to live. My father told the young doctor he wants to live to be with his family and most especially for his grandchildren.
The young doctor said, “OK, but that means you will be getting far more service than almost anyone else in this ward.” And he extended his arm to wave to the hallway with the hospital rooms that were full of patients who were elderly like my father.
He then advised my father, “A lot of care homes would not accept people who want to continue to treatment like that.”
The young doctor said he would have to check if the care home my father is being sent to would accept my father given that he chooses to continue to receive medical interventions in an attempt to live. My father sat in the chair by his hospital bed with his worn book of bible quotations on his lap. My father’s fingers never left the page as he spoke to the doctor as if drawing strength from the words on the page.
At the same time, I could see a female patient, who was older than my father – who seemed to be one of the very very very old – being helped by a team to walk up and down the hallway from her hospital room. And a young nurse spoke to her, in a Chinese accent, “You must walk so you can get better.” With a lovely emphasis on the word “better” as though the nurse was speaking gently to a child.
When I asked why my father could not similarly walk for exercise the nurse explained that my father was required to stay inside his room due to the current Covid-19 policies. The nurse told me that the elderly female patient was a foreign resident and therefore able to pay for private care and there was as the nurse put it, “a big big difference” between public and private care.
The nationality of patients shouldn’t matter. Yet we Canadians are forbidden to pay for private medical care in our Canadian hospitals. In contrast, foreign residents are required to pay for private care in Canadian hospitals to access our health care services. So where does that leave us? Apparently, from what I have seen the private care that all foreign residents can access in hospitals is of a higher standard with incentives built-in through the payment process that impact health policy even to the point of affecting life or death decisions.