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Saturday, November 20, 2010 9:13 AM
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Terryl Rand Collins MD
The death of a medical traveller after he could not obtain treatment highlights yet another ethical dilemma in the Canadian medical system - and another way that the system is failing patients.
Don't get me wrong; I believe in the Canadian medical system. As a retired physician, I know the value of government-supported medical care. I practiced medicine for 15 years in the US, and I know how many American families put out as much for their medical insurance as they do for their mortgage.
Yet that doesn't mean that I don't think it needs a lot of work, and not just in the area of MS. Patients with "non-emergent" conditions wait months or a year for care for gall bladders, hips, shoulders, and many other conditions that are not immediately life-threatening. Lives are put on hold, and muscles slacken from disuse due to pain.
Consequently, many patients go out of country for care, most commonly to the US. Yet, like Danny Williams, these patients are vilified for being "disloyal". This creates problems when they return and need continuing care. Just like our MS patient, they are in a double bind - can't get the care at home, yet treated like traitors (or not treated at all, which is worse) when they return.
Much of this guilt trip comes from the very same governments that fail to provide the services in the first place. Blaming the patients or those who provide needed services in an alternative manner (like the fee-for-service clinics, or those overseas who provide treatment for MS patients) is a convenient way to avoid an honest analysis of the failures of the system. And stigmatizing the patient only adds insult to the original injury.
As a physician, I agree that there are still many questions about CCSVI, the treatment is untried, and overseas clinics may or may not be well regulated. Yet Canadian physicians have a duty to provide care, whether they approve of overseas treatment or not.
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