Under an Alberta Health Services’ rule, only persons vaccinated against COVID-19 are eligible for transplant surgery. By definition, this is discriminatory and intentionally so..However, Albertans may well ask themselves whether that’s the kind of discrimination they want and if it is, who should be accountable for it — unelected health bureaucrats, or elected officials..If that’s what Albertans want, elected officials need to own it. At the moment they don’t — and are no doubt grateful — if hot-potato policies can be shrugged off to the AHS.. Sheila Annette LewisSheila Annette Lewis .For most of us, this may be of academic interest only. For one Alberta woman however, it is a crucial discussion. Sheila Annette Lewis, learned last year she needed life-saving transplant surgery. Upon this diagnosis, she was told before the surgery would be performed she would need to not only be fully vaccinated for COVID, but also have her childhood vaccinations renewed. At the time, this was not a formal AHS policy but the judgment of the physicians involved. In November of 2021, a national committee of transplant specialists agreed among themselves this was indeed a necessary pre-condition: Thereafter, the AHS made the committee’s policy its own..Ms. Lewis, 57, complied with the order to renew her childhood vaccines. But, as the COVID vaccines were (and remain) experimental, she declined them..But her life still depended upon getting a transplant, so she began legal action. The details of her ailment and the treatment she needs are as a result now subject to a court-ordered publication ban, but we can say without the operation, she may not survive to see the results of her appeal..The King’s Bench judgment dismissing her complaint is instructive:.“This is not the first time medical judgments about allocation of scarce resources have been made in the face of competing needs. While such decisions are doubtless exceedingly difficult, they nevertheless must be made. In this case, the Charter does not apply to the respondents’ exercise of clinical judgments in formulating pre-conditions to [organ] transplant, including requiring vaccination against COVID-19 in the wake of the pandemic.”.In other words, a lot of people want transplants. If you won’t take the jab, there are other people who will and they’ll get what’s available. In a brusque, Benthamite ‘greatest good of the greatest number’ way, that sounds like necessary pragmatism..But is it? We expect judges to be judgmental, of courses. But one recoils from the screen with dismay at the moral condescension explicit here:.“Ms. Lewis has the right to refuse to be vaccinated against COVID- 19, the Charter cannot remediate the consequences of her choice.”.Make your bed, and lie in it, then..Really? Is that what Albertans should expect from their medical system?.Here are three reasons why not..1) In the Canadian single-payer public system, the client has no choice. That is, if Ms. Lewis will not accept the needle at her arm, she is left with the gun to her head. Like all Canadians however, she's still expected to support the system through her taxes. It’s just that in her case, she's refused the treatment she needs..2) When Canadians opted for publicly-funded health care half-a-century ago, they gave up the right to judge people seeking treatment. Thus, when a drunk driver ends up in hospital, they are treated as their injuries require. They’re not relegated to the back of the queue because they did something stupid. Neither is a person with diabetes penalized, or somebody with emphysema, because their life choices put them in hospital. And, the person who having said, ‘Hold ma beer and watch this,’ injured himself trying to replicate a stupid stunt on YouTube will be treated with the same impartial care extended to a person who finds themselves in hospital through no fault of their own. When Canadians seek medical attention, we do not judge their decisions. We simply treat them. Except, apparently, for Ms. Lewis..3) The decision to exclude the unvaccinated from transplant eligibility was taken by people who are not accountable for their decision. Indeed, their very identity has been concealed. They made their decision at a time when both government messaging and the overwhelming majority of media coverage was heavily slanted against people who had rejected vaccination. With the exception of a few doctors who were broadly condemned for speaking up, they had little support. If any other point of view was considered, there is no record of it. A year later, in a less emotionally charged atmosphere, it would be good for elected officials to review that discussion, with ‘the other side’ adequately represented. After all, the medical profession is not unanimous. Some US states, like Canadian provinces, require vaccination; others merely follow the recommendations of the American Transplant Society, which encourage vaccination, but do not mandate it and will conduct transplants on clients who have refused anti-COVID vaccination either because they don’t like it, or because it has been established they are allergic to it..I do not know Ms. Lewis. I am also not a physician. I can imagine her feelings, and I gather from her lawyer that apart from vaccination, she meets requirements for a transplant. But like the judges, I am not qualified in a professional sense to say that she should or should not receive an organ transplant..What I can say is first the decision on whether or not to offer medical treatment of any kind to any person in Alberta requiring it, should not turn upon their vaccination status. Second if there is to be such a policy, it is above the pay grade of nameless, faceless, unaccountable medical bureaucrats..It must be formed through open, public discussion..And it should be made by men and women who are then prepared to defend their decision, if necessary in an election..Anything less is discrimination for the sake of it.
