Category Archives: Politics

Robocalls and a Royal Commission

I dearly love The Rick Mercer Report.  Rick doesn’t mince words when it comes to his opinions on politics and especially when he sees something going wrong with our country…so Rick usually has alot to say.  Sometimes it’s serious, sometimes it’s funny but it’s always entertaining and dead on the money – the mark, to me at least, of an excellent comedian.

For those not familiar with The Rick Mercer Report, every episode has a section called “Rant” and it’s always my favourite part.  Few people can execute a rant with the precision and clarity that Rick can. His latest has to do with the Robocall Scandal.

Not sure what I’m talking about?  Okay well, as a it happens Rick has a previous Rant on the same topic – it should do for a primer if the wiki link above falls into the TL;DR category:

Alright now that you have some background we get to the part I like the most, Ricks idea on what-the-fuck we should do about it.

This is an excellent idea, the Harper government has been battling this monster for a while now, it’s not going away.  What little trust there has been in Harper has been rattled.  A Royal Commission initiated from the only person above the Prime Minister would go a long way to restoring faith that the Government of Canada still belongs to the Canadian people.  That, when necessary, the Governor General will step up and intervene – because frankly I’ve always thought of the position as more ceremonial than anything else – a rubber stamp for the PM.  This is the type of scenario that justifies such a position.

I’d love to be proven wrong on this.  Hell, I’d love to be shown that it wasn’t Harper or his government – I have no love for the man or his policies but you hope at least he was fairly elected to office.

Mr. Johnston, your position demands that you be addressed as “His Excellency the Right Honourable David Johnston” well sir, as far as I’m concerned, it’s your time to earn such a grand title.  I may not have faith in any god, but I believe in Canada.  I’m watching our sibling nation, the U.S., tear itself apart and it’s frustrating – to watch our own country start to degrade in a similar manner is utterly heart breaking and infuriating.

We’re better than this and we can rise above it.  But first we must know whom is to blame for this and fix it.  Democracy, for all its flaws, is still a beautiful thing and it’s too precious to leave to chance.  Make no mistake, this behaviour is corrosive to the very idea of Democracy – how seriously we treat this will determine whether we live in a free country or one that just claims to be.


Reprint: A Doctor on Transvaginal Ultrasounds

This is a reprint of a guest post originally published on Whatever.  Because of their position the author is known simply as “An Anonymous Doctor”.  The progress this kind of legislation is making in the US is staggering and depressing all at once.

For me the hope is that a country founded by rebels still has the will and ability to rebel when it counts.  There are a myriad of issues they’re currently wading through and there always seems to be a “trickle up” effect on Canada, which boils my blood to no end…but this isn’t the time for that rant.

Unfortunately, everyone has the right (politicians included), to be stupid, ignorant and bigoted.  Such is the burden of living in a free society – you need to be able to tolerate shit you don’t agree with, thick skin can be essential equipment at times.  However, those rights end where the rights of another start and this legislated-transvaginal-ultrasound-nonsense is one of those lines.

But I’ve said and mangled this introduction enough – time to hear from someone who’s a much better writer than I and whose stance I fully agree with and support.

Where Is The Physician Outrage?

Right. Here.

I’m speaking, of course, about the required-transvaginal-ultrasound thing that seems to be the flavor-of-the-month in politics.

I do not care what your personal politics are. I think we can all agree that my right to swing my fist ends where your face begins.

I do not feel that it is reactionary or even inaccurate to describe an unwanted, non-indicated transvaginal ultrasound as “rape”. If I insert ANY object into ANY orifice without informed consent, it is rape. And coercion of any kind negates consent, informed or otherwise.

In all of the discussion and all of the outrage and all of the Doonesbury comics, I find it interesting that we physicians are relatively silent.

After all, it’s our hands that will supposedly be used to insert medical equipment (tools of HEALING, for the sake of all that is good and holy) into the vaginas of coerced women.

Fellow physicians, once again we are being used as tools to screw people over. This time, it’s the politicians who want to use us to implement their morally reprehensible legislation. They want to use our ultrasound machines to invade women’s bodies, and they want our hands to be at the controls. Coerced and invaded women, you have a problem with that? Blame us evil doctors. We are such deliciously silent scapegoats.

It is our responsibility, as always, to protect our patients from things that would harm them. Therefore, as physicians, it is our duty to refuse to perform a medical procedure that is not medically indicated. Any medical procedure. Whatever the pseudo-justification.

It’s time for a little old-fashioned civil disobedience.

Here are a few steps we can take as physicians to protect our patients from legislation such as this.

1) Just don’t comply. No matter how much our autonomy as physicians has been eroded, we still have control of what our hands do and do not do with a transvaginal ultrasound wand. If this legislation is completely ignored by the people who are supposed to implement it, it will soon be worth less than the paper it is written on.

2) Reinforce patient autonomy. It does not matter what a politician says. A woman is in charge of determining what does and what does not go into her body. If she WANTS a transvaginal ultrasound, fine. If it’s medically indicated, fine… have that discussion with her. We have informed consent for a reason. If she has to be forced to get a transvaginal ultrasound through coercion or overly impassioned argument or implied threats of withdrawal of care, that is NOT FINE.

Our position is to recommend medically-indicated tests and treatments that have a favorable benefit-to-harm ratio… and it is up to the patient to decide what she will and will not allow. Period. Politicians do not have any role in this process. NO ONE has a role in this process but the patient and her physician. If anyone tries to get in the way of that, it is our duty to run interference.

3) If you are forced to document a non-indicated transvaginal ultrasound because of this legislation, document that the patient refused the procedure or that it was not medically indicated. (Because both of those are true.) Hell, document that you attempted but the patient kicked you in the nose, if you have to.

4) If you are forced to enter an image of the ultrasound itself into the patient chart, ultrasound the bedsheets and enter that picture with a comment of “poor acoustic window”. If you’re really gutsy, enter a comment of “poor acoustic window…plus, I’m not a rapist.” (I was going to propose repeatedly entering a single identical image in affected patient’s charts nationwide, as a recognizable visual protest…but I don’t have an ultrasound image that I own to the point that I could offer it for that purpose.)

5) Do anything else you can think of to protect your patients and the integrity of the medical profession. IN THAT ORDER. We already know how vulnerable patients can be; we invisibly protect them on a daily basis from all kinds of dangers inside and outside of the hospital. Their safety is our responsibility, and we practically kill ourselves to ensure it at all costs. But it’s also our responsibility to guard the practice of medicine from people who would hijack our tools of healing for their own political or monetary gain.

In recent years, we have been abject failures in this responsibility, and untold numbers of people have gleefully taken advantage of that. Silently allowing a politician to manipulate our medical decision-making for the purposes of an ideological goal erodes any tiny scrap of trust we might have left.

It comes down to this: When the community has failed a patient by voting an ideologue into office…When the ideologue has failed the patient by writing legislation in his own interest instead of in the patient’s…When the legislative system has failed the patient by allowing the legislation to be considered… When the government has failed the patient by allowing something like this to be signed into law… We as physicians cannot and must not fail our patients by ducking our heads and meekly doing as we’re told.

Because we are their last line of defense.

Author: An Anonymous Doctor

Originally posted: 20 March 2012