"Your mother is now a negative statistic for this unit," the discharge nurse tells a grieving daughter. "Every additional day that she remains in hospital, she drives our efficiency ratings down." This is what Janice Stein wrote when told that her elderly mother must be discharged. (Stein, Janice Gross (2001). The Cult of Efficiency, Anansi Press). Canadian health care is a turnstile operation. Professional ethics are compromised, practice standards are co-opted and long wait lists prolong illness. Crowded emergency rooms last year forced one B.C. hospital to triage at the local Tim Hortons. Years ago as a young hospital social worker, I was asked how I would handle the pressure of discharging chronically ill or homeless patients. The panel said my priority would be to support efficient bed management and that my first obligation was to the employer. I recited my code of ethics, and of course, did not get the job.
These are clear and ominous signs of what will happen, if as requested by the pending Carter case, euthanasia/suicide becomes a "treatment" option. The rationale then is not likely to be "choice", but efficiency.
Margaret Killin-deMello MSW,Surrey, BC