In a split decision, the Supreme Court dismissed an appeal by doctors to stop life support for Hassan Rasouli, 61, who has been on a ventilator in a profoundly brain-damaged state following surgery for a brain tumour in 2010.
But what does the ruling mean for the insurance industry? Jan K. Grude, the CEO of Pacific Blue Cross, has seen the cost of health care continue to rise in Canada, and warns that palliative care costs will soon skyrocket as baby boomers begin to enter the 70 plus age bracket.
“Our (health care) system currently consumes in excess of 10 per cent of GDP,” he told Insurance Business online. “In British Columbia for example, it consumes 42 cents of in-province generated tax dollar. And it keeps on going up. It is not sustainable.”
Chief Justice Beverley McLachlin wrote that, under Ontario’s Health Care Consent Act, treatment cannot be confined to something that doctors consider to be of medical benefit to the patient.
Canada’s health care system is a political hot potato few are willing to hold, says Grude, but with greater demands being placed on the system, it is a time bomb waiting to happen unless it is discussed now. (continued.)
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“The only way to make it work is either to squeeze more blood out of the stone called health care funding,” he says, “and squeezing health authorities and health staff to be even more productive to reduce costs while not compromising service delivery, or we’ve got to look at some mechanism that allows people to make choices, and those choices will have to be based on acuity or income.”
The doctors treating Rasouli at Toronto’s Sunnybrook Health Sciences Centre argued that it was in their patient’s best interest to end the current treatment regime — effectively ending his life.
“There is a difference between killing and letting die. This is letting die. It’s the natural conclusion of life,” Bernard Dickens, professor emeritus of health law and policy at the University of Toronto, told reporters in an interview last year. “And in that sense, there is nothing unnatural or nothing wrong about it. The difficulty is the family members — sometimes patients themselves — are sometimes not willing to accept that.”
Rasouli’s wife, a licensed physician in Iran, refused consent, citing the couple’s Shia Muslim religion and a belief that her brain-damaged husband’s movements indicate some level of consciousness.
Two lower Ontario courts both sided with Rasouli’s wife, but disagreed on the interpretation of the law, leaving it to the Supreme Court to sort out the legal complexities. (continued.)
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Quality of life – which was a consideration in Friday’s Supreme Court ruling – is just one of the questions the medical community and society as a whole is coming to terms with, as Canadians continue to gripe about the availability of health care, and the increased costs of maintaining the current system.
“There is an enormous volume of people that is aging, those born in 1946 and onwards, that are making their way through the system,” says Grude. “Fifty per cent of all health care dollars are consumed after the age of 65. And it may come to a point where it is too late. The financial damage will be so severe it will be hard to dig ourselves out of it. We think we have problems now, Baby boomer Number 1 came through, turned 65 two years ago – what about the balloon that is in behind?”
The Rasouli case, in some respects, comprises a mirror image of the assisted suicide debate that has once again become the focus of public attention.
British Columbia’s Court of Appeal recently overturned a lower court and upheld a ban on physician-assisted suicide.
