Public services becoming dehumanized, warns Quebec Ombudsman

Public services in Quebec are becoming dehumanized, warns Quebec Ombudsman Marc-André Dowd in his annual report – which he tabled on Thursday.

In particular, Dowd highlights the case of a man at the end of his life, “very weakened by illness,” who lived alone and received home support. He had a cat, which he considered a life companion, but could no longer maintain the litter box.

However, the CLSC refused to add litter box cleaning to his care plan. According to the Ombudsman, the man’s “distress and solitude,” the fact that he had requested medical assistance in dying, and his attachment to his cat called for a different response.

It was clear, he said, that special support should have been given to the dying man on “humanitarian grounds, beyond the strict interpretation of the program.” This “absurd, inhumane” case demonstrates the need for greater “flexibility”, he argued.

Hubbub and indifference

Also, during an unannounced visit to a CHSLD, the Protector witnessed dinner being served in the dining room. He found that staff were feeding residents “mechanically”, talking to each other, while the television was turned up to full volume.

Yet a guide produced by the Ministry of Health states that during meals, “staff should focus their communication and direct their attention to the residents”, and “position themselves to facilitate eye contact”.

Such a lack of communication, attention and consideration for CHSLD residents is an example of the dehumanization of care,” deplores the Ombudsman in his report. The facts denote a distressing loss of meaning for this type of place, which should be a living environment.”

Strapped in an armchair, facing a wall

Another example: a man hospitalized in a geriatric unit is frequently tied to his armchair for long periods, with a view of a wall.

His next of kin had previously consented to a control measure – a belt with an anti-trigger buckle – but the staff used it systematically, even in the absence of any justification.

In addition, antipsychotic medication, which was only to be administered in the event of agitation or hallucinations, was given to prevent inappropriate language. In this case, we’re talking about physical and chemical restraint.

“In terms of infringement of fundamental rights, the issue of coercion is pretty ‘top’,” said Dowd at a press conference at the National Assembly. We’re depriving a person of their freedom. It has to be an exceptional measure for the shortest possible time.

“I’m concerned about this issue of restraint, because we see it in healthcare, but also in correctional services,” he said. In both cases, there’s a shortage of staff, and new hires don’t always have the necessary training.

Fundamental rights compromised

Currently, 20.5 per cent of regular correctional officer positions are vacant. Periods of cell confinement are “unduly” prolonged, and inmates are denied access to a change of clothes or underwear for several weeks.

“In one case, the person waited two months,” the Protector points out in his report.

It’s a question of humanity,” summarized Marc-André Dowd at a press conference. Even if the context is difficult, it’s a human being (…) giving a service to a human being. It’s common sense.”

The Quebec Ombudsman processed a record number of requests this year, 24,867, compared with 22,053 last year. A strong upward trend has been observed over the past three years, not only in the number of requests, but also in the number of complaints that are substantiated.

However, the watchdog assures us that when he makes recommendations, “the authorities, ministries and organizations accept our recommendations 99% of the time, in other words, we look for corrective measures”.

“These results help build confidence in public institutions,” he says.

–This report by La Presse Canadienne was translated by CityNews