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www.archdisabilitylaw.ca 
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Sent via email at nwhitmore@cpso.on.ca and feedback@cpso.on.ca
April 13, 2021
Dr. Nancy Whitmore, Registrar and CEO
College of Physicians and Surgeons of Ontario
80 College Street
Toronto, Ontario M5G 2E2

Dear Dr. Whitmore:

Re: Triaging of Critical Care in Ontario

I am writing on behalf of ARCH Disability Law Centre in response to your email correspondence to members of the College of Physicians and Surgeons of Ontario on April 8, 2021, and the College’s subsequent response to the AODA Alliance dated April 12, 2021. ARCH shares the concerns raised by the AODA Alliance in its April 9th and April 13th letters. 

We understand and appreciate the context of your correspondence, and the need to respond to the challenging circumstances that this pandemic continues to thrust on our health care service providers including physicians and surgeons. We also understand the need for a plan as this third wave of the pandemic overwhelms hospitals and critical care resources. 

Your email correspondence addresses physicians’ obligations regarding the withholding and withdrawing of critical care. You state that the College supports deviation from its policies in following triage frameworks as developed by the command table. 

Respectfully, your stated intention to ensure public trust in decision-making is eroded by supporting a critical care triage protocol that has been kept secret, on which there has been no proper public consultation, and which has been subject to serious disability discrimination objections.  Disability advocates, and other marginalized communities, have been outspoken for over a year since the first Triage Protocol draft was leaked, identifying serious unlawful discriminatory implications that have persisted and have not yet been remedied. In addition, your correspondence does not clarify that all actions by your members must be taken free from any discrimination. Human rights protections under Ontario’s Human Rights Code and the Canadian Charter of Rights and Freedoms continue to fully apply during a pandemic. It is precisely during times such as these that our human rights protections are most critical. We are concerned that the College’s messaging disregards and dispenses entirely with such human rights concerns, to the serious detriment of Ontario physicians and patients. 

Moreover, in considering public interest and protecting the rights of our most vulnerable patients, any messaging by the College that supports a potentially discriminatory framework and contemplates limitations on patients’ rights such as the making of complaints to the College is troubling and inappropriate. 

The public looks to the College to objectively and impartially decide any individual complaints against member physicians. It must not pre-decide issues on which it will have to rule. The public must be given confidence that its complaints process is a fair one. The College’s April 8, 2021 email to its members is inconsistent with that obligation, on a topic where the public needs a strong assurance, rather than a cause for concern.

We urge the College to rescind and clarify its message and ensure that its members understand their paramount human rights obligations during this pandemic, and their continued human rights obligations regardless of what triage frameworks are ultimately approved. 

Sincerely,
ARCH Disability Law Centre

(Original letter has digital signature)

Robert Lattanzio
Executive Director 

cc:
Premier Doug Ford    premier@ontario.ca 
Christine Elliott, Minister of Health    Christine.Elliott@ontario.ca
Helen Angus, Deputy Minister of Health    Helen.Angus@ontario.ca
Raymond Cho, Minister of Seniors and Accessibility    Raymond.Cho@ontario.ca
Denise Cole, Deputy Minister for Seniors and Accessibility    Denise.Cole@ontario.ca
Mary Bartolomucci, Assistant Deputy Minister for the Accessibility Directorate Mary.Bartolomucci@ontario.ca
Todd Smith, Minister of Children, Community and Social Services Todd.Smithco@pc.ola.org 
Janet Menard, Deputy Minister of Children, Community and Social Services Janet.Menard@ontario.ca 
Ena Chadha, Chief Commissioner, Ontario Human Rights Commission    cco@ohrc.on.ca
David Lepofsky, Accessibility for Ontarians with Disabilities Act Alliance aodafeedback@gmail.com