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LETTERS: 'Criminal element' in ER — readers react to Sydney doctor

Dr. Chris Milburn is an emergency room physician in Sydney.
Dr. Chris Milburn is an emergency room physician in Sydney. - Contributed

Dehumanizing patients

Re: Dr. Chris Miburn's Nov. 16 opinion piece,  "'Criminal element' sent to ER puts docs in dicey spot."

I agree that all health-care workers — in fact, all workers — should be able to work in safe environments free of violence and harassment. I also acknowledge that the ER — the place where people of all backgrounds go when they are in a vulnerable state — presents difficult situations, for staff and patients. 

However, I disagree that this work can in any way be described as dealing with “the criminal element.” We see people with lives, stories and health concerns. People to whom we provide care, based on their need, not their background. People who can, at times, be challenging to work with for a range of reasons. 

They may have faced trauma in their lives — negative events in childhood have been linked to criminal justice system involvement, substance use, poor health, depression, anxiety and suicide. Often, people who seem to act out do so as a way of coping. And, far too often, those who are most likely to be labelled as “criminals” have been disproportionately targeted, as is seen by Halifax police racially profiling and stopping black residents at a much higher rate than white residents.

Unequal treatment can also be seen in health care. Research has shown that people who are black are less likely to get proper pain control in an ER compared to those who are white. People with mental illness often receive substandard health care. People who are Indigenous are often stereotyped when obtaining health care. It wasn’t long ago that Brian Sinclair, an Indigenous man in Winnipeg, died in an ER waiting room because of discriminatory behaviour by many staff.   

The answer is not to demean patients by labelling and dismissing them, or making them seem less deserving of care. A better approach is to treat each patient with humanity (in contrast to seeing them as dehumanized as part of the “criminal element”), examine our own biases and how they impact care people receive, and have supports in place to both prevent and deal with volatile situations. 

Dr. Monika Dutt, family physician, Sydney

Supervised injection site lacking

Re: Dr. Chris Miburn's Nov. 16 opinion piece,  "'Criminal element' sent to ER puts docs in dicey spot."

Halifax Regional Police need to be held to a higher standard. The few “good” police there are serve the public in spite of the system, not because of it. Remember, this is the same police force that only within the last year reluctantly addressed the unjust practice of street checks. 

Those in police custody are not “criminals.” They have yet to be charged and found guilty of anything. These are innocent members of the public who are dying in police custody. My fellow colleagues in the health-care system would do well to remember that. These are patients who deserve as much compassion and dignity as “the poor old lady with cancer.”

Police custody is rarely the best place for people suffering with addiction. Neither are “flop houses, alleys or at home.” This is one of many reasons to expand the amount of supervised injection sites in this province. Sydney, where I also work in the emergency room, desperately needs such a site.

As for Dr. Milburn misappropriating a poem originally written about the Shoah, we would do well to remember who carried out that genocide. It was “jail guards”, “police officers”, and tragically, even “doctors.”

Cameron Taylor, Sydney, Dalhousie medical student 

Patients primarily to blame

Re: Dr. Chris Milburn’s Nov. 16 opinion piece. I understand his point completely. When someone puts their own life at risk by engaging in acts that are life-threatening, I cannot see why anyone else should be held "criminally" responsible for their death. Yes, it is sad for a family, but it is basically no one else’s fault that the affected person contributed most to the unfortunate results.

Even when an oversight in judgment is involved, I fail to see how it could rise to the "criminal" charge level, if the incarcerated has put themselves in such a dangerous situation. I would be very disappointed in any jury that found anyone in such a case guilty of anything criminal.

As the doctor implies, physicians make mistakes and do not suffer this kind of reprisal.

John Bassett, Halifax

Own up to crimes

Re: Dr. Chris Milburn's Nov. 16 opinion piece about the "criminal element" in the ER. I'd like to thank him for taking the time to explain to the general public what takes place when an intoxicated or criminal individual is brought to the ER. 

Having witnessed such situations some years ago, I can relate to his observations. These cases take priority, when they should be the last attended to. 

Many people who commit crimes often claim they don't remember their actions. I firmly believe that if I enter a bank with a gun in hand, I've gone there with one intention: to rob the bank!  Regardless of my mental state, I obviously know what I'm doing. I haven't gone there waving a Kleenex or a newspaper. The same is true in the case of murder; if I shoot or stab someone, I am armed to commit the deed. Being drunk, on drugs, magic mushrooms, etc. may alter my thinking, but I'm still able to commit the crime. 

Those in government need to consult with doctors like Chris Milburn, the police, paramedics and nursing staff in ERs to get the true picture of what people are contending with today. If this situation isn't soon remedied, I don't want to imagine where we're headed.

Norma Kennedy, Dartmouth

Quite the eye-opener

I thoroughly enjoyed Dr. Chris Milburn’s Nov. 16 opinion piece giving readers a doctor's perspective on the effect the "criminal element" has when it hits emergency rooms. ER staff must determine if the “criminal” can be cleared for lockup or jail.

The sad part in this scenario is the use of the word “criminal” — the individuals in question might not be criminals in the truest sense of the word. Instead, they could be some unfortunate people with addictions who have fallen back into drug use or who have gone on an alcoholic binge.

As Dr. Milburn pointed out, we the general public have no idea of the risks doctors, nurses and other ER staff are exposed to, nor do we see just how they are treated by intoxicated individuals.

When I read the article about the Halifax special constables convicted of criminal negligence in the death of a man in custody, I immediately thought how sad and unfortunate that death was. How could that have happened? Who was at fault? Condemnation for the use of a spit hood? Accusations of a man left unattended?

Dr. Milburn’s article made me realize the dangers faced by these medical and police professionals, etc. Another point raised by Dr. Milburn is the fact that while an individual in police custody is being assessed, someone else in the ER in distress may not be attended to as promptly.

Dr. Milburn’s article is certainly a eye-opener and timely, and helps us understand his plight and that of his colleagues.

Drew Preston, Greenwich

Listen to Milburn

Dr. Chris Milburn’s article on the “criminal element” in the ER is absolutely correct. Our frontline public service providers, first responders and caregivers cannot and should not be held to impossible standards that are often put in place for political and public optics.

We can only hope that our decision-makers take note of Dr. Milburn’s insight and actual experience and reflect them in their ongoing decisions and policy development.

P. Cochrane, Halifax

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