Monday, March 3, 2008

Robert Latimer's Parole

The following is an essay which appeared, in an edited form and with a different title, as an Op-Ed feature in The Western Producer, a Canadian newspaper. The occasion was news that Robert had been denied day parole to a halfway house — a decision reversed on appeal to The National Parole Board of Canada.

The case began with Tracy's death in 1993, and ended in 2001 with Robert's conviction on the charge of second degree murder. That conviction came only after the matter had been to the Supreme Court of Canada — not once, but twice.


by Rob Brown

Giving effective, ethical, health care to people can be very difficult. That’s particularly true when the only possible results are bad, and people have to pick the “least worst” option.

So I continued to be haunted by the lives of Tracy Latimer and her dad, Robert. I believe they paid dearly for failures by the medical system, and the justice system.

When Tracy Latimer was born, some things went terribly wrong. Her brain was deprived of crucial oxygen. She ended up with a mental age somewhere around six months or less. She couldn’t communicate effectively; people usually had to guess what she was thinking or feeling She suffered repeated physical seizures, many times a day. Her body became twisted because of her condition. Doctors, trying to do the “least worst” thing for her, did several surgeries to release muscles and tendons, and put steel rods in her back to straighten it. Through all this, the only pain medication she received was basic acetaminophen (“Tylenol”); it was as effective as trying to stop an elephant with a fly swatter. Anything stronger would have interfered with the medications to control her seizures. Testimony at trial showed she was in extreme, chronic, unrelieved pain. (The only other option might have been a medicated coma, which would leave her permanently unconscious.)

Medical people “"played God"’ with Tracy’s life; they did the best they could in a losing battle. Yet I believe they failed Tracy Latimer.

In Canada, parents are expected to care for their children. In any other circumstance, had Robert Latimer allowed Tracy to be in as much pain as she was, he could have been charged with child neglect or child abuse. Being a conscientious and loving parent, Robert Latimer did what he thought he needed to do. He acted to ended his daughter’'s pain.

Ironically, in Europe this situation might be handled so much more effectively, according to a recent tv program. (It even showed a man taking a dose of terminal medication.)

Because of his actions, Robert Latimer was changed with murder. At the trial, the jury didn'’t receive information members requested about the punishment for a second degree murder conviction. (Normally, people making decisions need to consider the consequences of their actions; that is true in the process of ethical decision-making but not true for juries.)

The matter came to The Supreme Court of Canada. Courts have to balance the facts and the law. Written judgement from the Court shows that key facts were apparently missed. A suggestion that there might have been another or better way to cope with Tracy’s pain flew in the face of the evidence presented at trial by her surgeon.

When Robert applied for early parole, he was denied. He was told he had not developed “sufficient insight and understanding” of his action. With respect, it’s the Parole Board panel which seems to lack “insight and understanding.” Once again, the legal system failed Robert Latimer.

Indeed, Canada’'s Parliament has continued to lack “insight and understanding,” and lack courage, in handling this matter of extreme pain. Meanwhile, there have been a number of cases of pain-ending action by individuals. Robert is in prison for murder. — Other provinces and courts have handled situations very differently. In one case, a person was not even tried in court. In another, a person was convicted of manslaughter, and the judge suspended sentencing.

Until the law comes to a clearer understanding of these circumstances, I fear we may see more Robert Latimers.

In addition, I made many of these same points on the afternoon of March 2, 2008, in conversation with Rex Murphy on "Cross Country Checkup," Canada's national talk show on CBC Radio 1. The key additional point I made on radio was to say that I thought the representatives of the disabled had really missed a key opportunity here. While Tracy was a member of the group "people with disabilities" she was also, more importantly, a member of the group "children in extreme pain." Others in that group would include, for example, a girl who is "able-bodied" but who is suffering from metastatic bone cancer. (Because of the peculiarities of that form of cancer, it is very difficult to treat the pain people experience when they have it.) I noted that disability groups could have made common cause with the cancer societies, in saying to government and medical people, "we need better ways of caring for children in extreme pain."

In reply to Rex's last question, I said that I didn't think we had really learned anything from this 15 year experience. If anything, people are entrenched in solid positions, and there isn't much dialogue. My concern is that we need to get past those fixed positions, or nothing will change. And lack of change will not be good for anyone.
No matter how we look at this, the death of Tracy Latimer was a terrible event.

The unanswered questions:

1. How do we help people deal with their debilitating and degrading pain?

2. What can we do to make sure there are no more Tracy Latimers?

Any suggestions about how we might reach a national consensus on this issue?