There is a considerable body of material about the phenomenon of 'whistle-blowing' in medicine. In this context, whistle-blowing refers to the situation where a person relays information to someone outside the regular reporting process of a hospital in order to reveal something that has happened, in an attempt to bring about a more public investigation. Obviously, with the issues of confidentiality and privacy that go with medical treatment, hospital personnel cannot easily speak publicly about how a particular patient or group of patients have been treated or are being treated in a particular facility, by a particular doctor, or within a particular medical program. As well, with hospitals having put in place processes for staff members to relay their concerns about treatment, it is reasonably expected that if the proper process is used, proper steps will then be taken to address legitimate concerns.
There may be reasons why someone may become frustrated. The process may be too slow. The concern may not be accepted for reasons that are not appropriate, for example, a doctor's view being given greater weight than a nurse's, simply because of differences in status. (It must be kept in mind that doctors largely control review processes within hospitals.) For nurses, there is the additional matter of overcoming the historical burden of silence expected of their profession. Nurses who speak out, particularly in a manner that is critical of doctors, are still seen as committing an act of disloyalty, regardless of the legitimacy of the concern. Alternatively, the hospital may not be interested in investigating the issue, perhaps for reasons of legal liability.
Little protection exists for 'whistle-blowers' in the Canadian medical system, particularly if the system does not validate their complaints. Given the outcome of the Wiseman Committee process, Youngson had good reason to fear that her complaints would not be validated by the hospital, even if she went public with them. The problems that confronted Youngson and the other nurses in getting heard do not reflect a lack of professional responsibility on their part; rather, they appear to reflect the historically subordinate role that the nursing profession has played in our health-care system.
The issue of whistle-blowing was raised with the Inquest as something that required redress in Manitoba's medical-care system. There does appear to be merit to that view. In this case, none of the persons involved actually went outside the processes available to address the concerns they had. While those with concerns appear to have spoken with all those in positions of authority who they could identify, none of their actions came close to involving people who were outside the very institution that had a responsibility to do something about those concerns. However, the concern that Youngson had about going to speak to authorities outside the hospital and the personal and professional risk she ran on doing so, point to the need for change in this area. Chapter Ten contains recommendations for changes to protect whistle-blowers.
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|Section 1||Chapter 1 - Introduction to the Issues|
|Chapter 2 - Pediatric Cardiac Issues|
|Chapter 3 - The Diagnosis of Pediatric Heart Defects and their Surgical Treatment|
|Chapter 4 - The Health Sciences Centre|
|Section 2||Chapter 5 - Pediatric Cardiac Surgery in Winnipeg 1950-1993|
|Chapter 6 - The Restart of Pediatric Cardiac Surgery in 1994
January 1, 1994 to May 17, 1994
|Chapter 7 - The Slowdown
May 17 to September 1994
|Chapter 8 - Events Leading to the Suspension of the Program
September 7, 1994 to December 23, 1994
|Chapter 9 - 1995 - The Aftermath of the Shutdown
January to March, 1995
|Section 3||Chapter 10 - Findings and Recommendations|
|Appendix 1 - Glossary of terms used in this report|
|Appendix 2 - Parties to the Proceedings and counsel|
|Appendix 3 - List of witnesses and dates of testimony|