In May 2010 an international student from Saudi Arabia began puking blood at home; he did so for several hours before seeking medical attention. When the Ambulance came, they did what is expected of the medical community and provided some immediate medical assistance—i.e. they gave him an IV and brought him to the emergency room at Burnaby Hospital. The gentleman then waited for approximately two hours while he continued to puke blood. Finally the doctor came to see him but before providing treatment the doctor said: “Are you an international guy?” The student was puzzled at the question. The doctor then said “Are you Canadian or are you an international guy?” The student then responded by saying that he is from Saudi Arabia and that he is not Canadian.
At that point, the doctor said: “I will not touch you until I receive $1000.” The student said that he has medical insurance through his school but the doctor said: “That insurance is for the Hospital but you must pay me before I will treat you.” The student explained that he had the money but no access to it at that moment. The doctor said once again: “I will not touch you until I have $1000.” The doctor then left the room leaving the young man to continue to vomit blood while he tried to think of a way that he could receive treatment in a foreign land before he died.
Approximately 9 hours passed from the time the student began vomiting blood, it was 2 to 3 hours after the doctor refused to provide emergency medical attention on the grounds that he required payment; the student finally found the number to the emergency contact at his embassy.
As the student was finishing describing the situation to his embassy, the doctor entered the room again and the student handed the doctor the phone. Immediately after the doctor spoke with the embassy he began providing emergency medical attention. Only after the doctor had let the student puke blood for 4-5 hours at the hospital; and only after the student (luckily) knew to call his embassy, did the doctor finally make an attempt to provide medical service to the young man.
According to the College of Physicians of Alberta:
The Canadian Medical Association Code of Ethics (which the CPSA endorses) states physicians cannot discriminate against patients on grounds such as age, gender, medical condition, national or ethnic origin, physical or mental disability.
However, in some circumstances:
- You may not feel qualified to handle the patient’s treatment
- The patient has missed several appointments
- The patient has signed a treatment contract and is not following your treatment plan
- The patient has been abusive or threatening to you and/or your staff
Note: Doctors may not refuse to treat/accept a patient in an emergency situation if they have the skills required to do so.
Since the doctor provided medical attention after he was instructed to by the Saudi Arabian Embassy, he was qualified to attend to the situation. Before he spoke to the Embassy he refused to treat the patient based on the fact that he was a foreign national and thus needed to pay in advance of treatment, money that the individual was unable to provide at the time when he needed treatment. Had the situation been worse or had it gone on for much longer, the student could have died because he did not have $1000 to provide the doctor with. During the whole process the student was surely suffering.
Had the student not been able to contact his embassy for some reason, the doctor may never have attended to the patient if he stuck to his word. A future situation of this nature may arise where a doctor refuses service to his patient because he is not a Canadian national (and therefore must pay $1000), if in this case the patient dies then it is the responsibility of our country and the doctor that we employ.
This situation should never occur in this country. We should never allow a doctor to refuse medical service because the patient does not have money which directly relates to the fact that the person is not a Canadian national—one of the reasons the doctor wanted money is because of the possibility that money might not come from the foreign national.
When I heard this story, I became disgusted to think that we live in a country where this might occur. A doctor with the skills and the tools necessary to save the life of another human being should not refuse to do so if the patient is from a foreign country and is not capable of immediately coming up with the money demanded by the doctor. To refuse medical attention in this circumstance is an unethical practice at the very least: at the most it could become an international disgrace to our country should a future patient under similar circumstances die because the doctor chooses not to provide medical attention. This must be dealt with to avoid a possible death and to avoid a possible international relations disaster.
However, on the other hand, how is it possible to do so without having an influx of foreign nationals coming to Canada (especially from the United States) to receive medical attention. Surely the Canadian medical field is already understaffed. Canadian tax dollars cannot cover the costs of this project.
Should there be an international fund that each nation pays into for this purpose? Can an international medical organization work to solve this issue? For example, if a foreign national needs medical service while abroad, the money required for the medical service would come from the international authority that each country pays into and then, in turn, the individual must pay back the international organization. The international organization would have jurisdiction within each member nation to apply the pressure necessary to collect the funds from the individual using the service. No individual would be required to pay in advance of treatment, and the possible negative consequences of waiting for treatment would never arise. Is this a possible solution to the problem? Are there alternative solutions?
For example, requiring insurance companies to pay doctor’s fees as well…
~Justin Allen Philcox