The call just got louder for a coroner’s inquest into the overdose death of an Oak Bay teen as the former B.C. representative for children and youth weighs in with her support.
Mary Ellen Turpel-Lafond, now a law professor at UBC, adds her voice to the call after seeing the recommendations and action items that came out of the Vancouver Island Health Authority’s internal quality review conducted into the medical care Elliot Eurchuk received before he died.
Eurchuk, 16, was in and out of the hospital for four major surgeries in 2017, being prescribed highly addictive opioids each time. Elliot developed a drug dependency and when his prescriptions ran out, he turned to street drugs. He overdosed and died at his family’s Oak Bay home on April 20.
The VIHA internal review was recently completed, and while the actual report could not be shared due to Section 51 of the BC Evidence Act which prohibits the disclosure of opinions expressed as part of the review process, VIHA sent the Eurchuk family a letter with the recommendations and actions that came out of the report.
“Following an extensive quality review of the care we provided, we have implemented four actions specific to Elliot’s case to improve care for individuals in our care, particularly youth,” wrote Victoria Schmid, Executive Director of Quality, Safety & Improvement at Royal Jubilee Hospital.
The actions included providing families greater opportunity to formally participate in reporting concerns, even where they may not have authority in care decisions for their loved ones; increasing care professionals’ supports in balancing legal and ethical considerations, and supporting them in the challenges they face with very difficult situations, including the sharing of information with parents or caregivers; developing a patient journey map to better understand the course of care and improve linkages between the Emergency Department, pediatric unit and psychiatry, community supports – system-wide; a learning summary created from the review will be shared provincially with all health authorities to ensure that they are able to make improvements across the BC health system where applicable.
“The review failed to address the issue of consent. It talked about ethical issues, but these are actually medical legal issues around whether a young individual in crisis is capable of consenting,” said Turpel-Lafond.
Other provinces and places, she says, publish a guide to consent.
“And almost always they identify things like mental health and addiction issues. B.C. hasn’t done that yet,” said Turpel-Lafond. “The Infants Act in B.C. has not been updated.”
The Infants Act states that children under 19 years of age may consent to a medical treatment on their own as long as the health care provider is sure that the treatment is in the child’s best interest, and that the child understands the risks and benefits of the treatment.
“Elliot was in and out of emergency rooms – all kinds of professionals would have had to assess his consent and engage with the family. So what guidance did they use? What guidance are they using today?” said Turpel-Lafond. “The letter to Elliot’s parents didn’t respond to the situation.”
“I think we are in a really important time of change. People are recognizing that mental health and addictions needs work. Some really solid recommendations could really help at this point,” said Turpel-Lafond. “I’m not advocating for young people to not have consent, this is about a specialized field for adolescent mental health and addictions.”
In her capacity as a professor of law at UBC, she has been doing some legal work around the Infants Act.
“I get to see how the law is quite out-of-date in B.C.. It needs really open discussion and review,” said Turpel-Lafond.
“Kids try to make these decisions for themselves. If they don’t want the help, there is nothing in our legal system that allows us as parents to get them the help they need,” said Rachel Staples, Elliot’s mother.
While the internal reviews are valuable processes, Turpel-Lafond says, they are not processes for the purpose of public accountability.
“This is why I think the parents are fully within their rights, and we should support them as a community, to request a coroner’s inquest where a jury of community members can hear all of the evidence and consider whether or not some fundamental changes are needed,” said Turpel-Lafond. “Certainly some of the ones that haven’t been addressed in this letter which is pretty vague and addresses some already long-promised things.”
Elliot’s dad Brock Eurchuk expressed disappointment and concern around how the recommendations outlined in the letter would be implemented.
“Recommendations presented in a broad, diffuse manner can be difficult, if not impossible, for sprawling bureaucracies to implement,” said Eurchuk. “All health care providers require clear, effective direction that prioritizes patient care and a desired positive outcome.
“Perhaps my disappointment in the correspondence and the report recommendations resulting from a review of my son’s care is born out of my having a need for an apology and a clear acknowledgement of the health care system’s numerous failures to care for Elliot. An apology from the various institutions that failed Elliot implies a need to react, to respond, to make improvements that will not let another preventable death occur,” said Brock Eurchuk.
Elliot’s parents say they are calling for a coroner’s inquest to find out what systemic changes need to take place to prevent this from happening again.
As the former representative for children and youth, Turpel-Lafond says some of the most effective areas where change was made was when there was a coroner’s inquest.
“We need to examine things to know what happened. The coroner’s inquest is one appropriate forum and I think the request is a reasonable one. I think it could shed some very important light on whether the system can be improved,” said Turpel-Lafond. “I think this is a good use of public resources, and could assist and aid other families.
“Consent in the health care system requires a really close public examination, so I do support the call for a coroner’s inquest,” said Turpel-Lafond.