Essay topics summer, 2023: Select one topic

1. The More Beds, Better Care Act, 2022, S.O. 2022, c. 16 - Bill 7

This bill amends the Fixing Long-Term Care Act, 2021 to add a new provision for patients who
occupy a bed in a public hospital and are designated by an attending clinician as requiring an
alternate level of care. Bill 7 allows hospitals to override patient consent to secure a long-term
care bed as far as 70 kilometres away in southern Ontario and 150 kilometres away in northern
regions. Hospitals can charge a mandatory fee of $400 a day to ALC patients who refuse to go to
a home arranged on their behalf.

This new provision authorizes certain actions to be carried out without the consent of these
patients. The bill authorizes persons to be moved 70 km from their home. Refusal to comply will
result in the person or the family being billed $400 daily until they agree to the transfer.

Premier Doug Ford has defended the legislation, which stops short of allowing hospitals to
physically move someone, saying it’s necessary to address the pressures on the province’s health
care system by freeing up hospital beds for those who need them. There is a record of 5,930
alternate-level-of-care (ALC) patients – meaning they no longer require treatment in hospital –
of whom 2,000 are waiting for long-term care.

Since the bill came into effect on Sept. 21, 2022 hospitals have placed 4,745 ALC patients into
long-term care, said Jake Roseman, press secretary to Long-Term Care Minister Paul Calandra.

As of Jan. 15, there were 5,600 ALC patients in hospitals across the province, including one-
third who were waiting for a long-term care bed, the Ontario Hospital Association said. This is
down from an all-time high of 6,100 in mid-September.

You are a Health care professional working on a medical unit. Mrs. Luca will be stable soon.
When stable, she will be deemed ALC. This patient speaks Italian and a little English. She has
mild cognitive impairment, is immobile and needs help with personal care. Her family cannot
care for her at home.

Under The More Beds, Better Care Act, 2022, S.O. 2022, c. 16 - Bill 7, she will be moved to a
bed she did not select. She selected homes that provide services in Italian or have Italian
speaking staff and are located where her family can visit her. The homes she selected are full and
have wait lists. Her family lives near Dufferin and Lawrence. They do not have a car and cannot
afford to buy a car. Her family visit daily and assist her with eating her meals and help staff with
her personal care.

She and her family do not want to be transferred to a home that is not on public transit or close
enough that they can afford a taxi to visit her at least every other day. The homes proposed are
50-70 kilometres from their home. The clinical team, the patient and her family agree she will
have few visits from her family and friends when she moves so far away. Also, they will not be
able to help with her care. She and her family agree to apply for more homes that are reachable
by her family.
The clinical team meets. All agree that they do not want her transferred to a home where she will
be isolated. One option is for the physician not to deem her ALC. When a home closer to her
family has a bed, they will reassess her. The physician says, this has to be a team decision.

Question:

You are a team member. Would you support or not support this plan to delay her transfer until a
bed is available in one of her selected homes?

Support decision with deontology, act-utilitarian or rule unitarian reasoning.

Discuss why you agree or disagree with this law. Use deontological or utilitarian reasoning to
support your position.

Here is a link to the bill and a link to an ethical analysis of the bill.

https://www.ontario.ca/laws/statute/s22016

https://healthydebate.ca/2022/09/topic/more-beds-better-care-act/

2.Mandatory or Voluntary Long Term Care Standards?

The federal government in late January, 2023 presented new national standards for long term
care  aimed at addressing systemic problems exposed by the coronavirus pandemic, but there is
no plan to make the standards mandatory.

See articles called LTC part 1 and 2 under essay topics to learn about the proposals.

Question:

Discuss why these standards should be mandatory or not.

Use deontological and rule utilitarian theory to analyze the case.

.3. Medical-aid in-dying and Mental illness

Canadians whose only medical condition is a mental illness or disorder and who otherwise meet
all eligibility criteria, were to be eligible for MAID on March 17, 2023. The change in law has
been postpone for one year to allow further preparing for this change. In order to be eligible for
medical assistance in dying, you must meet all of the following criteria. You must:

 be eligible for health services funded by the federal government, or a province or territory
(or during the applicable minimum period of residence or waiting period for eligibility)
generally, visitors to Canada are not eligible for medical assistance in dying
 be at least 18 years old and mentally competent. This means being capable of making
health care decisions for yourself.
  have a grievous and irremediable medical condition

 make a voluntary request for MAID that is not the result of outside pressure or influence

 give  informed consent to receive MAID

Source: https://www.canada.ca/en/health-canada/services/medical-assistance-dying.html

Questions:

1. Present both sides of the argument: allow or not allow.

2. Discuss why you agree or disagree with the proposed changes.

Note:

 This is not an essay about whether you think MAID is ethical.

 It is not an essay about whether the delay was justified.

 The essay is about whether you agree or disagree with this specific change.

Article by Council of Academics on this topic is found below essay topics and will be
helpful; when you start your research.

4. Vaccine hesitancy and lack of informed decision-making by front line workers

The response to Covid 19 is examined in The Lancet report published September 2022.The title
of the report is Covid 19 response: A Massive Global Failure. The reasons for the failure are
many and interrelated. Report is found below essay topics.

https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(22)01585-9/
fulltext#seccestitle390

Specifically, the report gives details of 10 failures and one is a failure to combat systematic
disinformation. An explanation of this failure is what the report calls a lack of rationality related
to systemic false news and conservatory theories. In short, they argue soundly that vaccine
hesitancy and false news about vaccines undermined basic public health policies based on
evidence from being implemented consistently. It is known that alternatives to mandatory
vaccination and respect for normed consent such as no-cost for vaccination. education,
community outreach was not effective. As the report makes clear there was a failure to combat
systemic misinformation. Belief in false information was accepted as a reason not be vaccinated.
During the pandemic many persons including health care professionals were vocal and open
about their belief in false news. In many health care organizations, there was mandatory
vaccination policy but not in all institutions. Also, their privacy was respected.

This decision to respect refusal of vaccination by front line workers based on misinformation
came at a great cost to Canadians.

Read this article about the cost of vaccine hesitancy and misinformation on our health care
system and citizens. Found below essay topics.

Note the opening statement. Vaccine hesitancy, fuelled by misinformation and conspiracy
theories, led to thousands of unnecessary deaths and hospital stays and cost the health care
system at least $300-million during two COVID-19 waves in 2021, according to a report that
highlights the urgent risk to society of such false claims.

Governments will be planning for the next pandemic. Based on the high cost of respecting
vaccine hesitancy

1. Do you support mandatory vaccination policy for workers in close contact with patients
and vulnerable person, such as health care professionals?

2. Would you respect a refusal to be vaccinated by a health care professional who gives the
reason is based on false news and mis-information? Exclusions would be granted for
valid health reasons. Belief in false information could not be given as a reason for refusal

Use deontology or rule utilitarianism to support your decision.

5..Pediatric ethics: Child marriage in Canada

Approximately 1% of 15-19-year-olds in Canada were married or in common law unions in

2016. Sources consistently show girls are more likely to marry as teens than boys. Discuss
whether child marriages should be illegal in Canada. Use Upshaw’s principles to evaluate a
public health policy making child marriage illegal.

Research paper about child marriages is found on course page under essay topics.

Question: Discuss why you agree or disagree with this policy-based on either deontology or
rule-utilitarianism.
6. Mandatory treatment for persons with chronic substance dependency in BC.
https://www.cbc.ca/news/canada/british-columbia/david-eby-involuntary-treatment-criticism-
1.6664848

Read the article above to learn about the decision by the British Columbia Ministry of Health and
addictions to support mandatory treatment under very strict conditions for persons who have a
chronic substance dependency health problem.
Question:
1.Present both sides of the argument: support or do not support this policy.
Use deontological or rule utilitarian reasoning when presenting arguments for and against the
policy.
2.Which position do you support and why?
There are articles about the Red Fish centre that provides mandatory treatment found below the
essay topics.