More doctors are demanding Quebec's government change a policy regarding air ambulances.
For decades parents and relatives have been denied permission to accompany children undergoing a medical evacuation from remote areas to emergency medical care in a city.
The province's position has always been that there just is not enough room aboard the aircraft, and so parents have to make their own arrangements for transportation.
That means they often arrive days later, leaving children alone with hospital staff.
In December Dr. Saleem Razack, Dr. Samir Shaheen-Hussain, and another doctor penned an open letter calling on the province to change its policy.
Quebec Health Minister Gaetan Barrette said in January that he was unaware of all the details of policy, but that he knew Quebec paid transportation costs for parents flying to join children that had been on an emergency flight.
He said later in the month that one reason for denying parents permission to fly was that the province only had two ambulance planes, and that they often made several stops to transport patients.
Dr. Catherine Farrell, an intensive care specialist and president-elect of the Canadian Paediatric Society, said being removed from parents for medical care is scary enough, but it's worse considering most of the children who have to fly for emergency treatment are members of First Nations and may not speak English or French.
"This policy affects not just the children who are separated from their parents at a very crucial time when they are ill, when they are stressed, when they are going to a strange environment where they are going to be treated by people that they may have never met before who may be treating them in languages with which they are not familiar, and within some critical decisions have to be made, it affects the parents as well. We want parents to be part of the decision-making process and to inform us about their child," said Dr. Farrell.
"It really does happen that I have to sign a consent for emergency surgery, sometimes emergency neurosurgery, without being able to tell parents what's happening, what the risks are, what the expected outcome is. It's a responsibility that I'm used to assuming but I don't feel right about it."
The Paediatric Society said Quebec should change its rules -- or change the planes for aircraft with more room.
Dr. Laurence Alix-Seguin, an emergency room doctor at Ste. Justine Hospital, said practices have changed over the years and it's now normal for parents to stay with children undergoing treatment, and that standard of care should also extend to medical flights.
"If a child is scared, if a child is afraid and has to go through a difficult procedure or painful procedure, to have the parents at their side is really helpful," said Dr. Alix-Seguin.
Dr. Shaheen-Hussain recalled one boy and his attempts to figure out why he was crying.
"We had difficulty finding an interpreter, we don't speak Inuktuk and the child didn't speak English or French. Finally got an interpreter and found out the child was crying because he missed his mom," he said.
Other opponents have also pointed out the parallels between the medical flights and the way indigenous children were taken from their families and sent to residential schools in Canada.
"What's really distressing is that Canada does have this dark history of government-sanctioned, forced removal of indigenous children from their families," said Dr. Radha Jetty of the First Nations, Inuit, Metis Health Committee.
"We have to realize that these health care systems, these policies, are racist, that they're discriminatory, and choosing not to to change these antiquated policies perpetuates this racism."
