Thursday, November 26, 2020

Politics Over Public Health

 I'm no fan of Premier Kenney in Alberta. I didn't like him when he first emerged to run for MP, and his actions as an MP disgusted me most of the time. 

Then there are this morning's revelations of political interference in the Chief Medical Officer of Health's (CMOH) conduct of her duties. The article is lengthy and thorough.  Suffice it to say that Kenney and his Minister of Health, Tyler Shandro have been exerting far more political influence than is justified in the government's response to the COVID-19 pandemic.  

I'm not going to spend a lot of time trashing Kenney over this - frankly, if you couldn't see that coming from Kenney the day he set foot in Alberta politics, you probably just haven't been paying attention.  

It's Dr. Deena Hinshaw that I want to pay a little bit of attention to today.

Up to this point, we have suspected that Dr. Hinshaw has found herself being ignored by the Kenney government, but she has been fairly cagey about what's going on behind the scenes.  Perhaps she has even held the belief that she can "change things from within" - frankly I do not know. What I do know is that Dr. Hinshaw now faces a serious ethical quandary.  

Up to this point, many in the public have been willing to grant Dr. Hinshaw the benefit of the doubt.  Saying, in essence "well, she seems to be trying to do the right things, so we'll trust her".  Now we have clear evidence of how Kenney and Shandro have been exerting political control over her actions as CMOH.  

There's an ethical dilemma for Dr. Hinshaw at this point. We now know unequivocally that she hasn't been able to exercise the kind of decision making authority that she should. This blows a giant hole in her credibility as the public face of the government's COVID-19 response. The question so many will ask is simple:  "Is she saying what she believes, or is she being ordered by politicians to say what she is saying?"

In the first case, we have to suspect that she is in fact complicit with the government's political decision making, regardless of its impact on the people of Alberta; in the second case, we have to conclude that she is ineffective because she is essentially hostage to the political interventions of Kenney and Shandro.  

Whether I personally like Dr. Hinshaw or not is immaterial.  She is caught in the ethical morass of trying to juggle political intervention in her work with the more science and data driven aspects of it.  

The civil service is supposed to be non-partisan, and the various Officers of that civil service should be able to operate independently of the political considerations of the minister's wishes. Because Dr. Hinshaw reports not to the Legislature as a whole (as I think should be the case), but reports to the Minister of Health, her ability to act independently is severely curtailed.  

Therefore, Dr. Hinshaw now stands at a precipice in her career. She can resign as CMOH, citing political interference in her work as a confounding problem in her ability to act effectively, or she can stay in place, and becomes seen as complicit in the actions of the Kenney government, no matter how awful they get. 

Ethically, let's remember that which ever direction she chooses to go, her actions will have a serious impact on Albertans.  

If she leaves the post, we are likely to see Kenney appoint someone whose partisan pedigree is more suitable to his way of viewing things.  That could be even more damaging to Alberta than staying - although staying in place has another price to consider.  

If Dr. Hinshaw remains in her post, not only does she end up taking on the personal cost of trying to constantly weigh her duties as a practitioner against the political interference coming from the minister's offices, but she potentially will come to be seen as complicit with the government in their mismanagement of the COVID-19 pandemic. Neither choice is particularly enviable.  

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