The guidelines “could lead to situations where English-speakers could be refused service in a language they understand in critical medical situations,” said Sylvia Martin-Laforge of the QCGN.
A team of bureaucrats in Quebec’s Health Ministry has issued a 31-page directive spelling out the “exceptional” circumstances in which English is allowed to be spoken in hospitals and other medical facilities, with some imagined linguistic scenarios outlined in excruciating detail.
But representatives from the anglophone community who have read the densely worded directive are already calling it confusing and potentially dangerous.
Among the exceptional circumstances in which a language other than French can be spoken:
- “An operator at the 811 health hotline receives a call from an adolescent who is in a state of psychosis and who is speaking in English. The operator is able to communicate in English too,” advises the directive, which was issued on July 18.
- “A patient shows signs that his or her health and safety may be compromised in the short term (because of suicidal signs, worrisome or threatening attitudes or behaviour, etc.). Staff may use a language other than French to ensure prompt and appropriate care.”
The Health Ministry produced the directive in response to the adoption two years ago of Bill 96, the Coalition Avenir Québec government’s overhaul of the Charter of the French Language. Bill 96 requires that all government workers — including those in hospitals and nursing homes — use French “systematically” in written and oral communications with their clients, with certain exceptions, like emergencies.
The goal behind the July 18 directive was to clarify the exceptional situations in which English can be used in the health sector, but critics counter that it does the opposite.
“Why are we even talking about this?” asked Sylvia Martin-Laforge, director general of the Quebec Community Groups Network (QCGN).
“People’s lives are at stake. Isn’t providing the best, most rapid treatment possible the most important thing? We’re talking about health care, for goodness sake. No one — no one — should have to stop to think in any medical situation: ‘Am I allowed to use this language? Will someone rat me out if I do? Should I play it safe?’
“These rules seem ridiculously picayune, prone to slowing down treatment rather than speeding it up, and would further bureaucratize a health-care system that is already widely criticized for being horrendously over-bureaucratized,” Martin-Laforge continued in a statement.
“In the face of health emergencies, the priority should not be whether English can be used but how quickly one can provide care. These directives are dangerous,” she added. “They set guidelines that could lead to situations where English-speakers could be refused service in a language they understand in critical medical situations.”
“Patients and health workers shouldn’t have to look over their shoulder, they shouldn’t have to worry about being reported, they shouldn’t have to worry about being second-guessed,” Maldoff said. “On top of that, they shouldn’t have a directive like this that says, ‘Well, if patients really can’t speak in French, then go find an interpreter or translator to use.’
“So now you’re not only looking over your shoulder, you get into delays in service. Well, delays aren’t good (in health care). They try to say they’re being generous about this because if it’s urgent, you can use another language. But don’t use that other language systematically.”
Maldoff’s reading of the directive is that it would also apply to hospitals and other medical institutions that have been granted bilingual status under the Charter of the French Language. Such examples include Santa Cabrini Hospital, where Italian is spoken; the Montreal Chinese Hospital, where Mandarin is spoken; the CHSLD Polonais Marie-Curie-Sklodowska, where Polish is spoken; and the Jewish General Hospital, where English, Yiddish and many other mother tongues are used every day.
“So you’re in a bilingual institution, recognized as such. (The directive) says the general rules apply to a bilingual institution. They (staff and patients) should or shouldn’t use (another language) systematically?”
What’s more, an inspection was to have taken place on Wednesday in unoccupied operating rooms of Santa Cabrini in the city’s east end.
“A francization adviser visited Santa Cabrini Hospital this week to meet with an administrative representative of the facility,” OQLF spokesperson Chantal Bouchard said in an email Thursday. “The visit was part of the hospital’s efforts to comply with the Charter of the French Language. However, no inspector from the (OQLF) has visited a Montreal hospital or is scheduled to do so in the next few days.”
Among the other scenarios listed in the directive in which a language other than French can be uttered in a health institution:
- “An anglophone father arrives at the hospital with his 10-year-old son who can speak French. The child’s condition is serious and will require immediate medical intervention. If the health professional is able to, they can use English to obtain the father’s consent without delay.”
- “A 14-year-old girl (the legal age for making decisions without parental consent) goes to the youth clinic of a local community service centre to have an abortion. She is accompanied by her aunt or friend, who will be responsible for following the instructions after the procedure. Since this person does not understand French, it is permissible to give her the checklist in another language.”
- “It is possible to use another language, in addition to French, when the exclusive use of French is not possible and the communication is (needed) to repatriate a (dead) body.”
While the CAQ government has moved relatively swiftly to draft the language directive, it was criticized by the QCGN before Bill 96’s adoption for dragging its feet in setting up long-promised English-language access programs for health services in many outlying parts of the province.