MPP Monte Kwinter Helped to Bring Medicine Out of the Dark Ages
“In the treatment of the sick person, the physician must be free to use a new diagnostic or therapeutic measure, if in his or her judgment it offers hope of saving life, re-establishing health or alleviating suffering.” Helsinki Accord 1964, signed by Canada 1989
“5.1. A member shall not be found guilty of professional misconduct or of incompetence under section 51 or 52 of the Health Professions Procedural Code solely on the basis that the member practises a therapy that is non-traditional or that departs from the prevailing medical practice unless there is evidence that proves that the therapy poses a greater risk to a patient’s health than the traditional or prevailing practice. 2000, c.28, s.1.” Health Freedom Bill, by Monte Kwinter
Occasionally someone comes along who can think clearly, observe correctly, and clear the fog that everybody else is trapped in. Liberal MPP Monte Kwinter is just such a person – someone who made it possible for Canadians to emerge from the Dark Ages of authoritarian, innovation-phobic, antiquated medicine, thereby liberating the practice of mainstream healthcare and empowering patients. He is the author of the famous Health Freedom Bill, which amended Ontario’s Medicine Act in 2000 by adding to it those self-evident imperatives that keep the practice of medicine open to new diagnoses and therapies.
Monte Kwinter is retiring from politics this year. He is 86 years old and has served in the Ontario legislature for 32 years. We would like to take this opportunity to celebrate him and thank him for making Canada a better place in which to practice as a doctor and survive as a patient. It is curious that the Wikipedia entry about Kwinter makes no mention of his Health Freedom Bill, which generated such enormous publicity and public debate throughout the 1990s. Imagine no mention of the Canadian Constitution in a Wikipedia entry on Pierre Trudeau! I mention those two achievements together because they are profoundly connected: Kwinter’s provincial effort only works because it is grounded in our constitutional guarantees, and those guarantees would merely be words on paper unless anchored in practical applications throughout the country. With his Bill, Kwinter established our human right to the medical care of our choice.
The Kwinter amendment, introduced in April 1997 as a Private Member’s Bill, was designed to prevent doctors, dentists, and 20+ other health professions from losing their licenses for offering new, emerging medicines to their patients. The Kwinter amendment brought the 1964 Helsinki Accord on human rights, ratified by Canada in 1989, into provincial law. A similar amendment had been passed in Alberta in 1996, but since the largest number of Canadian doctors practice in Ontario, it needed an Ontario-based practical genius to cause a nationwide awakening.
Since healthcare delivery in Canada is legally controlled by the provinces, a federally acknowledged international treaty could be ignored by provincial medical authorities. Our system of administrative law, going back to King Henry VIII of England, gives regulatory colleges greater powers than the police. In fact, provincial colleges, especially the College of Physicians and Surgeons of Ontario (CPSO), have been known to revoke doctors’ licenses just because they didn’t like whatever the physician did. In many cases, the CPSO provided no science-based evidence to support their attacks on a given doctor, gave no consideration to the scientific evidence provided by the defence, and no written standard to which the college could point as spelling out exactly what the expected standard of practice is which a doctor ought to follow. (Google “Glasnost Report 2001” and read some of those stories.)
Cloak and Dagger Maneuvers of Medical Politics
All that began to change, and is still changing, thanks to Kwinter’s Health Freedom Bill. Of course, it really is a scandal that this legislative action was even necessary. Some historical context will be helpful. Back in the early 1990s, Ruth Grier, the Ontario Minister of Health in the then NDP government, suggested that the Helsinki Accord section on medicine should become a part of Ontario law. She got as far as having something like it put in the quality assurance regulations, section 26: “The fact that a member uses or recommends a non-traditional treatment is not, by itself, determinative of deficient clinical ability.” Unfortunately, those regulations affect only quality assurance issues and cannot prevent the disciplinary process (i.e., Section 75 of the Regulated Health Professions Act), from being abused. The CPSO objected to Grier’s regulatory safeguard and had that regulation removed when the Kwinter Bill became law.
Around that same time, Monte Kwinter happened to be interviewed on a radio show. The interviewer was Dr. Jerry Green, who mentioned during a commercial break that his license had been revoked because he was found “guilty” of recommending nutritional support to patients undergoing chemotherapy. A little later, Kwinter happened to play a game of golf with the chief of one of Toronto’s large hospitals. As they chatted, the man told him about a natural remedy (glucosamine) that had saved his dog’s ability to walk, as well as his own, yet it was not permitted by the medical profession for use in humans.
Later on, during a chat with then PC Premier Harris, Kwinter learned that the Premier’s ‘tennis elbow’ had been successfully treated with acupuncture. The Premier further commented that he was well aware of how the CPSO was obstructing medical innovation, and said that his PC government could not introduce a Bill that was a direct attack on a government agency, so he asked if Kwinter, being a Liberal, would like to introduce a Private Member’s Bill.
While this legislation was being planned, many doctors were losing their licenses and being hauled into disciplinary hearings – this in spite of significant mainstream research supporting their therapies and regardless of overwhelming positive patient outcomes. In fact, the CPSO declared repeatedly “patient outcome does not matter.” The records show that the disciplinary panels were explicitly instructed by prosecuting CPSO lawyers to disregard evidence showing that the accused doctor possessed additional training through international medical organizations. “You” (the panel members sitting in judgment) “have never heard of these” organizations and “therefore you must find the doctor guilty of falling below the (unknown and undefined) standard of practice expected in Ontario.”
The most famous case was that of environmental medicine expert Dr. Jozef Krop, the subject of the longest running medical discipline case in history (1988 – 2003). At stake was a new approach to understanding disease. Research showed that traditional models of disease causation had become less relevant in an increasingly toxic environment and that illness caused by environmental and dietary toxins could not be successfully treated with drugs. The most telling example of the clash between the old and new medicine happened during the Krop disciplinary hearings: The prosecution attempted to introduce as damning evidence a 1994 article published by the American Council on Science and Health, aka Quackwatch. That Quackwatch article outlined what would happen if environmental illness was formally recognized: “People would be asked to refrain from wearing colognes or perfumes in the workplace”; “use of chlorine bleaches in swimming pools would be restricted”; gasoline would be “re-examined because the neurotoxin hexane will receive new scrutiny”; breast implants, carpet glues, dry cleaning fluid, and tobacco production and sales would be impacted because of the promotion of “irrational fears of all chemicals around us… thereby costing society millions of dollars and restricting people’s lives in unnecessary ways and diverting them from effective [drug] medical treatment.” The Krop case was just one of many more being prosecuted at the same time. The others included the case of Dr. Carolyn Dean who had recommended reduction of refined sugar use, Dr. Sukhdev Singh Kooner who cured childhood asthma without chemical drugs, and many more.
Kwinter’s Health Freedom Bill Causes an Uproar
The Kwinter Health Freedom Bill became law in 2000. It caused an uproar. The relentless publicity in support of this Bill caused the CPSO to try and defuse it by coming up with an absurd Complementary Medicine Policy. In the formulation process, not a single doctor practising in this way was asked to provide input, and their requests to be consulted were simply rejected. The ‘Old Boys’ were going to do this by themselves (when it appeared it was as outdated as their authors’ knowledge; it has been amended twice since and is a little more tolerable). Since then, what the CPSO attempted to define as “complementary” or “alternative” has become so totally part of mainstream medical research that the terms have become meaningless.
The list of effects that the Kwinter Health Freedom Bill has had would fill a book. A struggle for truly evidence-based medicine was now possible and had a chance of succeeding; mainstream medical research was exploding at that time, revealing the toxicity and lack of usefulness of many standard drugs and proving the biology of environmentally and nutritionally mediated illness.
In Ontario, consciousness was raised through many press conferences, always held at Queen’s Park and always sponsored by MPP Kwinter. Speakers included famous lawyers like Michael Code (now a judge) who observed that the regulatory authorities could be found guilty of “obstructing justice” and appeared to be in “la-la land” for not making patient outcome their central concern. One by one, all of Canada’s provinces incorporated the Kwinter Bill into their laws. Radio and TV coverage, from Michael Enright to David Suzuki and The Fifth Estate, aired program after program on the issues identified by Kwinter’s bill.
In 2000 there were two or three lawyers working in defence of harassed doctors; now there are several legal firms working against the abuses of administrative law and they have established a veritable bulwark of helpful case law. Dr. Krop’s case has become a legal tool known as the “Krop Defense” and is used all over Canada. An investigation of the CPSO’s complaints process, the KPMG Report, was initiated by the government; the Glasnost Report was published, and the Toronto Star started their “Medical Secrets” series, which won the prestigious Michener Award twice. The Canadian Human Rights Commission published its reports on Multiple Chemical Sensitivity and EMF toxicity, recommending workplace accommodation and Medicare coverage. Key people responsible for the medical witch hunts were fired.
In 2012, the CPSO finally defined “standards of practice” but buried it in the December 2012 Council Meeting documents. Yet it does exist and has been used effectively. The standard of practice, found on page 308 of the council record, is: “What is or was taught to medical students and residents during the relevant time period at issue.” Had this existed during those 1990s witch-hunts, no disciplinary trials would have been possible. (Today, the restrooms at the CPSO offices request people to refrain from using perfumes!)
Shortly before the Kwinter Bill became law, I asked him if he expected support from the other members of the Legislative Assembly. His reply was: “Almost all of us take our vitamins.” The Bill was passed with unanimous support! During the final Committee hearings on December 11, 2000, Kwinter talked about the CPSO’s “vigorous rejection” of his Bill, voicing the concerns that doctors would become free to sexually assault their patients or wrap children suffering from pneumonia in cabbage leaves. In his typical, low-key authoritative style, he summarized his efforts by saying: “This Bill has 67 words and it’s really a statement of principle: freedom of choice for the patient, freedom of choice for the doctor, do no harm, and don’t be afraid to use your best judgment within the confines of the Medicine Act to do it.”