Operating in the Dark: The Accountability Crisis in Canada's Health Care System

Marilyn Mardiros is an associate professor of health sciences at the
University of Ottawa.

Operating in the Dark was written in response to stories of suspected
medical malpractice. Priest, an investigative journalist, begins her
work with a historical overview to aid our understanding of the current
controversies within the Canadian healthcare system. Clearly
demonstrated is the fact that little information is publicly available
so that patients can make informed decisions. Authority for making
patient-care decisions has been left to doctors and hospitals, the
rationalization being that they know what is best for the patient.
Unlike the situation in the United States, in Canada there are no
consumer guides that collect information or monitor hospitals and
doctors; nor are there toll-free numbers that prospective patients can
call to find out if there are malpractice concerns associated with a
particular physician.

Each chapter serves as a case study about the lack of accountability to
taxpayers. The author covers such issues as informed consent (especially
with respect to high-risk surgery), quality of care in hospitals, what
consumers need to know before experiencing an illness that may require
hospitalization, and the difficulty of obtaining information about the
quality of a physician’s medical practice. Other topics addressed
include the need for a patient charter of rights, gender and drug
trials, excessive medical intervention, improper prescribing for women
and the elderly, and access to home-care services and cancer treatment.
Actions that individuals and groups can take to gain control over the
health-care system are suggested.

This highly readable book is recommended for consumers of health-care
services in Canada, health professionals, and those who work in health
policy and planning.