Public Safety Committee on April 28th, 2008

[Peggy Nash, NDP, Parkdale—High Park, ON]

Some people do take those financial inducements, either through travel or benefits of some kind, or they do studies. We didn't see who funded the studies that you had identified, but there are studies that are funded by Taser as well.

Can I ask your opinion of those who do take those financial inducements? Do you have any opinion on that?

[Dr. Graeme Dowling]

As physicians, we are essentially not allowed to do that. If you're writing a research paper for any journal, any grant you receive you must declare up front, and that's to rule out the conflict of interest that you are suggesting: “My project was funded by”--we'll say--“Taser, and I found that tasers are really great devices.” In a medical paper you have to declare it right up front.

[Dr. Andrew McCallum]

In many ways, it's the question of the moment in health care research as well, because as you know, drug companies sponsor the vast proportion of drug studies that are done, and often there has been the practice of withholding unfavourable results in the past.

I think it's a very germane question, and I think your questions regarding the papers I showed are quite appropriate. Some of them are Taser-sponsored, and you can probably infer which ones are. Some of them are independent. For example, the Toronto study that was done was an independent study, and that was the one that showed that at one to three times the normal dose application, ventricular fibrillation is possible in pigs.

I think it's very important. Whenever I evaluate the results of any trial, I certainly look at the funding source. I think the acceptance of support automatically does raise the issue of the objectivity of the research, whether or not it's unconscious or conscious.

[Peggy Nash, NDP, Parkdale—High Park, ON]

For those who take funds from Taser, whether it's research funding or other kinds of benefits--because there certainly have been publicized cases of that--do you have any thoughts you want to share with us on that? Does it undermine the credibility of those individuals?

[Dr. Graeme Dowling]

Yes. The role of coroners, medical examiners, and forensic pathologists is to be independent, to not take sides. At the end of the day, we'll have an opinion, and when that opinion is challenged--and each one of you, through your questions, are clarifying and challenging views that we've put forward--it's our job to be fair and honest and give you everything.

It's the same in court and it's the same in trial. We can't take sides. That's our job. I can't imagine personally ever accepting that type of offer, because to me it would not, personally, be correct to do.

[Dr. Andrew McCallum]

I can't say it much better than that.

[Peggy Nash, NDP, Parkdale—High Park, ON]

Okay. Thank you.

[The Chair, Conservative, Garry Breitkreuz]

We'll now go over to the government side. Mr. MacKenzie, please.

[Dave MacKenzie, Conservative, Oxford, ON]

Thank you, Chair.

And thank you to both of you, doctors. I very much appreciate your evidence here today and I know we've spent a great deal of time talking about the independence of other people. I have no question about your independence and your integrity and I think that's what's important to us here today.

Dr. Dowling, you indicated that in the Otto Vass death, I believe, there was no use of the taser.

[Dr. Graeme Dowling]

That's correct. I presented the one case, yes.

[Dr. Andrew McCallum]

No, I'm sorry. That's very--

[Dave MacKenzie, Conservative, Oxford, ON]

Have I got them mixed up?

[Dr. Andrew McCallum]

Yes, you did. That's an Ontario case. The Otto Vass inquest was an inquest into the death of a man who was psychiatrically ill, who presented in an excited delirium state and who required subduing. It was very much the same kind of piling on situation in which a number of officers were involved. He died.

The jury found that it might have been easier to subdue him and hence get him to treatment had a taser been available. They recommended a taser, based on that.

[Dave MacKenzie, Conservative, Oxford, ON]

Okay, I appreciate that.

I apologize, Dr. Dowling, for the confusion.

I think we have heard that in other situations.

I know some of my colleagues are always concerned--and I think rightfully so--about the multiple use of the taser. If I'm right on this one, Dr. Dowling, you talked about multiple uses, that it gave you a great deal of concern. Likewise, I have that same concern. If it isn't working after four or five times, maybe we need to find something else. But what else is there?

[Dr. Graeme Dowling]

That's my other hesitation. The word “penultimate” has been used here. The taser is the choice that a police officer has before pulling his gun. And if the taser is not working, I don't know. If it's a case of excited delirium and you really feel that's what it is, perhaps back off, because you hate to see the gun come out. I don't think Canadians like to see that. I don't.

[Dave MacKenzie, Conservative, Oxford, ON]

That might be part of the danger. If we say that this is the last tool before a firearm, it doesn't leave anything else. I think that's a fair enough assessment. I don't think that's what we want and I don't think that's what my friends want, and I don't think that's what the police community wants.

Dr. McCallum, I read in your background that you spent some time in Sunnybrook Hospital in emergency. I'm sure you've seen what you have described as excited delirium.

[Dr. Andrew McCallum]

I have.

[Dave MacKenzie, Conservative, Oxford, ON]

What would happen if we did nothing? Is there a reasonable length of time in which the person would either exhaust themselves or settle down? I think that's what Dr. Dowling is saying. If we simply back away, will they come back to a normal state?

[Dr. Andrew McCallum]

I would say that in my experience that has not happened. Two things happen. Occasionally even the most psychotic patient, when confronted with a significant show of force, will capitulate. That does happen. So if you walk into the room with a sufficient number of health care personnel--orderlies, nurses and doctors--and say, “We have to give you an injection. Please let us do it”, they'll look around the room and then say okay. That does happen.

But with a significant proportion of these individuals it doesn't happen, and they do one of two things. They either begin to harm themselves by striking their head against things or hitting themselves and you end up with a blood bath that's self-induced, or they begin to strike out at the people who are around them and start to threaten them as well. And in those circumstances, in my view, you can't allow the state to continue unrestrained.

That's an emergency medicine point of view as opposed to a coroner's or medical examiner's point of view. That is the circumstance that is far more common. It's very rare that someone can be left to their own devices and will settle. It does happen, though, and it's an option that perhaps could be explored more often in the field than it is.

[Dave MacKenzie, Conservative, Oxford, ON]

It might be difficult to do if other people are around.

[Dr. Andrew McCallum]

Absolutely. You couldn't allow the public to be at risk, for example, with someone rampaging. They'd need to be contained, clearly, but could you establish a secure perimeter? In other words, if the individual is harming himself or herself--mostly himself--if that happens, then you've got to move in. Could you do that? Yes, I think you could do that in some circumstances, but there are going to be situations where that will not be possible.

[Dave MacKenzie, Conservative, Oxford, ON]

Going back to your previous life in Sunnybrook--and you're a good-sized man—

[Dr. Andrew McCallum]

I look like a police officer too. It doesn't hurt on a Saturday night in the emergency department.

[Dave MacKenzie, Conservative, Oxford, ON]

But having said that, some of these folks are not all that big.

[Dr. Andrew McCallum]

That's true.