CMAJ • May 25, 2004; 170 (11). doi:10.1503/cmaj.1040615.
© 2004 Canadian Medical Association or its licensors
All editorial matter in CMAJ represents the opinions of the authors and not necessarily those of the Canadian Medical Association.
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NEWS
NOUVELLES

SYNOPSIS

Legal Issues

Breast cancer patients sue over radiotherapy wait times

Heather Pengelley

Montreal

Quebec Superior Court Justice John Bishop has authorized a class action suit on behalf of 10 000 Quebec breast cancer patients who contend they had to wait too long for radiotherapy.

"This is the first time someone has taken action against waiting lists," says Montréal lawyer Michel Savonitto, who filed the suit in 2000 at the request of a Montréal woman. Bishop's precedent-setting ruling could open the door to similar lawsuits across Canada.

Anahit Cilinger had a partial mastectomy with lymph node removal in October 1999 and was put on a waiting list for radiotherapy. Twelve weeks later, she was still waiting.

There was no place in Quebec where she could receive radiotherapy, and she couldn't get confirmation of plans to send her to the US. Angry and anxious, she returned to her native Turkey, where she paid US$12 000 for radiotherapy at an Istanbul hospital.

"Nobody could tell her what the final delay would be," says Savonitto. "For her, it was unacceptable."

Cilinger spearheaded the class action suit. "I don't want other women to suffer the way I did while I was waiting for my treatment," she said.

If the suit is successful, Savonitto estimates it could cost hospitals $25 million to $50 million.

Savonitto filed more than a dozen medical articles to back his case. The evidence convinced Bishop that a medically acceptable delay between breast cancer surgery and radiotherapy ranges from 8 to 12 weeks. In his 41-page decision, delivered Mar. 9, he acknowledged a higher risk of breast cancer recurrence exists after longer delays.

Hospital administrators at the dozen Quebec hospitals named in the lawsuit may have to defend their decisions in court.

The court must decide what constitutes an acceptable standard of care for women who need radiotherapy after breast cancer surgery. The real question, says Margaret Somerville, founding director of the McGill Centre for Medicine, Ethics and Law, is whether failing at that standard constitutes negligence.

"These time periods seem very important," she admits, "but this is a zero-sum game. There's only so much money [in the health care system]. What do we do?" — Heather Pengelley, Montréal, Que.





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