An Alberta physician fired for voicing support for the Kyoto Protocol has declined an offer to return to his position. Dr. David Swann of Calgary, who was fired as chief medical officer of health by the Palliser Health Authority Oct. 2, had cited concerns about the board that oversees the health unit before making his decision. “My trust has been severely shaken during this process,” he told CMAJ shortly before rejecting the offer to return in mid-October. “In a personal sense, it's a direct assault. In a professional sense, it undermines the basis on which we believe we're working under the Public Health Act. It damages the credibility I need to deal with threats to public health, and it has shaken me profoundly.”
Swann's troubles began shortly after he was quoted in a Medicine Hat newspaper saying that Alberta should work with other provinces to meet environmental targets set by the international Kyoto agreement regarding reduced greenhouse gas emissions.
After the story appeared the board of the Palliser Health Authority, just south of Calgary, decided in a closed-door meeting to fire Swann for speaking out, apparently because of the Alberta government's opposition to the Kyoto Protocol. The government is concerned about its potential economic impact.
Swann is no stranger to controversy. Aside from his longstanding support for antismoking legislation, he recently held a 24-hour vigil outside Progressive Conservative leader Joe Clark's Calgary constituency office to protest the impact Western economic sanctions are having on the children of Iraq (CMAJ 2002;166[10]:1319).
However, those were mere breezes compared with the recent gales. Within days of the board's move, federal Health Minister Anne McLellan and environmentalist David Suzuki, along with the Alberta Medical Association (AMA) and the Alberta and Canadian public health associations, had protested his dismissal. The result was a 5-hour meeting between the board and Swann, during which he was offered his job back. After mulling over the offer for several days, he declined it.
Swann, who still retains his duties with the nearby Headwaters Health Authority, had held the Palliser post for 10 years. As far as his early-October dismissal is concerned, he commented: “It's like a chill has fallen on Alberta.”
AMA President Steve Chambers received “countless” phone calls and emails of support for Swann. He sent a President's Letter supporting Swann to AMA members, and a separate one to the health authority's Board of Directors that called for Swann's reinstatement. “We feel that physicians should be able to speak out on matters of health if they feel it's important for the health of a patient. In the case of a medical officer of health, the patients are the people who live in that region.”
Chambers, who said Swann had the full support of the AMA regardless of the decision he made about returning to the Palliser job, thinks that media attention focusing on the affair may have a positive impact. “One good thing is it's helped people look at the role of the medical officer of health. I think the public are reassured that the ability of a doctor to speak out for their patients has been crystallized.” — Brad Mackay, Toronto