Health
Canadian medical college suggests doctors prioritize ‘social justice’ over ‘expertise’

From LifeSiteNews
The proposal by the Royal College of Physicians and Surgeons of Canada ‘would seek to center values such as anti-oppression, anti-racism, and social justice rather than medical expertise.’
Canada’s federal medical regulatory body is being roundly condemned for suggesting that medical experts should “center” their care around woke politics rather than medical knowledge.
According to an internal report published November 23 by Dr. David Jacobs, the Royal College of Physicians and Surgeons of Canada has proposed a new model of practice which encourages doctors to focus on “social justice” rather than providing medical expertise to their patients.
“In this internal document from the @Royal_College of Physicians and Surgeons of Canada, there is a proposal from the EDI group to prioritize social justice over medical expertise,” Jacobs wrote on X, formerly known as Twitter. “This is bonkers.”
Warning ⚠️ EDI can be bad for your health!
In this internal document from the @Royal_College of Physicians and Surgeons of Canada, there is a proposal from the EDI group to prioritize social justice over medical expertise.
This is bonkers.#Cdnpoli @fordnation #Onhealth pic.twitter.com/9e98ZynbJo
— David Jacobs (@DrJacobsRad) November 24, 2023
The Equity, Diversity, Inclusion, and Accessibility Interim Report, written by Dr. Ritika Goel, reads, “A new model of CanMEDS would seek to center values such as anti-oppression, anti-racism, and social justice rather than medical expertise.”
The proposal suggests that medical professionals be instructed on “equity and advocacy” to enable them to “more effectively engage in community-led social change.”
“Such a model of CanMEDS would allow medical schools to appropriately embed and infuse lenses of social justice, anti-oppression, advocacy and equity throughout their teaching, and thereby teach future physicians how to incorporate such thinking into all of their clinical, teaching and research work,” it added.
The report is part of new requirements entitled CanMEDS 2025. CanMEDS is a framework which outlines how physicians can provide patients with the care that they need. The original expectations were put in place in 1996 with the most recent update taking place in 2015.
According to the college’s website, the new goals under CanMEDS 2025 will “support the goals of anti-racism and anti-oppression” and “support the goal of equity, diversity, inclusion, and accessibility.”
Jacobs is hardly alone in his condemnation of the proposal. Harvard professor Jeffrey Flier wrote on X, “For a medical society, or a medical school, to prioritize ‘social justice’ over medical expertise is to declare themselves unfit for their professional roles.”
For a medical society, or a medical school, to prioritize "social justice" over medical expertise is to declare themselves unfit for their professional roles. https://t.co/H6e5UA6lZ8
— Jeffrey Flier (@jflier) November 24, 2023
Similarly, Mark F. Proudman, who holds a doctorate in imperial history from Oxford, sarcastically posted, “A new model of medical care ‘would seek to centre … social justice, rather than medical expertise.’ I thought it was conservatives and populists who were hostile to expertise?”
However, the proposal should not come as a surprise to Canadians as medical colleges have become increasingly politicized, focusing on pushing woke ideologies rather than patient care.
For example, British Columbia nurse Amy Hamm is testifying to keep her nursing license after she was accused of “transphobia” for defending women’s rights and spaces. After months of hearings, Hamm was given a chance to defend herself earlier this month from accusations by the B.C. College of Nurses and Midwives (BCCNM) that she is unfit to work as a nurse because she believes that sex is based on biology.
Similarly, Ontario pro-freedom Dr. Mark Trozzi is at risk of losing his license for taking a stance critical of the mainstream narrative around the COVID-19 so-called “pandemic” and the associated vaccines.
Furthermore, British Columbia is still banning unvaccinated healthcare workers from working in provincial facilities, despite an ongoing healthcare worker shortage, leading many to suggest that politics is being placed over patient welfare.
Business
Cannabis Legalization Is Starting to Look Like a Really Dumb Idea

Back in March 2024, I wrote about some early indications that Canada’s legalization of cannabis was, on balance, causing more harm than good. Well it looks like we’ve now moved past “early indications” and entered the “nervously searching for the exit” stage.
The new concerns follow the recent release of a couple of groundbreaking Canadian studies: Cannabis Use Disorder Emergency Department Visits and Hospitalizations and 5-Year Mortality which found evidence relating cannabis use to early death, and Convergence of Cannabis and Psychosis on the Dopamine System which describes a possible biological mechanism linking cannabis use to psychosis.
Canadian governments had very little moral liability for the medical consequences of cannabis use before they legalized it in 2018. However, legalization predictably led to a near doubling of consumption. In 2012, according to Statistics Canada, just 12.2 percent of Canadians 15 and over had used cannabis in the previous 12 months. By 2022, that number had climbed to 22 percent – representing nearly seven million Canadians. Cases of cannabis use disorder (CUD) treated in Ontario hospitals increased from just 456 in 2006 to 3,263 in 2021.
The government’s decision to legalize the drug¹ has arguably placed millions of additional people at risk of serious health outcomes.
Let’s take a look at the new evidence. The mortality study used hospital care and mortality data for more than eleven million Ontario residents. The researchers were given meaningful access to raw data from multiple government sources and were apparently compliant with all appropriate privacy regulations. They tracked 107,103 individuals who, between 2006 and 2021, were treated in an Ontario hospital for cannabis use disorder.
The main control group used for statistical comparison was all Ontarians. And the secondary control group was made up of individuals with incident hospital-based care for other substance use disorders, like alcohol, opioids, stimulants.
The primary outcome tracked by the study was all-cause mortality. The secondary outcome was mortality subdivided into alcohol poisoning, opioid poisoning, poisoning by other drugs, trauma, intentional self-harm, cancer, infection, diseases of the circulatory system, respiratory system, and gastrointestinal system.
The researchers adjusted for age, sex, neighborhood income quintile, immigrant status, and rurality (urban vs rural residence). They also controlled for comorbid mental health and care for substance use during the previous 3 years.
In other words, this looks like a well-constructed retrospective study based on excellent data resources.
What did they discover? People who received hospital-based care for cannabis use disorder were six times more likely to die early than the general population. And those CUD-related deaths lead to an average 1.8 life-years lost. After adjusting for demographic factors and other conditions, the added risk of early death was still three times greater than the general population. (Although people with CUD incidents were less likely to die young than those with other substance abuse disorders.)
CUD incidents were associated with increased risks for suicide (9.7 times higher), trauma (4.6 times higher), opioid poisoning (5.3 times higher), and cardiovascular and respiratory diseases (2 times higher).
The Convergence of Cannabis and Psychosis study was performed in and around London, Ontario. This one is a bit beyond my technical range, but they claim that:
Elevated dopamine function in a critical SN/VTA subregion may be associated with psychosis risk in people with CUD. Cannabis was associated with the hypothesized final common pathway for the clinical expression of psychotic symptoms.
Which does indicate that there may be more connecting cannabis to overall harm than just social or economic influences.
I’m not suggesting that the government should restore the original ban on cannabis. Like alcohol prohibition, the moment when that might have been possible is now long past. But I am wondering why politicians find it so difficult to wait for even minimal scientific evidence before driving the country over the cliff?
Addictions
‘Over and over until they die’: Drug crisis pushes first responders to the brink

First responders say it is not overdoses that leave them feeling burned out—it is the endless cycle of calls they cannot meaningfully resolve
The soap bottle just missed his head.
Standing in the doorway of a cluttered Halifax apartment, Derek, a primary care paramedic, watched it smash against the wall.
Derek was there because the woman who threw it had called 911 again — she did so nearly every day. She said she had chest pain. But when she saw the green patch on his uniform, she erupted. Green meant he could not give her what she wanted: fentanyl.
She screamed at him to call “the red tags” — advanced care paramedics authorized to administer opioids. With none available, Derek declared the scene unsafe and left. Later that night, she called again. This time, a red-patched unit was available. She got her dose.
Derek says he was not angry at the woman, but at the system that left her trapped in addiction — and him powerless to help.
First responders across Canada say it is not overdoses that leave them feeling burned out — it is the endless cycle of calls they cannot meaningfully resolve. Understaffed, overburdened and dispatched into crises they are not equipped to fix, many feel morally and emotionally drained.
“We’re sending our first responders to try and manage what should otherwise be dealt with at structural and systemic levels,” said Nicholas Carleton, a University of Regina researcher who studies the mental health of public safety personnel.
Canadian Affairs agreed to use pseudonyms for the two frontline workers referenced in this story. Canadian Affairs also spoke with nine other first responders who agreed to speak only on background. All of these sources cited concerns about workplace retaliation for speaking out.
Moral injury
Canada’s opioid crisis is pushing frontline workers such as paramedics to the brink.
A 2024 study of 350 Quebec paramedics shows one in three have seriously considered suicide. Globally, ambulance workers have among the highest suicide rates of public service personnel.
Between 2017 and 2024, Canadian paramedics responded to nearly 240,000 suspected opioid overdoses. More than 50,000 of those were fatal.
Yet many paramedics say overdose calls are not the hardest part of the job.
“When they do come up, they’re pretty easy calls,” said Derek. Naloxone, a drug that reverses overdoses, is readily available. “I can actually fix the problem,” he said. “[It’s a] bit of instant gratification, honestly.”
What drains him are the calls they cannot fix: mental health crises, child neglect and abuse, homelessness.
“The ER has a [cardiac catheterization] lab that can do surgery in minutes to fix a heart attack. But there’s nowhere I can bring the mental health patients.
“So they call. And they call. And they call.”
Thomas, a primary care paramedic in Eastern Ontario, echoes that frustration.
“The ER isn’t a good place to treat addiction,” he said. “They need intensive, long-term psychological inpatient treatment and a healthy environment and support system — first responders cannot offer that.”
That powerlessness erodes trust. Paramedics say patients with addictions often become aggressive, or stop seeking help altogether.
“We have a terrible relationship with the people in our community struggling with addiction,” Thomas said. “They know they will sit in an ER bed for a few hours while being in withdrawals and then be discharged with a waitlist or no follow-up.”
Carleton, of the University of Regina, says that reviving people repeatedly without improvement decreases morale.
“You’re resuscitating someone time and time again,” said Carleton, who is also director of the Psychological Trauma and Stress Systems Lab, a federal unit dedicated to mental health research for public safety personnel. “That can lead to compassion fatigue … and moral injury.”
Katy Kamkar, a clinical psychologist focused on first responder mental health, says moral injury arises when workers are trapped in ethically impossible situations — saving a life while knowing that person will be back in the same state tomorrow.
“Burnout is … emotional exhaustion, depersonalization, and reduced personal accomplishment,” she said in an emailed statement. “High call volumes, lack of support or follow-up care for patients, and/or bureaucratic constraints … can increase the risk of reduced empathy, absenteeism and increased turnover.”
Kamkar says moral injury affects all branches of public safety, not just paramedics. Firefighters, who are often the first to arrive on the scene, face trauma from overdose deaths. Police report distress enforcing laws that criminalize suffering.
Understaffed and overburdened
Staffing shortages are another major stressor.
“First responders were amazing during the pandemic, but it also caused a lot of fatigue, and a lot of people left our business because of stress and violence,” said Marc-André Périard, vice president of the Paramedic Chiefs of Canada.
Nearly half of emergency medical services workers experience daily “Code Blacks,” where there are no ambulances available. Vacancy rates are climbing across emergency services. The federal government predicts paramedic shortages will persist over the coming decade, alongside moderate shortages of police and firefighters.
Unsafe work conditions are another concern. Responders enter chaotic scenes where bystanders — often fellow drug users — mistake them for police. Paramedics can face hostility from patients they just saved, says Périard.
“People are upset that they’ve been taken out of their high [when Naloxone is administered] and not realizing how close to dying they were,” he said.
Thomas says safety is undermined by vague, inconsistently enforced policies. And efforts to collect meaningful data can be hampered by a work culture that punishes reporting workplace dangers.
“If you report violence, it can come back to haunt you in performance reviews” he said.
Some hesitate to wait for police before entering volatile scenes, fearing delayed response times.
“[What] would help mitigate violence is to have management support their staff directly in … waiting for police before arriving at the scene, support paramedics in leaving an unsafe scene … and for police and the Crown to pursue cases of violence against health-care workers,” Thomas said.
“Right now, the onus is on us … [but once you enter], leaving a scene is considered patient abandonment,” he said.
Upstream solutions
Carleton says paramedics’ ability to refer patients to addiction and mental health referral networks varies widely based on their location. These networks rely on inconsistent local staffing, creating a patchwork system where people easily fall through the cracks.
“[Any] referral system butts up really quickly against the challenges our health-care system is facing,” he said. “Those infrastructures simply don’t exist at the size and scale that we need.”
Périard agrees. “There’s a lot of investment in safe injection sites, but not as much [resources] put into help[ing] these people deal with their addictions,” he said.
Until that changes, the cycle will continue.
On May 8, Alberta renewed a $1.5 million grant to support first responders’ mental health. Carleton welcomes the funding, but says it risks being futile without also addressing understaffing, excessive workloads and unsafe conditions.
“I applaud Alberta’s investment. But there need to be guardrails and protections in place, because some programs should be quickly dismissed as ineffective — but they aren’t always,” he said.
Carleton’s research found that fewer than 10 mental health programs marketed to Canadian governments — out of 300 in total — are backed up by evidence showing their effectiveness.
In his view, the answer is not complicated — but enormous.
“We’ve got to get way further upstream,” he said.
“We’re rapidly approaching more and more crisis-level challenges… with fewer and fewer [first responders], and we’re asking them to do more and more.”
This article was produced through the Breaking Needles Fellowship Program, which provided a grant to Canadian Affairs, a digital media outlet, to fund journalism exploring addiction and crime in Canada. Articles produced through the Fellowship are co-published by Break The Needle and Canadian Affairs.
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