Public health officers walk fine line between public and politicians, scholars argue

There’s a fine line between a public health officer’s duty to the people they serve and their duty to the elected officials who appoint them, some scholars have claimed.

But, they add, governments should be clear about what’s science and what’s politics. And no one should be under any doubt that chief medical officers of health — including Alberta’s Dr. Deena Hinshaw — have the right and responsibility to protect public safety.

“She does not require the permission of the cabinet, the premier, the minister, anybody in order to make mandatory orders restricting the spread of COVID-19,” said Amir Attaran, who teaches in both the University of Ottawa’s law and medicine faculties.

The issue bubbled over in Alberta this week after the CBC released leaked tapes from a meeting of public health officials, including Hinshaw, that suggested scientific advice on stopping the spread of COVID-19 was being distorted by political concerns about economic costs.

Hinshaw has said it’s her job to present options and Premier Jason Kenney has said it’s the job of elected officials to make decisions.

That’s not what the law says, said Attaran. Medical officers of health have every right to close businesses, shutter schools and isolate groups with no political permission necessary and others have done just that.

Attaran points to an Ontario officer who closed bunkhouses for migrant farm workers over COVID-19 concerns despite the objections of local farmers and politicians. That decision was later upheld in court, where judges ruled financial concerns were irrelevant.

“If they start treating cost as relevant, they’re violating court precedent,” Attaran said.

Lorian Hardcastle, a University of Calgary law professor who also teaches in the medical faculty, said politicians may weigh many factors in their decisions.

But she claimed Hinshaw, the face of Alberta’s COVID-19 fight, has been used by the United Conservative government to muddy the waters between science and politics.

“Because she’s a doctor and has ethical obligations in terms of her work reflecting science, you think [her] statements reflect the science.

“And they don’t. They’re a mix of science and politics.”

Hardcastle points to an earlier COVID-19 press conference in which Hinshaw delivered the government’s message that gatherings would be limited to 15 people.

“That sends the false impression to the public that it was safe to have 15 people over. It was not safe to have 15 people over — but by her saying it, that implies her medical endorsement of what was a political decision.”

Attaran scoffs at arguments that decisions should be made by elected officials, not appointees.

“Elected officials passed a law giving medical officers of health this untrammelled power,” he said.

“They only have these powers because a policy decision was made by an elected legislature. Where’s the democratic deficit?”

Nobody wins when public health officers come to be seen as government puppets, said Hardcastle.

“When we get to a point when the science and what government is doing start to get too far apart, people start to question whether the person in that role is sufficiently devoted to the science as opposed to endorsing political views.

“The government has put (Hinshaw) in an unfortunate position.”