2006-06-01 Reply to College of Physicians & Surgeons: psychotropic drugs lorazepam and haloperidol. Physician forced, over-dosed, caused amnesia, abuse of human rights.
June 1, 2006
TO: College of Physicians and Surgeons
M. Camille Dunlop
YOUR FILE: #32/06. YOUR LETTER: May 19, 2006
In response to communication from Donna Malcolm, 05 May 2006, Addressed to College of Physicians and Surgeons, Dr. Shaw
In accordance with your request I hereby advise “the College in writing of the concerns that remain unresolved.”
I believe you will want objective evidence.
I doubt it will be helpful to your assessment of the veracity of my statements, versus those of Donna Malcolm, if I merely challenge what she says (which I do!).
I have therefore selected an item which captures some of my concerns and which demonstrates the lens through which Donna Malcolm viewed me. The item is verifiable, with information provided by Donna herself, and with evidence external to myself. “UNRESOLVED CONCERNS, ONES FOR WHICH OBJECTIVITY EXISTS” is attached.
If this is insufficient, I believe you are then in a position where you must assess whether my initial submission to you is truthful. If that be the case, I recommend that:
– You speak with Dr. Stuart Houston, who, as recorded in the earlier submission visited me in the Psych Ward and initiated the suggestion that he attend and provide evidence to the Appeal Hearing (the hearing was cancelled before it could happen).
– You speak with Sue Peterson of The Safe Drinking Water Foundation who also visited me in the Psych Ward.
– I have the opportunity, in person, to answer questions you might have about the incongruities between the record I provided to you, and that of Donna Malcolm.
I would like to thank Donna for inputting into this process, a copy of my note to people in my email network, a few of who are doctors. The note was a request for assistance in the form of information, and includes reference to Risk Management. Donna submitted a copy of my note to the College – as evidence of my manic behaviour, I believe.
To assist understanding of the note: Prior to sending it into my network, I had shared information on Risk Management with people in the network, but in the context of Health Canada’s Pest Management Regulatory Agency (PMRA), which is run on the basis of Risk Management. (The PMRA is responsible for the assessment and licensing of pesticides in Canada.) … Is Risk Management appropriate in the PMRA (or in health care? – I am a graduate of the College of Commerce and am interested in the question.) It used to be the case that prevention (the precautionary principle) prevailed over what is today called Risk Management.
So, behind the note is the question: Is Risk Management an appropriate tool in these public institutions, or, is it as George Soros, the billionaire Fund Manager alludes to in his book “Open Society, Reforming Global Capitalism” , p.30, “…Scientific method is a good example: It worked for nature; therefore we want to apply it to society. The market mechanism is another case in point: It works well in allocating resources among private needs; therefore we are tempted to rely on it for fulfilling public needs. … “. (The Risk Management model is appropriate in some business settings, but is it appropriate in unlocking the causes of deterioration in a person’s health?)
This bit of background may be helpful to someone reading what Donna submitted (my communication). I believe everyone is familiar with the use of X, Y and Z to denote unknowns, as in algebra, so there is no need to explain that part of the note.
I received a handful of replies to the email, with appropriate suggestions, so it is not incomprehensible. The email was sent out Friday night; I went back to the Hospital for information on Saturday morning. The replies came in while I was in the Hospital (2 weeks).
The email is presented as evidence of manic behaviour.
An equally legitimate interpretation is that it is evidence of healthy behaviour.
I was seeking information to try and better understand my situation. From my earlier documentation: I was shown the x-ray of my lung with the large amount of fluid on it and I was told by the doctor on Wednesday night to come back to the clinic on Friday. I went home and used the Internet to inform myself about fluid on the lung. On Friday I was told by Dr. Lacny that Wednesday’s doctor had basically been incompetent (not his precise words) and, after obtaining the results of the blood test that should have been done, I should get right over to Emergency because things there close down by about 4:00 – 4:30 pm Friday. I was told that nothing (little?) gets done over the weekend; there was urgency because of this. I did as Dr. Lacny directed.
The events of Friday afternoon in the Emergency Ward are recorded in my earlier submission. At the end of the day I signed a waiver form and returned home where I did more work. I was perplexed by one thing that the medical process considered irrelevant. It is a sign of healthy behaviour that I sought more information (my email submitted to you by Donna Malcolm).
Let me elaborate a little. In my earlier submission I said “so I got information on one other symptom I had experienced prior to going to the Clinic. I looked it up under “skin discoluration” which was the best way I could think to describe it.”. The process at the Hospital was not interested in this bit of information, maybe because it is unrelated to fluid on the lung – I don’t know. But I was interested in it. And dissatisfied with what I had learned to date about it.
Specifically the “skin discolouration” occurred on my right hand. It was quite alarming and I shook my head to see if I was hallucinating. This was during the time prior to going to the walk-in clinic when I thought I had a bad flu with aching bones and fever. It was on the Sunday I believe. I knew I wasn’t hallucinating when, unsolicited, my daughter said, “Mom, what’s wrong with your hand?”. The hand she and I were looking at, was not my hand by any stretch of the imagination. It was a hand that belonged on the body of a person in their nineties. It was an eery bronze (as I recall) in colour (not as in “tanned”); it was skin stretched over the bones of a skeleton, there was no “meat” in my hand. You would have thought that you were hallucinating had you seen such a hand on your body! Had there not been someone there to verify what I was seeing, I would have believed that I was hallucinating. I simply could not make any sense of it. At the time I was fatigued (and sick), so just stuck my head in the sand and went to sleep.
On Monday I got up and started doing things. The “flu” symptoms were replaced by pains in my side, especially when I breathed in. They did not abate and by Wednesday evening I decided to have them checked out. As I finished explaining to the doctor about the “flu” and then the pains in my side, the pains stopped. I was disconcerted by this, thinking “My God! Is this psycho-somatic? The pains are gone. The doctor is going to find that there is nothing wrong with me!” When an x-ray showed a large volume of fluid on my lung, I was actually quite relieved, as weird as that may seem! The pains that took me to the walk-in clinic did not happen again. Except for fever, sweating, fatigue and weakness I was comfortable after presenting myself for medical assistance. (I had not taken any pain killers or any other medication.) (3 to 4 weeks later, on April 1st, it was confirmed that I had tuberculosis.)
By Friday when I left the Hospital I had seen many doctors and had many tests. As stated in the email submitted by Donna, “I have been from well-intentioned doctor to well-intentioned doctor today. Not once was I asked any question about what was happening with my urine.” I used urine as the example because skin discolouration is sometimes associated with liver and maybe kidney (?) malfunction. That and the small volume of urine I experienced, and more importantly, the timing of the symptoms, led me to think there might be a relationship between this and the build-up of fluid on the lung. Unfortunately, the symptom (withered hand) had disappeared so I couldn’t show it to anyone. And you will understand that “the process” had no interest in hearing about it. Nevertheless, as part of a problem-solving exercise I could attempt to get more information and understanding on my own. An attempt to obtain information, to understand, is a sign of healthy behaviour. If it isn’t, then the admonitions I give my children are creating more numbers of alleged manic people like myself!
You might also appreciate that once I had been committed to the Psychiatric Ward I deemed that it was not in my best interests to talk about this and some other things. Had I, at that time said that I experienced my hand in the form it might be when I am 90 years old, it would have been confirmation of the diagnosis that I was manic. A man I know came to the Psych Ward to visit a woman he knew and was overtly surprised to see me there. I could not say to him, “But I don’t belong here”, because that would have confirmed the diagnosis to anyone overhearing the statement. I could not smile or chuckle to myself when I considered who were the real nuts in the Cuckoo’s Nest, because again, smiling or chuckling to myself would have been used to confirm the diagnosis. I could not laugh at the predicament in which I found myself, a world turned upside down, because that too, would have been used as confirmation. All I needed was to have the fluid-on-the-lung dealt with. At the risk of being re-committed!, let me tell you this – afterwards I have regaled friends with a description of my predicament until tears of laughter streamed down our cheeks. My advice to them: don’t ever go to the Hospital, especially if you are sick, without a companion to advocate on your behalf. You never know where you’ll end up!
I appreciate your attention to my file.
I have included some thoughts for provocation. It is not a requirement that you read them!
(Contact information deleted)
UNRESOLVED CONCERNS, ONES FOR WHICH OBJECTIVITY EXISTS:
In response to communication from Donna Malcolm, 05 May 2006, Addressed to College of Physicians and Surgeons, Dr. Shaw
Regarding page 4, Item #7 (a) “was the doctor justified in forcing an injection which caused permanent amnesia for a period of time and in forcing mood-altering drugs on me?”
Donna Malcolm defends “I know of no evidence that haloperidol 3 mg and lorazepam 2 mg cause permanent amnesia, I do believe that if a person’s thoughts are much disorganised, memories are not laid down in the usual way. A severe manic state is somewhat like a delirium, such as after surgery or a brain injury, and typically much of this period is not remembered whether drugs are administered or not. The treatment with risperidone and divalproex are recognised and research-based treatments for acute manic states. I know of no instances or evidence that the short term treatment (3 days) with these two medications has ever produced amnesia.”
The evidence is not hard to find.
“Intravenous or intramuscular administration of the recommended dose of 2 mg to 4 mg of lorazepam injection to patients is followed by dose-related effects of sedation (sleepiness or drowsiness), relief of preoperative anxiety, and lack of recall of events related to the day of surgery in the majority of patients. The clinical sedation (sleepiness or drowsiness) thus noted is such that the majority of patients are able to respond to simple instructions whether they give the appearance of being awake or asleep. …”
Donna’s statement illustrates the persistence of a diagnosis in spite of the contrary evidence I submitted to the College and thereby to her. She determined that I was manic and therefore interprets everything about me from that viewpoint.
“I do believe that if a person’s thoughts are much disorganised, memories are not laid down in the usual way. A severe manic state is somewhat like a delirium, such as after surgery or a brain injury, and typically much of this period is not remembered whether drugs are administered or not … “
I think all would agree that “a lack of recall” is the same as “permanent amnesia of a period of time” (my description).
It was not too difficult for me to find on the Internet that lorazepam is associated with a lack of recall.
The length of the period of amnesia is related to the dosage given. And if the drug is used in conjunction with certain other drugs, the effect is increased.
Not only is there persistence of diagnosis, but a reasonable interpretation of the information is that Donna over-prescribed by using haloperidal 3 mg and lorazepam 2 mg simultaneously.
For my body weight and alleged condition, the maximum I should have been administered is 2 mg of larazepam with warning that the dosage of certain other drugs that might be used in conjunction must then be reduced in dosage. The information follows.
I have included information on haloperidol to show that the dosing I received ignored the warning to decrease the dosage if a second drug is used. The information on haloperidol, as with that on lorazepam, states that use of the drug will add to the effects of certain other drugs used in conjunction.
It is unacceptable that I was held down and forcibly given these drugs, under the direction of Donna Malcolm, especially when she is poorly versed “I know of no evidence …. ” .
You may note in the information below that haloperidal, although commonly used in “emergency” situations, is for “acute” and “acute and chronic” cases. My situation was neither.
The evidence below also substantiates my claim of abuse of power and unjustified violation of … my civil rights.
Regarding page 3, Item #6 (Donna Malcolm): “ As far as I can tell the procedures stipulated by the Act were followed in regards to Ms Finley’s care in that a legal representative was informed immediately of her compulsory admission, the legal representative saw her within a few hours, and proceeded to put in place an appeal hearing.”
Access to legal counsel, to which I have a right, was effectively denied. I was not allowed access to a phone to call my own lawyer. I was given access to the Health Authority’s lawyer. From my earlier complaint form “And so I understand that a person who has received the injection can carry on conversations but when they come out from the influence of the drug, have no recollection of anything that has happened. So I was given access to a lawyer, but it was meaningless access.” To this day, I would not know that I had talked with any lawyer, except that I was told I had.
This is confirmed by the information on the drug:
“Intravenous or intramuscular administration of the recommended dose of 2 mg to 4 mg of lorazepam injection to patients is followed by dose-related effects of sedation (sleepiness or drowsiness), relief of preoperative anxiety, and lack of recall of events related to the day of surgery in the majority of patients. The clinical sedation (sleepiness or drowsiness) thus noted is such that the majority of patients are able to respond to simple instructions whether they give the appearance of being awake or asleep. The lack of recall is relative rather than absolute, as determined under conditions of careful patient questioning and testing, using props designed to enhance recall. The lack of recall and recognition was optimum within 2 hours following intramuscular administration …
The intended effects of the recommended adult dose of lorazepam injection usually last 6 to 8 hours. In rare instances and where patients received greater than the recommended dose, excessive sleepiness and prolonged lack of recall were noted.”
Evidence that the combined dose was greater than recommended appears below.
RESOURCES (I have cut and pasted. Scroll through; select what is pertinent to you.)
Intravenous Injection: For the primary purpose of sedation and of anxiety, the usual recommended initial dose of lorazepam for intravenous injection is 2 mg total, or 0.02 mg/lb (0.044 mg/kg), whichever is smaller.
(INSERT: There is no indication that the dose for intramuscular injection is different from that for intravenous injection. I am 120 pounds. .02 mg/lb = 120 X .02 = 2.4 mg. So, giving benefit of the doubt, given my alleged condition, and ignoring the fact that I have a history of over-reacting to drugs, 2 mg would be the recommended initial dose.)
This dose will suffice for sedating most adult patients and should not ordinarily be exceeded in patients over 50 years of age. (I was 56 at the time.)
Doses of other injectable central nervous system depressant drugs should normally be reduced. See Precautions.
INJECTIONS (INSERT: Precautions)
General: The central-nervous-system effects of other drugs, such as phenothiazines, narcotic analgesics, barbiturates, antidepressants, scopolamine, and monomine-oxidase inhibitors, should be borne in mind when these other drugs are used concomitantly with or during the period of recovery from lorazepam injection.
Haloperidol 3 mg
(Link no longer valid http://www.mayoclinic.com/health/drug-information/DR202278)
Haloperidol (ha-loe-PER-i-dole) is used to treat nervous, mental, and emotional conditions. It is also used to control the symptoms of Tourette’s disorder. … For haloperidol, the following should be considered: …
Constipation, dizziness or fainting, drowsiness, dryness of mouth, trembling of the hands and fingers, and symptoms of tardive dyskinesia (such as rapid, worm-like movements of the tongue or any other uncontrolled movements of the mouth, tongue, or jaw, and/or arms and legs) are especially likely to occur in elderly patients, who are usually more sensitive than younger adults to the effects of haloperidol. ….
Although certain medicines should not be used together at all, in other cases 2 different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are taking haloperidol, it is especially important that your health care professional know if you are taking any of the following:
- Amoxapine (e.g., Asendin) or
- Metoclopramide (e.g., Reglan) or
- Metyrosine (e.g., Demser) or
- Other antipsychotics (medicine for mental illness) or
- Pemoline (e.g., Cylert) or
- Pimozide (e.g., Orap) or
- Promethazine (e.g., Phenergan) or
- Rauwolfia alkaloids (alseroxylon [e.g., Rauwiloid], deserpidine [e.g., Harmonyl], rauwolfia serpentina [e.g., Raudixin], reserpine [e.g., Serpasil]) or
- Trimeprazine (e.g., Temaril)—Taking these medicines with haloperidol may increase the frequency and severity of certain side effectsCentral nervous system (CNS) depressants (medicine that causes drowsiness) or
- Tricyclic antidepressants (medicine for depression)—Taking these medicines with haloperidol may result in increased CNS and other depressant effects, and in an increased chance of low blood pressure (hypotension) …
- The dose of haloperidol will be different for different patients…
- For short-acting injection dosage form:
Adults and adolescents: To start, 2 to 5 milligrams, usually injected into a muscle. The dose may be repeated every one to eight hours, depending on your condition.
(INSERT: I was given 3 mg which indicates standard and not reduced dosing, as recommended in the dosing information on lorazepam when it is used in conjunction with certain other drugs.)
This medicine will add to the effects of alcohol and other CNS depressants (medicines that slow down the nervous system, possibly causing drowsiness). Some examples of CNS depressants are antihistamines or medicine for hay fever, other allergies, or colds; sedatives, tranquilizers, or sleeping medicine; prescription pain medicine or narcotics; barbiturates; medicine for seizures; muscle relaxants; or anesthetics, including some dental anesthetics. Check with your doctor before taking any of the above while you are taking this medicine . …
If you are receiving this medicine by injection :
- The effects of the long-acting injection form of this medicine may last for up to 6 weeks. The precautions and side effects information for this medicine applies during this time .…
… Other side effects not listed above may also occur in some patients.
Haloperidol is used in the control of the symptoms of:
- Acute psychosis such as drug psychosis (LSD, amphetamines, PCP), psychosis associated with high fever or metabolic disease
- Acute and chronic Schizophrenia
- Acute manic phases until the concomittantly given firstline drugs such as Lithium or Valproate are effective …
Haloperidol is considered indispensable for treating psychiatric emergency situations. It is enrolled in the World Health Organization “List of Essential Medicines”.
Information for the Patient: As appropriate, the patient should be informed of the pharmacologcal effects of the drug, such as sedation, relief of anxiety, and lack of recall, and the duration of these effects (about 8 hours), so that they may adequately perceive the risks as well as the benefits to be derived from its use.
THE MONSTERS WE HAVE CREATED
We are making mistakes. It is my hope that the following will prompt reflection in some people and not an out-right rejection, as it will in others – the defensive.
There is a lawyer who spends his time between the City and a small Town. Of the Justice system he said, “We have created monsters.”.
Medicare is another such monster (I say, again, at the risk of being re-committed!)
I think we need to look at two things:
– is Risk Management an appropriate model for HEALTH care ( as opposed to MEDI care). From Soros. Page 47, “The behaviour of people – exactly because it is not governed by reality – is easily influenced by theories. In the field of natural phenomenon, scientific method is effective only when theories are valid; but in social, political, and economic matters, theories can be effective without being valid. …”
– Is the Medical Profession up-to-speed with the public? out of numerous examples:
(a) “Tooker was driven to suicide after just 5 weeks on an antidepressant drug that agitated him. What is known about these drugs? By sharing information, I’m turning my anger into action,” says tour participant… (attached)
(b) “New Canadian research shows that the suicide rate among seniors taking selective serotonin reuptake inhibitors was nearly five times higher than among those who were treated with other forms of antidepressants.” (attached)
(c) “This is directly related to David Suzuki’s “Selling Sickness”, on the “Nature of Things”, Sept 30 and Oct 3/04. Also to Angell Marcia’s book “The Truth About the Drug Companies: How They Deceive Us and What to Do About It” (Angell is former New England Journal of Medicine editor, now senior lecturer at Harvard Medical School). (I have more information if you would like it.)
(d) Dr. Tana Dineen did her Ph.D. at the University of Saskatchewan, and authored “Manufacturing Victims” in 1996. You may want to do a quick read of it.
(e) Pharmacare and medicare, the masking of symptoms, versus addressing the causes of disease .. My case is a sad commentary on the system
WHY DO I BOTHER?
Against my will, I was administered drugs that gave me amnesia. I said and did things of which I have no recollection. I was locked up for a week. I was forced to take other drugs.
Why did it happen?
- in the first place, my behaviour was “outside the system”. When you go to Emergency (which is where my file was), you go for Treatment by Professionals, not for information. Had I said, “I am here for medical treatment”, everything would have been fine. But I said, “At this point, I just want information. I want to better understand the cardiovascular system, the flow of the blood as it circulates in the organs of my body. Also, I was here yesterday. I would like information from my file. It was either my liver or my kidneys that were tested and found to be healthy. I don’t remember which one it was. Would you mind looking in my file for the information and telling me which one it was.” (This was on a weekend when laboratory services are pretty well shut down, when I knew they would not be “treating” me. The question about which organ was healthy is part of the process of elimination in problem solving.) The workers could not understand a request for information; it was outside their frame-of-reference. I became the confused one.
- On the previous day I asked questions (some would say “challenged”) people in positions of authority.
- I was more informed than many people are.
- I am not afraid to ask questions and expect answers.
- I assumed responsibility for what was happening to me. I believed that I could provide intelligent information about my own being to doctors who will interview me for five minutes. And I believe that I have the responsibility for being informed and being the one to make the final decision about what will be done. (I note that the doctors I saw on Friday, the ones who brought the waiver form to me for signature after which I was free to leave, actually listened to my explanations, presented their concerns, but in the end respected my decision to leave the Hospital, at least for the time being and knowing I had full capability to return. It is noted that without information about the drugs that were forced on me, and when my civil rights were taken away, the decisions forced upon me were the wrong ones.)
- OTHER PEOPLE IN THE SYSTEM knew that everything was not right. They did not stand up and speak out. From my original submission to the College: “I made a point of asking, when speaking with a doctor from a different ward (for example, Internal Medicine), “Doctor, where should I be placed in order for you to deal most effectively with the fluid on my lung? Should I be here, or should I be in Internal Medicine?”. I was told I should be in I. M. I asked if they could initiate paper work that would transfer me out of this Ward to where I should be. It was awkward because there were no clear lines of authority. I asked the question directly: “who has the authority to initiate the paperwork to transfer me?”. There was no definitive answer. I then surmised that because Donna Malcolm had committed me, she maintained power.”.
- The Medicare system is designed to process people: I talked enough while I was going through the system. But I was saying the same thing over and over in response to the same set of questions administered by each interviewer, probably “professionally designed” and standardized. If you think about it, that system actually controls the information that gets recorded. My guess is that people probably get allergic to the information: I suspect that my file is thick, but it contains a whole lot of repetitive information. You will know if I’m wrong.
- I don’t believe the system is actually designed to “care” for people. The evidence I offer is the example of Donna Malcolm’s response to my email. … if the intent is to “care” for a person, the first thing you do is to listen to them. You take yourself out of the equation, you focus, and you piece together what it is that the person is telling you. If you don’t, then you are caring for yourself, not the other person. Donna did not ask what my note was about. She assigned her own “professional” interpretation. In other words, she didn’t hear me. If other people thought I was mentally ill, then I suspect that they, too, did not actually try to hear or understand what I was saying. It is like talking with a person who has, for example, an East Indian accent. You can dismiss them saying, “I can’t understand a word they’re saying.” Or, you can focus, listen intently, and find that if you try, you can understand what they are saying. If you care about the other person, you will hear what it is they are saying. Had I presented myself to be processed, there would have been no problem.
You know that what happened to me has happened to others, and it will continue to happen: we have created the conditions for it.
SO WHY DO I BOTHER?
You are cutting too close to the line between freedom and fascist or nazi regimes. If I have been forcibly drugged and locked up, I know for sure that it has happened to other people and at this same location.
I have the advantage and hence the responsibility of being able to defend against this abuse of power. And so I will. A democracy is dependent upon the engagement of its citizens in the processes of the society. It is a fragile thing that must be safeguarded. We are on a slippery slope if “authorities” can get away with the abuse of rights of which my experience is example.
Healthy Mind, Healthy Body Planet Tour by Train
Tuesday, May 16, 7 pm, Frances Morrison Library (23rd Street)
Cross-country multimedia presentation commemorates life of renowned environmentalist Tooker Gomberg; sheds light on dangers of anti-depressants and the influence the pharmaceutical industry has in our lives.
“Tooker was driven to suicide after just 5 weeks on an antidepressant drug that agitated him. What is known about these drugs? By sharing information, I’m turning my anger into action,” says tour participant and Tooker’s widow Angela Bischoff.
Committed to low-impact transportation, tour participants will use the train and other forms of mass transit for their cross-country tour. Bischoff, director of Greenspiration, will be accompanied by Kelly Reinhardt and Bridget Haworth of boilingfrog, an independent media organization based in Toronto.
The Healthy Mind Body Planet Tour celebrates the most current information, analysis and inspiration related to mental, physical and planetary health. We will look at the reasons for the recent rise in depression, and at the myriad of treatments available, including pharmaceutical.
The Healthy Mind-Body-Planet Tour arrives in Saskatoon as part of their journey through 23 Canadian cities and towns. This event is free, donations welcome. More info visit http://www.greenspiration.org
Globe and Mail
Drug heightens suicide risk in seniors, study shows
By ANDRÉ PICARD
PUBLIC HEALTH REPORTER
Monday, May 1, 2006, Page A7
There is more damning evidence that a popular class of antidepressants that includes Prozac, Paxil and Zoloft may trigger intense suicidal thoughts in some patients.
New Canadian research shows that the suicide rate among seniors taking selective serotonin reuptake inhibitors was nearly five times higher than among those who were treated with other forms of antidepressants. That heightened risk lasts for about a month.
FOR PROVOCATION You can only protect your liberties in this world by protecting the other man’s freedom. You can only be free if I am free. Clarence Darrow.
When liberty is taken away by force it can be restored by force. When it is relinquished voluntarily by default it can never be recovered. Dorothy Thompson
Freedom is what you do with what’s been done to you. Jean-Paul Sartre
On my list of books to read, “Development as Freedom” by Amartya Sen, 1999: “Amartya Sen makes a convincing case that development should be defined in terms of freedom, not in terms of gross national product.” How “developed” is Canada, in the light of my experience?