Chapter Five: The Limits of a Theory of Recognition: Toward a Nursing Ethics of Vulnerability

Abstract

At mid-afternoon on September19, 2008, Brian Sinclair,a45-year-old man of Aboriginal descentw heeled into the emergencyr oom( ER) of the Health Sciences CentreinW innipeg.H einteracted with atriage aide,showed his family physician's letter,then parked his wheelchair in what would be his final resting place. The video footage from securityc ameras shows Mr.S inclair moving around the waiting room with intermittentmoments of rest, and medical staff walking by him in anearly emptywaiting room but no onewhatsoever inquiring if he needed assistance.T wenty-four hours after his arrival, housekeeping was called to attend to abodily fluid discharge in the waiting room -Brian Sinclair's vomit. From 4:37 pm on September 20th to the time of the first attempt at resuscitationat00:51 am the following day, he does not moveaninch, his head slumped forward in what is nowknown to be the position he died in.During his entire stayi nthe ER,Brian Sinclair was invisible to the medical staff, even after he vomited in the waiting room. He spentw hat is more than likely eight hours dead in his wheelchair before anybodya ttempted anyr esuscitation maneuvers on him. Vulnerable and with no advocate, he was considered a"frequentflyer," drug user,and ahomeless First Nations man, and he died while attempting to get help for what he knew was as erious medical condition. Between his arrivaland the certification of his death, Brian Sinclair had neitherbeen triaged nor had anurse seen him in the 34 hours he spentinthe ER,although150 other patients had been processed throughthe department. A visitor eventually made the staff aware thatBrian Sinclair's neck was blue.Rigor mortish ad alreadys et in,with the coroner estimating that he hadd ied hours prior to the first attempt at resuscitation. According to the coroner's report, this death was preventable (Preston, 2014).The inquest into his death, published in 2014, makes clear thathis visit to the ER was only the last station in alife lived under unlivable conditions. In 2004, Sinclair had had abilateral lower leg amputation secondarytofrostbite, suffered after he hadbeen evicted from his apartmentinthe winter.During his hospital admission Mr.Sinclair was assessed by amultitude of medical professionals whoOpen-Access-Publikation im Sinne der CC-Lizenz BY-NC-ND

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