In 2013, when heroin addicts participating in a clinical trial at St. Paul’s Hospital in downtown Vancouver were denied access to prescription heroin by Health Canada once they left the trial, the hospital’s operator, Providence Health Care Society, joined five patients in deciding to bring a Charter of Rights and Freedoms challenge, claiming the addicts’ rights to life, liberty, and security of the person were infringed upon.
Providence Health Care is Canada’s largest Catholic-operated health-care organization operating 16 health-care facilities in Greater Vancouver.
One of the key figures in the decision to launch the legal action was Zulie Sachedina, who has been Providence’s vice president of human resources and general counsel for the past 15 years. “It was not something that an organization such as ours does lightly,” she says of the Charter challenge. “We’re a large health-care provider and want to stay on the right side of our funders and government. But this became an ethical issue for the organization.”
A temporary injunction granted in 2014 by the B.C. Supreme Court has allowed St. Paul’s to continue providing prescription heroin. “The legislation hasn’t been overturned, and we don’t know how the new [federal] government will address this issue,” says Sachedina. “Also, the study that is the foundation of this work is undergoing review.” The case is “a little bit in limbo” until the study’s final results and the Trudeau government’s position becomes clear.
While the prescription heroin case was tough for Sachedina, it’s certainly not the only difficult one she has managed. Like any large health-care provider, Providence has to deal with occasional disputes over the withdrawal of life support, parental opposition (on religious grounds) to necessary medical treatments for minors, and lawsuits for alleged malpractice and negligence. Those kinds of issues eventually come to Sachedina and the risk manager who reports to her.
In such fraught situations, she brings together the medical personnel, the affected families, and Providence’s ethics department. “I would not typically take on such a case by myself,” she says. “This is an area where I would bring in external counsel and possibly the public guardian. Typically, it’s the mediation component [that I provide]. We’ve not actually had to go to court. Most of the times, it’s families acting in grief, and it’s been resolved [without litigation].”
A notable exception was the case of former patient Michael Jason Paur. In September 2015, the B.C. Supreme Court found St. Paul’s Hospital negligent in failing to prevent the 36-year-old patient from attempting suicide in 2011. The court ordered St. Paul’s to pay more than $390,000 in damages to Paur, who suffered a brain injury while trying to hang himself in a hospital bathroom. He was supposed to be closely watched by ER nurses at the time, the court found.
St. Paul’s is insured by B.C.’s Healthcare Protection Program. Providence’s in-house legal team had to “make sure that witnesses and records were available,” says Sachedina. “We were obviously disappointed with the court’s decision. We’re still exploring the possibility of an appeal.”
As both head of HR and general counsel, Sachedina is doubly involved in the issue of violence against health-care workers, which has emerged as a serious occupational safety concern in the health-care sector. She reports the number of violent incidents at Providence facilities has actually decreased in recent years, in part because of an increase in Code Whites (the signal for security and colleagues to render help with an aggressive individual).
“Our philosophy is, ‘Don’t take unnecessary risks,’” she says. “‘Do not feel that you need to be a hero.’ We’d rather staff call for help when it isn’t necessary than not call when they ought to have. Sometimes, just having a security presence in itself calms things down, so it’s best to call proactively.”
In implementing measures against workplace violence, Sachedina finds it’s an advantage to have the senior HR position and the general counsel role combined in one person. “You can bring both the legal knowledge and the best practices in HR, and it’s nice to have both of those linked together,” she says.
“They’re not either/or. Good HR practices are good risk management from a legal perspective as well.”
Sachedina, 58, was born in a small town in the southern highlands of Tanzania. After attending school in the United Kingdom, she immigrated to Canada just before turning 18. After completing an MHSc. in health administration, she worked as director of human resources at Toronto’s Orthopaedic and Arthritic Hospital for four years. “But my intention was always to combine health administration and the law,” she says. “It would give me the subject matter expertise to provide leadership and support.”
In the late eighties, she pursued a law degree at the University of Toronto and articled with Porter Posluns & Harris LLP, a firm she chose because of its health-care law specialization. Hired by the firm as a junior, she acted for Ontario’s College of Physicians and Surgeons in disciplinary proceedings against doctors accused of sexual misconduct toward patients.
After less than a year of private practice, Sachedina moved to the public sector. She had already served for three years as a part-time board member of the Criminal Injuries Compensation Board of Ontario, hearing claims from victims of violence for public compensation. She then became vice chairwoman of the Social Assistance Review Board, hearing appeals from welfare claimants.
Beginning in 1993, Sachedina spent eight years as a member of the Immigration and Refugee Board conducting refugee determination hearings, first in Toronto, then in Vancouver, where she moved in 1996 for family reasons. In particular, she dealt with asylum seekers from the imploding Yugoslavia. “There were such sad stories,” she recalls. “You knew that you had somebody’s future in your hands.”
By 2001, Sachedina felt she had made her contribution to refugee work, and she was concerned that her health-care knowledge would become stale if she didn’t return to the sector. She seized the opportunity to become Providence’s first general counsel. In fact, she says, “I was the first to occupy a general counsel position in B.C.’s health-care sector. The legal role was important to me. I had worked too long and hard to become a lawyer to give that up.”
Significantly, “I was not just providing legal advice,” she says. “I was part of the leadership team deciding where we wanted the organization to go and creating the plans to get us there. I did not want to just give advice and walk away.”
Sachedina is strongly committed to volunteerism, with an international focus. She served on the boards of Oxfam Canada and the Canadian Council for International Co-operation. She was also a member of the Ismaili Council for Canada, which helped resettle Afghan refugees in Canada.
Sachedina has been a member of the Ismaili Muslim community’s International Conciliation and Arbitration Board since 2009 and chairwoman since December 2015. The nine-member board hears appeals from the arbitral decisions of national Ismaili boards. She has heard 20 family-law appeals and two commercial appeals to date. “It’s a principle of the Ismaili faith that you don’t allow conflict to fester,” she says. “You resolve conflict in order to build a harmonious community.”