Page - 353 - in VULNERABLE - The Law, Policy and Ethics of COVID-19

353Fault Lines: COVID-19, the Charter, and Long-term Care into a comprehensive, properly funded, public health care system is long overdue.77 The tragic experience of COVID-19 in long-term care highlights a second barrier to equal access to care for disadvantaged groups: the absence of human rights-based accountability for health care decision-making.78 The interdependence between human rights and accountability is well understood internationally, and UN treaty mon- itoring bodies have criticized Canada for failing to meet its obligations in both areas.79 Paul Hunt explains: Because of the complexity, sensitivity and importance of many health policy issues, it is vitally important that effective, acces- sible and independent mechanisms of accountability are in place to ensure that reasonable balances are struck by way of fair pro- cesses that take into account all relevant considerations, includ- ing the interests of disadvantaged individuals, communities, and populations.80 The life, security of the person, and equality rights of long-term care residents were directly implicated in choices made by governments and health and hospital authorities in relation to the pandemic— most especially by COVID-19 transfer decisions. Yet no accountabil- ity mechanisms were in place to ensure that the rights and interests of this vulnerable group were taken into account in early pandemic planning, or that long-term care residents or those advocating on their behalf were included or even consulted, until the rising death count became a national disgrace. Over and above public expressions “of anger … sadness … frustration [and] grief,”81 federal and provincial/ territorial governments must accept and affirm that access to care is a 77. Lewis, supra note 18; Canadian Health Coalition, supra note 19. 78. See generally Martha Jackman, “The Future of Health Care Accountability: A Human Rights Approach” (2016) 47:2 Ottawa L Rev 437; Colleen M Flood & Sujit Choudhry, Strengthening  the  Foundations:  Modernizing  the  Canada  Health  Act,  Discussion Paper No 13 (Saskatoon: Royal Commission on the Future of Health Care in Canada, 2002). 79. Paul Hunt, Promotion  and  Protection  of  All  Human  Rights,  Civil,  Political,  Economic,  Social  and  Cultural  Rights:  Report  of  the  Special  Rapporteur  on  the  Right  of  Everyone  to  the  Enjoyment  of  the  Highest  Attainable  Standard  of  Physical  and  Mental  Health, UNHRC, 7th Sess, Un Doc A/HRC/7/11 (2008) at paras 51, 65; Porter, supra note 37. 80. Hunt, supra note 79 at para 64. 81. Brewster & Kapelos, supra note 27.