IMPORTANT NOTICE TO OUR MEMBERS AND VISITORS: 

Effective November 8, 2007 selected news articles and commentary will be posted on the C.A.G.E. bilingual blog at http://cagecanada.blogspot.com/  where you’re also welcome to post your own comments.   All past entries in this news section and all of ‘’news’’ sub-sections, will remain published here for future reference.

September 14, 2007  We were delighted to learn from the following article in the Ottawa Sun that the Perley Veterans in Ottawa will be getting their smoking room!  Kudos to these elderly, some who are sick and frail, to have found the energy and fervor to put up a fight for their comfort and safety in what is considered their home.  Kudos to those that helped make this happen through their compassion and generate donations.  Shame on the Ontario Government and the anti-tobacco zealots who remained inflexible to their plight and not only did not accept to grandfather the old smoking rooms, but refused to financially aid the homes to build new ones to the stringent government standards.  Had it not been for ordinary citizens, our vets would have had to go through another Canadian harsh winter dragging their worn out bodies outside, to indulge in one of the few pleasures left to them.  Unfortunately, most of the other elderly in Ontario will continue to be victims of zealotry and insensitivity of a government that allows a fanatic doctrine to rule over civility and common sense.  We already lost one elderly to hypothermia because of this zealotry, how many more are we going to sacrifice before this barbaric anti-tobacco movement takes a few steps back? 

Make room for veterans

You did it. You answered the call for those who once answered the call for you. Hundreds of you who didn't just talk the talk, but walked the walk for our aged former soldiers who smoke at the Perley and Rideau Veterans' Health Centre.

You've donated $85,000, exceeding by $3,000 the cost of renovating to government standards under the province's Smoke Free Ontario Act a room at the centre to accommodate the some 22 residents, mostly men, who smoke, as many of their generation did, one of the few pleasures they have left in their dwindling lives.

Men and women not in the best of health who are forced outside in all manner of weather to smoke.

Soon to end.

The money is in, architectural and mechanical plans have been finalized to meet the government's requirement that exempts from the Act institutions such as the Perley and Rideau, they've been submitted for provincial approval that is expected shortly, the contractors for the work will then be chosen, the room expected to open by late October or early November.

"The money started coming in right after you wrote your first column," says Paul Finn, the creative, dynamic executive director of the centre's foundation. "I'm so deeply gratified at people in this community supporting the veterans and seniors at the Perley and Rideau."

A thank you to Gord Bunke who tipped me off about the issue last December. Bunke, who is a caring, regular visitor to the centre. The centre's board had been against a smoking room, but after hearing submissions, and in a tight vote, approved such a room. But with a proviso: The vets would have to come up with the substantial money themselves, the hospital said it didn't have the budget.

There was more than just a whiff of suspicion that the board was hoping the vets -- mostly on small, fixed incomes and with minimal financial resources -- would not be able to raise the bucks, and it'd be off the hook.

The board underestimated the sympathetic, compassionate hearts of you who responded to my several columns over the months asking for your financial help in the cause.

Paul Finn: "We received donations from many Legion branches from $1,000 to $10,000 and amounts in between. Also from some retail businesses. But by far most of the donations were from individuals. The biggest was $1,000, the smallest $25. We've had some contractors who do this kind of work offer their services for free or at reduced cost.

"Some who donated also wrote letters saying that while they don't smoke themselves, or approve of smoking, they support the veterans in this matter. That their dads or grandfathers or uncles who served smoked, even if some of them don't anymore, and the veterans deserve the room as a way of thanking them for defending our freedom. I didn't get one letter saying they shouldn't be smoking, that smoking is terrible."

Finn, born in England after World War II, is not a smoker. "My father smoked three packs a day all his life, my mother was a casual smoker, my sister is a former smoker. I tried one cigarette when I was a kid, hated the taste, and never did it again."

But Finn has no time for those who ride the sanctimonious high horse when it comes to our former soldiers who smoke.

"I have a lot of understanding and sympathy for these men and women who smoke. They are good people. They smoke, so be it. Remembrance Day. Sooner is fine, but if the room was to open on Remembrance Day itself, that'd certainly be nice, wouldn't it?"

Speeding drivers face DNA swabs under new Big Brother powers

01.08.07

Drivers stopped for speeding - or even for failing to wear a seatbelt - could soon be placed on the 'Big Brother' DNA database for life.

The most trivial offences, such as dropping litter, would also lead to samples being taken under sweeping new powers which police are demanding.

The samples would stay on the database, alongside those of murderers and rapists, even if the people involved were later cleared of any wrongdoing.

Campaigners condemned the plan as a step too far which could affect someone's job prospects for many years.

Under current rules, a person can have his or her DNA and fingerprints taken only if stopped for a 'recordable' offence - a crime serious enough to carry a jail term.

Minor offences such as allowing a dog to foul the footpath are excluded.

But police - backed by the Crown Prosecution Service - want to take DNA samples, fingerprints and even imprints of footwear for all offences.

They argue that, just because a person initially commits a low-level misdemeanour such as dog fouling, it does not mean they will not progress to the gravest crimes.

A chance to take their DNA - making any future crime far easier to solve - would be missed without new powers. Police also want to take samples - usually a mouth swab - at the scene of the "crime".

They say having to take offenders to the police station, as happens now, is too "bureaucratic".

The Home Office suggested the new powers to police in a consultation document earlier this year. Ministers are now under pressure to confirm the change.

There are already four million samples on the database - including those of a million suspects who turned out to be innocent.

Helen Wallace of GeneWatch UK said last night: 'There is significant potential for the loss of public trust in extending the taking and use of biometrics. They pose a serious threat to individual privacy and are unlikely to be an effective way to tackle crime.

"Any attempt to take DNA samples outside a police station is clearly unworkable."

Sonia Andrews of the Magistrates' Association said: 'We would find it difficult to justify extending the ability to take biometric data to cover nonrecordable offences.'

The Information Commissioner's Office warned of the danger of people being turned down for jobs if checks reveal details of minor offences committed many years ago.

Under the current system records of such offences are deleted after time. But if they are tagged to a DNA sample on the database they could remain 'active'.

But the idea is backed by police across the country, according to consultation responses published yesterday.

Inspector Thomas Huntley, of the Ministry of Defence Police, said failing to take samples 'could be seen as giving the impression that an individual who commits a nonrecordable offence could not be a repeat offender.

"While the increase of suspects on the database will lead to an increased cost, this should be considered as preferable to letting a serious offender walk from custody."

Pete Hutin, of Sussex Police, said the "taking of DNA samples in custody is unnecessarily bureaucratic".

David Evans, of the CPS, argued that the move would allow a 'more comprehensive database'.

The Home Office said: 'The DNA database has revolutionised the way the police can protect the public through identifying offenders and securing more convictions.

"The database provides police with, on average, over 3,500 matches each month and in 2005-6 alone led to matches against 422 homicides, 645 rapes, 1,974 other violent crimes and over 9,000 domestic burglaries.

"The consultation is about maximising police efficiency and ensuring that appropriate and effective safeguards are in place. No decisions have yet been made and any detailed proposals will be subject to a further public consultation next year."

The police demand was revealed as the Human Genetics Commission, the Government's independent DNA watchdog, launched an inquiry into the database. Panels across the country will gather evidence on public opinion.

June 9, 2007 - Listen to Patricia Hewitt, Britain’s Health Minister, trying to justify the NHS policy of refusing surgery to the obese and the smokers.  http://www.youtube.com/watch?v=maSnafQQv6M

June 8, 2007 – Following the announcement of the National Health Service in Britain to deny smokers surgery (see article below), Dr. Michael Siegel expressed a very eloquent opinion on this policy that you will find at:  Anti-Smoking Group Supports Denial of Surgery to Smokers .  Excerpt:  My colleague at the Boston University School of Public Health - Professor Leonard Glantz - wrote in a January BMJ column: "The suggestion that we should deprive smokers of surgery indicates that the medical and public health communities have created an underclass of people against whom discrimination is not only tolerated but encouraged. When the World Health Organization announced that it would no longer employ anyone who smokes, public health and medical communities did not respond to this act of blatant bigotry. Similarly, it is shameful for doctors to be willing to treat everybody but smokers in a society that is supposed to be pluralistic and tolerant. Depriving smokers of surgery that would clearly enhance their wellbeing is not just wrong - —it is mean."

June 3, 2007 - An excuse to cut down costs by discriminating against an ‘’unpopular’’ segment of the population that not too many dare defend, or real medical reasons to deny smokers surgery unless they quit smoking?  The last paragraph of the following article says it all.  The Canadian healthcare system being public, there is a very real threat that Canada can follow suit.  Is this what we want from a ‘’universal’’ healthcare system?   This is not only unacceptable, but despicable.  Leaving it up to the state to decide that you either quit your habit or die, can be described as nothing less than being bullied into conformance.  Knowing that smokers are generally known to be less wealthy, their inability for most of them to turn to the private sector for treatment, also makes this policy a discrimination against the poor and creates a situation whereby only the wealthy are deserving of being masters of their bodies.    

From The Sunday Times

June 3, 2007

NHS trust to warn smokers: no surgery until you quit

Sarah-Kate Templeton, Health Correspondent

SMOKERS are to be asked to give up their habit before they are put on the waiting list for routine operations such as hip replacements and heart surgery.

National Health Service managers say smokers take more time to recover from surgery, blocking beds for longer and costing more to treat.

One primary care trust will launch a consultation on the new curbs this summer to coincide with the ban on smoking in public places to be enacted on July 1.

Rod Moore, assistant director of public health at Leicester City West Primary Care Trust, said it should become the norm for patients to stop smoking before all routine surgery.

“If people give up smoking prior to planned operations it will improve their recovery,” Moore said. “It would reduce heart and lung complications and wounds would heal faster. Our purpose is not to deny patients access to operations but to see if the outcomes can be improved.”

NHS managers want patients not to have smoked any cigarettes for a full month before surgery. But as they would be expected to take about two months to stop, operations could be delayed by up to three months.

The managers do insist, however, that it is up to doctors to decide whether the surgery can still go ahead if the patient fails to give up.

Some doctors argue that the policy could deter smokers from attending appointments because they believed that they would not qualify for treatment.

By December next year, all patients will need to have had surgery within 18 weeks of having been referred to hospital by their GP, according to new government targets. To avoid endangering the targets, patients would not be added to waiting lists until they had given up smoking.

Moore said: “If this were to be introduced, it would happen prior to referral [to hospital]. The clock would not start ticking. It would not interfere with the 18-week target.”

Leicester is believed to be the first trust to be planning such a wide-ranging measure since 2005, when the National Institute of Health and Clinical Excellence issued guidance that it was reasonable for smokers to be denied treatment if their habit would affect the outcome and cost of medical care.

For example, doctors routinely deny smokers surgery for blocked blood vessels in the legs because they say the problem will go away if they stop smoking. Doctors also argue that if the patient continues smoking the vessels will quickly become blocked again.

Now NHS managers say patients should give up smoking whether their condition is directly caused by the habit or not.

Vanessa Bourne, head of special projects for the Patients Association, said: “If the NHS is trying to reduce the number of people who qualify for surgery it should be frank about this and not pretend this is medically driven.

“If hospitals really wanted to improve outcomes for patients after surgery then there are other priorities such as tackling hospital infections.

“If these patients were being treated privately they would not need to give up smoking ahead of surgery, which suggests this has more to do with money than what is in the best interests of the patient.”

May 16, 2007 - This is not Canadian fascism.... yet, but since it originated south of the border and with the globalization tendancy, it is too close for comfort.  Behind the guise of helping families, children and society in general, the British government, mimicking U.S. experiments, will now be attempting to shape social behavior right in the womb.  Resembling a lab rat, the child will be monitored right up to its second year, closely followed by a team of ‘’do-gooders’’ in white coats.  Who gets to decide what is acceptable behavior when some of the greatest people, who helped advance our society, were in fact free-spirited individuals with creative minds?  Are we now going to stifle creativity right in the womb for the sake of a potential behavior that might not meet with the model the state deems exemplary?  Why do eugenics come to mind when reading such frightening news?  Will humanity ever learn from its past errors? 

Unborn babies targeted in crackdown on criminality

Blair launches policy imported from US to intervene during pregnancy to head off antisocial behaviour

Lucy Ward, social affairs correspondent
Wednesday May 16, 2007
The Guardian

Unborn babies judged to be at most risk of social exclusion and turning to criminality are to be targeted in a controversial new scheme to be promoted by Downing Street today.

In an effort to intervene as early as possible in troubled families, first-time mothers identified just 16 weeks after conception will be given intensive weekly support from midwives and health visitors until the unborn child reaches two years old.

Unveiling the findings of a Downing Street review, Tony Blair will make clear the government is prepared to single out babies still in the womb to break cycles of deprivation and behaviour.

He will also acknowledge that the state must do more to help a minority of families and will stress that the support they need cannot come through the promotion of marriage.

In an attempt to draw a clear division between Labour and the Conservatives Mr Blair will say that making marriage the primary focus of family policy will be ineffective and could lead to discrimination against children whose parents have split up or died.

The Nurse Family Partnership programme is the most striking attempt yet to pre-empt problems.

Downing Street will outline today how a £7m pilot scheme has already begun to recruit the first of 1,000 families in 10 areas in England.

Supporters of the policy say the risk of stigmatising unborn infants as potential future victims or troublemakers is outweighed by the advantages of helping poor families build on the aspirations they have for their children.

Under the programme, which has been copied from the United States, young, first-time mothers will be assigned a personal health visitor at between 16 and 20 weeks into their pregnancy. They will continue to have weekly or fortnightly visits until the child is two - far more than the few postnatal visits generally on offer.

The support includes help with giving up smoking or drug use in pregnancy, followed by a focus on bonding with the new baby, understanding behaviour such as crying, and encouraging a mother to develop her skills and resources to be a good parent. The programme is voluntary and the intention is to capitalise on the so-called "magic moment" when parents are receptive to support for themselves and their baby.

In the US, three large trials have seen consistently positive results, including higher IQ levels and language development in children, lower levels of abuse, neglect and child injuries in families, and improvements in the antenatal health and job prospects of mothers.

Proponents of the scheme, pioneered by the American paediatrician Professor David Olds, also point to the long-term cost savings, estimated at almost $25,000 (£12,500) by the time a child is 30.

The decision to target unborn babies is, in effect, an acknowledgement by Mr Blair that the government's focus on tackling social exclusion has left a hardcore - 2-3% - of the most excluded families behind.

The prime minister's introduction to today's family review says the state must help such children out of fairness, and because "some of these families actually cause wider social harms. The community in which they live suffers the consequences".

Kate Billingham, director of the project and deputy chief nursing officer, rejected suggestions the scheme could stigmatise deprived children. "I myself think labelling and stigmatising are used as ways of not giving people the help they want and their children can benefit from."

At a Downing Street breakfast to launch the policy this morning, Mr Blair will meet expectant mothers recruited to the scheme, as well as Professor Olds, its founder. Prof Olds told the Guardian the key to the scheme was its ability to "tap into" the instincts of parents. "We are wired as human beings to protect our children," he said.

It was possible that the UK's "superior health care system and social services" compared with the US could result in the relative benefits of the scheme here being smaller than the significant impact seen in American trials, he warned.

While the scheme is generally backed by children and parenting campaigners in the UK, concerns have been raised that the new focus on intensive help for excluded families could drain resources away from already overstretched health visiting services.

A spokeswoman for the Family and Parenting Institute said: "We very much welcome the health-led parenting projects, but they are only for a tiny proportion of the population and we think that a strong universal offer is critical for the majority of families who also need support and parenting help from health visitors.

"The problem is that the number of health visitors is falling - and there are massive variations in numbers throughout the country."

May 3, 2007 -  No, this isn't a Canadian story, but should we allow it to become one?  What used to be isolated cases that we would read here and there, have now become policy in some hospitals in the UK.   Who gets to decide which lifestyle risk is acceptable and which is not?  Who even gets to decide that these patients brought their condition upon themselves due to their lifestyle?  We are living sad times when doctors get to pick who they will operate on.  We are living sad times when people are left to suffer because they somehow ‘’deserve’’ it.  It used to be the patient would have the final word if the surgery was worth the risk. This decision no longer belongs to the patient because the state has to slash on expenses.  Unfortunately once the state takes control of your physical well-being, it eventually also demands control of your mind. 

Millions too fat for NHS surgery

By JAMES CHAPMAN - More by this author » Last updated at 13:46pm on 1st May 2007

Millions of patients could be denied some NHS treatments because they are overweight or smoke.

The controversial policy has already been adopted by around one in ten hospitals - many of them battling to claw back huge cash deficits.

Health Secretary Patricia Hewitt has stirred the row further, saying a ban on surgery to replace problem joints is "perfectly legitimate".

Doctors say the risks of operating on obese patients are higher and the treatment may be less effective, with new hips and knees wearing out sooner. Smokers can have a higher risk of complications.

But the spread of the policy has brought angry protests from obesity experts, Opposition MPs and patient groups.

They say patients are being denied treatment to save money, rather than on clinical grounds, and point out that problems with joints can often be a reason for obesity, as sufferers cannot exercise.

Dr Colin Waine, chairman of the National Obesity Forum, called the move 'very distressing' and said Miss Hewitt appeared to regard obesity as a "self-inflicted problem of which she can wash her hands".

A survey of 116 primary care trusts found that nine are refusing joint replacements to obese patients and four have blocked orthopaedic surgery for smokers. The trusts, which cover six million patients between them, are almost all heavily in debt.

Miss Hewitt has endorsed their decisions, insisting that hospitals are "absolutely entitled" to set their own treatment guidelines.

Health trusts in Suffolk were among the first to say that obese people would be denied hip and knee replacements as part of an attempt to save money.

The latest survey, conducted for Sky News, suggests that in the absence of national rules, primary care trusts are making up their own.

It found those with a specific policy of denying joint surgery to obese patients include North Staffordshire, Stoke, Lincolnshire, North Lincolnshire, Milton Keynes, Hereford, West Hertfordshire, East and North Hertfordshire and Suffolk.

North Staffordshire, Lincolnshire, North Lincolnshire and Milton Keynes are also refusing to perform joint surgery on smokers.

Surrey, South Staffordshire, Dorset, and Central and East Cheshire say they expect doctors to consider body weight and tobacco use before referring patients for surgery.

North Staffordshire has the toughest restrictions. To qualify for any routine operation, patients must have a body mass index below 30 and not have smoked for three months.

But Dr Waine criticised the use of the BMI system, which would rule out around one in five adults. He said experts now prefer waist circumference or waisttohip ratio as guides to obesity as they highlight abdominal fat.

He pointed out that rugby star Jonah Lomu had a BMI of 32 in his prime.

Dr Waine added: "Until you get to people who are very seriously obese there is very little evidence that outcomes of surgery are any worse. This is simply being used as an excuse for rationing."

Shadow Health Secretary Andrew Lansley said: "Treatments should be based on clinical needs. Trusts that have this policy are the same trusts who are trying to meet their deficits, so deny treatment to save money.

"This is sadly ironic, because investing in public health is the one thing that will reduce the number of people who smoke or who are overweight."

Joyce Robins, co- director of Patient Concern, said: "A national health service should not be deciding on who is worthy of treatment. This is a slippery slope. Do we next decide that those with criminal records should be denied healthcare?

"These people have paid into the system all their lives. They will find it hard to understand why they must pay for someone to have their fourth child or for those who injure themselves in dangerous sports while they are excluded from the service.

"It may help trusts balance their budgets but could cost society far more. Deny a muchneeded new hip and the patient will become crippled and the cost of caring for them will soar. It makes no sense."

Simon Clark, director of the Freedom Organisation for the Right to Enjoy Smoking Tobacco (FOREST), said: "I'm prepared to accept that, in some cases, being a smoker might mean a greater chance of an operation not being successful. But it's up to the individual to take that risk.

"Smokers pay enormous sums in tobacco taxation in addition to income tax and National Insurance. They have every right to be treated equally by the NHS. It's totally wrong for doctors to be playing God in this way."

Miss Hewitt, who will appear with Tony Blair today to celebrate ten years of Labour achievements in the Health Service, insisted: "Primary care trusts are absolutely entitled to get together with their doctors and say "these are the guidelines we are putting in place for this particular kind of treatment".

"This isn't a matter for managers or indeed Government ministers to decide who gets what operation - it's a matter for doctors and always has been."

Dr Peter Bradley, public health director of Suffolk PCT - £ 31million in debt - said: "We have limited resources and it's sensible to use money where we know treatment is going to work."

If you think that tobacco control has taken absurd proportions, you’re not the only one.  This has no longer anything to do with health, but with controlling human behaviour and punishing those that will not abide to the party rules.  The following apalling  two articles cannot leave anyone indifferent.   You CAN make a difference.  Tell the government what you think of what can now easily be considered hate against smokers and not against the habit.  Tell the world of what the Canadian government is doing to its elderly and the sick. 

Dying smoker left out in the cold TheStar.com - News - Dying smoker left out in the cold

No room under new rules for indoor smoking areas in hospitals
TimeSincePublished("2006-12-21-04:30:00","2006-12-21","Dec. 21, 2006");
Jack Lakey
Toronto Star

As Suzanne Penny prepares for death, one of the few remaining pleasures in life is her cigarettes. They are the cause of the cancer that ravages her, but also a soothing source of comfort. They helped Penny cope with the terror of diagnosis, brain surgery, radiation treatment and knowing she will die soon, and likely alone.

Cigarettes will be her partner on this final journey; there isn't anyone else. They are her friends. To indulge her habit, Penny must leave the Salvation Army Grace Hospital, at Church and Bloor Sts. She bundles up, rides the elevator six floors down and pushes her walker out to the smoking area, near the parking lot and next to an industrial garbage dumpster.

It's the law. There is no protection from wind, rain or cold, only a bench and a receptacle for butts. "It is quite delightful when it's dark and raining," said 58-year-old Penny, a trace of sarcasm tingeing her prim English accent.

Penny and many others in hospitals, chronic care facilities, nursing homes and seniors residences are on the wrong side of the Smoke-Free Ontario Act, which bans smoking in workplaces and public places. It took effect June 1.

The legislation is intended to reduce workers' exposure to second-hand smoke and make it harder for people to light up. But it left no wiggle room for hospitals, some of which had an indoor smoking area for gravely ill people before, but are no longer allowed.

Major Dennis Brown, CEO of Grace Hospital, said he sympathizes with smokers and understands the hardships caused by the new rules, but can't help them.

"When it was legal for us to have a smoking room, we felt that it made sense for people in their final days to have an area where they could continue to smoke and not be faced with symptoms and cravings," said Brown.

Before the province's rules kicked in, the city's smoking bylaw called for a specially ventilated room. Brown says a bylaw inspector told the hospital a year ago its smoking room didn't comply and to stop using it within 30 days, or face large fines.

To a patient with a long-nourished nicotine habit, facing a life-threatening illness without cigarettes may seem like a good idea to non-smokers, but is out of the question to them.

Just stand near the doors of any hospital and observe the procession of patients with jackets over gowns, sometimes in wheelchairs or with intravenous carts in tow, puffing away.

In the daily emails and calls to The Fixer, we occasionally get one that jumps out from the usual fare of tripping hazards and burned-out streetlights.

Penny's began by saying: "I am dying in the palliative care unit at the Grace Hospital. I would like to do so with a reasonable amount of grace and dignity, but that has been taken from me. I am a smoker.

"Forbidding smoking can't – won't – stop me from smoking, but I must go outside to do it. It is a decision that seems sure to give me pneumonia.

"I cannot stop smoking. Someone else's decision gives me no dignity and no choices. I feel sad and angry. Where is the mercy? Where is the humanity? Where are the exceptions?"

Her plea is especially ironic, given that both the University of Toronto and York University recently created rooms for professors who smoke marijuana for medical reasons, but didn't want to sneak around outside to do it.

Outside the front doors of the Grace, a red line has been painted across the pavement. No smoking is allowed inside the line, to comply with the rule that forbids smoking within nine metres of the entrance to a health care facility.

Rather than go to the designated smoking area, patients using wheelchairs and walkers often hover just outside the line, trying to escape the wind while puffing on cigarettes.

One man, outfitted in a shiny, chrome-coloured helmet, sits on the small seat of a walker and smokes while greeting visitors.

"He was always falling down and banging his head, so they gave him a helmet," Penny explained. "Some of the people down here don't have any money for cigarettes, so they beg for them from people going by. It's terribly sad."

Before she was diagnosed with terminal lung and brain cancer, Penny lived in Etobicoke and worked for the province's Office of the Public Trustee and Guardian. Her job was to find family members of people who died without a will, often to give them money they didn't know was coming.

For 40 years, she's smoked at least a pack a day, and says it was closer to two in the old days, when people still smoked at their desks.

"It's not the nicotine that's so hard to give up, it's the habit, the socializing. I always enjoyed it." She's been on her own since the infamous morning of 9/11, when her husband died of a heart ailment a couple of hours before planes started slamming into towers.

Her only family in Canada is her 24-year-old daughter Ashley, who has a small child and lives with her husband in Victoria, B.C. She's here for Christmas but has to go home Jan. 9. After that, Penny is on her own.

She's been a patient at the Grace for about six weeks, after a stay at St. Michael's Hospital, where she underwent brain surgery in October.

The long, fresh scar from where they went in climbs up the back of her head. It's easy to see; she has no hair.

Other than a few friends, she must deal with her impending descent entirely on her own. It is no wonder that she is driven to leave her bed and go out into the cold for a smoke, every hour or so.

She'd settle for a small bit of shelter somewhere closer to her room. Through a sliding glass door on one side of the lounge for palliative care patients is the Roof Garden, used for social events in good weather.

It's an open area but has a roof over it. To Penny, it looks a lot better than standing next to the garbage dumpster, but the new rules don't allow it to be used for smoking.

Greg Flood, a spokesman for the Ministry of Health Promotion, which is responsible for the legislation, said circumstances such as Penny's were taken into account when it was drafted, but it was decided that it was more important to protect others from second-hand smoke.

"When that bill was being enacted, we actually did consult with the ministry, specifically about our palliative care unit," said Brown. "We were told very clearly that there would be no exemptions for palliative care units."

Patients can always avail themselves of smoking cessation aids, adds Brown, including nicotine patches and chewing gum. It pains us to say there is no fix here.

Perley vets' final war

They fought for your freedom, now they need your help to win back one of their few remaining pleasures

What they need now, these 21 people living at Perley and Rideau Veterans' Health Centre, is help. Some good samaritans. Maybe even a single good samaritan of means.

Seventeen of the 21 fought for us in war. For our freedom. The help they are now asking is infinitesimal compared to what they once did for you, for me, for all of us.

Perley and Rideau says it hasn't the money for them. The board of directors says the 21 can have a controlled room for smoking, but they have to come up with the $70,000 an engineer's report said it will take to renovate the room to meet the stringent security and ventilation standards under the province's Smoke-Free Ontario Act that came into effect June 1 to combat the health hazard of second-hand smoke.

Good, decent people

Do not be so self-righteous and ignorant as to condemn these 21 out of the 450 veterans and non-veterans at Perley and Rideau. If you do, you are without heart and understanding.

The good samaritans would understand. Those who know that smoking is not a criminal offence. That there are good and decent people who smoke. Maybe some of them the good samaritans. Who maybe themselves had or have smoking parents. Or children. Or brothers, sisters. Or not.

Good samaritans who know that those who once went to war for us were of a generation that smoked. Who know that our government provided cigarettes for soldiers cheap and even free. Who know that smoking was their choice, their habit, one of the few calming pleasures they had in the hellfire of war. Who know that smoking is for many of them -- alone and mostly lonely -- their only pleasure in the deepening dusk of their lives at Perley and Rideau.

Veterans like wheelchair-bound Fred Warner, 91, a Chief Warrant Officer in the RCAF, World War Two, who quit smoking eight years ago -- "Not for health, just decided to" -- and whose new war is campaigning for funds for the smoking room as president of the Veterans' Residents Council.

"Before this government act, we had 12 enclosed smoking areas and nobody complained, nobody had to go outside," says Warner, a sparkly stud that belonged to his late wife in his left ear lobe, her former car's licence plate saying My Fred attached to his wheelchair.

"Now they're all forced outside no matter how rotten the weather. These are old, fragile people. Their health's not the best. Something bad's going to happen."

It already has. An elderly woman went outside recently, her wheelchair hit an obstruction and toppled on top of her. Her head was split open, she was taken to hospital with a broken hip.

Depression

Jack Coghill, a volunteer at the centre, sent a letter of resignation after a frail new vet -- lonely, no family, a smoker -- retreated, he says, into depression over the no-smoking-inside rule, and one day passed away. "That decision," wrote Coghill, "has had a devastating impact on the health and welfare of some of the 11 veteran newcomers that I have since visited."

However, long-term care facilities such as Perley and Rideau are permitted smoking-room exemptions under the provincial act. At first, the centre's governing board of directors said no to it. All the smoking rooms were shut down on day one without notice. One room even had demeaning yellow and black police-type tapes across the door saying Do Not Enter.

Staff are not allowed to assist smokers -- such as lighting their cigarettes -- and can help them to go outside and back in only if there's available staff, which there isn't always.

The act specifies smokers must stay nine metres from the building, but so far no Metre Monitors have been observed with tape measures harassing smokers who might be, say, only 8.7 metres away. Perley and Rideau has provided outside canopies for the smokers, but they don't keep rain, snow, and cold from entering, and one blew away the other day in an ice storm.

The board, at a meeting in September when it heard pro-exemption submissions, reversed its decision in a 6-5 vote. It would permit a smoking area if it met provincial standards. But the centre -- whose operating budget next year will show a deficit of $950,000 -- will not pay the cost.

It also made it clear that a smoking room will be only "transitional" towards a total non-smoking policy. Clearly, the centre is hoping this will be achieved through attrition. There's a year-long waiting list to get into Perley and Rideau and the eligible -- some hard-core smokers -- are told the centre is non-smoking pending the possibility of a room, and should it get one it will be only "transitional." The discouragement is implicit.

Greg Fougere, executive director of Perley and Rideau: "I think it'd be several years before the transition happens. Of the 608 long-term care homes in Ontario, only 20 have applied for the exemption. Yes, I'm concerned about people in their 80s having to go outside to smoke. But they're adults and I would hope they'd dress appropriately."

Fred Warner wrote a letter in October to the Imperial Tobacco Canada Foundation asking for financial help. He signed his name, but got a form letter back a month later addressed "Dear Sir/Madam" saying applications can be made only on-line. Warner isn't computer literate.

With the help of Paul Finn, managing director of Perley and Rideau's foundation, an electronic request was submitted. Imperial has acknowledged receiving it, nothing more.

One of the most powerful pro-exemption submissions in September to Perley and Rideau's board was from Elaine Whittemore who had a "legal responsibility" for an elderly World War Two naval vet at the centre.

Reading from her prepared script, she said: "As 80% of us don't smoke, why should we care and pander to the wishes of the 25 or so war veterans or elderly residents who smoke in your facility -- let them butt out or go outside with their walkers and wheelchairs, that will cure them in a hurry during the winter."

How to help

And then, addressing the centre's offer of smoking cessation programs: "The ridiculous and uncaring notion that 80 or 90-year-olds can be taught to cure their addictions of 70 years or so ... implies ignorance as well as arrogance, and most certainly a lack of empathy."

Do you have empathy for our veterans in this, their new, and certainly final, war? Are you a good samaritan who can help achieve the $70,000?

If so, contact Paul Finn at 613-526-7173. Mail a cheque -- you'll get a tax receipt -- to Paul Finn, Managing Director, Perley and Rideau Veterans' Health Centre, 1750 Russell Rd., Ottawa, Ont. K1G 5Z6. Make sure you specify it be allocated to the cost of the smoking room. Or, you can stop by in person with your cheque at Perley and Rideau.

Should you do so, and should you see some vets huddled outside in the cold, the rain, the snow, the wind with their wheelchairs, walkers, and canes for one of the only pleasures they have left, say hello and offer a handshake to our finest of the finest.