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The Current Transcript for February 25, 2016

Host: Anna Maria Tremonti

STORIES FROM THIS EPISODE

Listen to the full episode

Prologue

SOUNDCLIP

VOICE 1: And if you pass, then you go to the back of a building where they stick you with a needle, and you start plas-ing.

VOICE 2: And how often do you plas?

VOICE 1: Twice a week.

ANNA MARIA TREMONTI: She doesn't have a job so she's plas-ing, selling her blood plasma at a for-profit blood donor clinic in Albuquerque, New Mexico. The US has 500 of them. Canada has one newly opened in Saskatoon, the first for-profit blood donor clinic in the country. Which its owner says will address what he calls a severe shortage of plasma in Canada. We'll hear from the head of the far more dominant not for-profit agency Canadian Blood Services on questions of sourcing blood products and paying donors in an hour. Also today, Wael Ghonim was the Google executive who’s anonymous Facebook page fueled the purpose and enthusiasm of hundreds of thousands of social media followers and street protesters in the early days of Egypt's revolution. He said then that to liberate a society all you need is the Internet. Today, he is not so sure…

SOUNDCLIP

Egypt is not going to prosper without all of us working on the ground, connecting with people not virtually, but actually on the ground, is essential.

AMT: Hear the evolution of his view of a revolution in half an hour. But we begin today with a question that some would prefer not to ask and others believe must be confronted. As Canada considers new legislation for a physician-assisted death, should children also have a right to that choice? I'm Anna Maria Tremonti. This is The Current.

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Doctor-assisted death should be available to children, advocates argue

Guests: Dr. Stephen Liben, Lee Ann Chapman, Dr. Eugene Bereza

SOUNDCLIP

I feel strongly in my heart and in my guts that this is my destiny, that this is part of my journey. I'm fighting for the right to die with dignity, so that I could die with the assistance of a physician if my life becomes so unbearable, with so much pain that I can't go on anymore.

AMT: Well that is Gloria Taylor, the BC woman who fought for and won the legal right to die with the help of a doctor. Gloria Taylor died in 2012 of natural causes before The Supreme Court of Canada could rule that people with “grievous and irremediable medical conditions” have the right to ask a doctor to help them die. Today the parliamentary committee on assisted dying will release a long awaited report. Up until now the discussion has focused almost exclusively on adults. But, as the federal government works out a legal framework for doctor-assisted death in Canada, some child rights advocates are calling for the law to allow minors to also have access to assisted death. Today we're asking where Canada should draw the line when it comes to children and doctor assisted death and end of life care. We begin in Québec where the government already has laws surrounding physician-assisted death and access does not extend to minors. Dr. Stephen Liben is the Director of the Montreal Children's Hospital Pediatric Palliative Care Program. He joins us from Montreal. Hello Dr. Liben.

DR: STEPHEN LIBEN: Good morning.

AMT: You've been working with young patients for much of your career as a doctor. Have you ever been approached by children wanting their life to end?

DR: STEPHEN LIBEN: Well that's so rarely that someone, a child, will say they've had enough for example and what's important then is to explore with them what they mean by that. And I can't remember maybe even a single case where they actually wanted to die. They've had enough of treatments, they've had enough of pain maybe, they really want to go home, they want to be kept comfortable, but had enough of living is very rare indeed. And when it does happen it calls into question other questions such as, are they depressed, what are we missing, those kinds of things.

AMT: When your young patients are terminally ill, some of them know it, I guess. What kinds of conversations, tell me a little bit more the kinds of conversations you do have with them.

DR: STEPHEN LIBEN: Right so, the kinds of kids that we have these conversations with are often the young adolescents or adolescents and there their lives are cut short, they know that they’re cut short for adolescence that know that. And they're doing what most adults I think are going to try to do, which is make meaning of their life, wrap up important relationships, make sense of the life that has left and grieve the life that won't be lived. There's a lot of work that's done and there's a lot of living that these kids squeeze out as much they can. Not always, but almost always, with whatever life they have in front of them.

AMT: And when they talk about ending, like things ending, they’re often in pain, so can you talk to me a little bit about that line between wanting to…you’re suggesting sometimes that they want the suffering to end…but that's not the same as wanting their life to end.

DR: STEPHEN LIBEN: Right I guess that's one of the biggest myths around is that somehow end of life has to be painful. I don't know it persists I guess the movies always have these depictions of people grabbing their chest and in agony. I mean our job in pediatric palliative care is specifically to make sure they aren't in pain or that the pain is rare or very treatable. So we’re not…you can’t have much of a conversation with somebody if they’re in a lot of pain, like you know when you have a bad tooth ache, your whole becomes that tooth ache and then you promise God that if your tooth ache goes away you'll always be happy again. Of course you aren't, once your tooth ache gone, but pain obliterates everything else. So the first thing we do is make sure that they’re as comfortable as they can be and with today's technologies and drugs that's often very, very good most of the time and if they can't then they can be sleeping most of the time. So the most important part of the answer I think your question Anna Maria, is that it's a myth that kids are in pain at the end of life. They don't have to be in pain at the end of life.

AMT: What do you think is behind the cases we have seen of minors asking for life saving treatments to end?

DR: STEPHEN LIBEN: I think that's a different conversation. Asking to say I don't want my third bone-marrow transplant or I don't want another round of chemotherapy, is not the same thing as saying I want you to kill me and have me die today. So a lot of the kids that we work with actually have had enough of the treatments because at a certain point the chance of any kind of positive outcome from treatment can become very, very low and that makes a lot of sense at that time to say you know what I've chosen not to do it again. So we’ll be very supportive of those children but at the same time, they are not saying that they want to die. In fact once they stop treatment or once they get proper symptom control, many of them are happy to live and go home and do things and live their lives.

AMT: How important was it for you to have children excluded from the Quebec legislation on physician-assisted dying?

DR: STEPHEN LIBEN: It was very important because I think it's not that it's some huge…like say it became legal for kids, it's just it's just incredibly unhelpful to have a law that does that. It's is going to muddy the waters. When a child says I want to die or I’ve had enough, that everyone's going to what, automatically go to the courts now and get court orders and try and figure out whether they're really competent and all that? It's just a huge...it's like the wrong question is being asked. It's about addressing your suffering. So I think to have it legal is completely unnecessary and a waste of resources. We should be asking questions like, not why do children not have the right to ask for their death, but why do children not have the right to have good pain some to control and proper home care and nurses in the home to help care for them? We don't have any of those resources. Those are the important questions that are not being asked.

AMT: And yet some children's rights groups argue that age and the age of majority is an arbitrary an unfair barrier to accessing doctor-assisted death and that the real bar should be mental competency. You know, if you're 17 you're still a child, if you're 18 you become an adult and you can make that decision.

DR: STEPHEN LIBEN: You know, on that point, I agree that it is an arbitrary definition in age. That the developmental age of a person or you know their capacity and how and mature they are should trump their exact age. I agree that it is arbitrary. I mean society has deemed that those arbitrary aligns are important for all kinds of things I guess, for driving a car, for all kinds of things that we decide that we know wouldn't a competent 16 year old be able to do. Go into the army or get married or actually you can do that at certain ages. So, there is arbitrariness to it, it's true. The question is, is it wise to place these decisions in the hands of younger and younger children? Is that a wise thing? Is that something that we want to engage in a society? How is that actually going to be helpful to anybody? That's the question I can’t answer.

AMT: Should it be in the hands of their parents?

DR: STEPHEN LIBEN: I would say definitely not. Parents have cried out in anguish and said all kinds of things. It's a matter of acting, now against...it's more a matter of for some parents who can’t, who cannot separate their own suffering from their child’s suffering. They’ll want their child's life to end because they can't handle the suffering of it themselves, even if their child is not in pain anymore. And it is really tricky with babies, for example, a baby may look very comfortable to all the rest of us, for some parents they may prefer the child dies because they feel that that will end their suffering sooner. And in those cases they might ask for assisted death. And that will be tricky.

AMT: Dr. Liben it's important to hear your voice, thank you.

DR: STEPHEN LIBEN: Thank you.

AMT: Dr. Stephen Liben Director of the Montreal Children's Hospital’s Pediatric Palliative Care Program, he joined us from Montreal. Lee Ann Chapman is the Vice President of the Canadian Coalition for the Rights of the Child, which urged the parliamentary committee to allow for what they call capable children, access to physician-assisted death. Lee Ann Chapman joins us from Vancouver, hello.

LEE ANN CHAPMAN: Good morning.

AMT: First of all what is a capable child?

LEE ANN CHAPMAN: A capable child if someone who has the capacity to understand the treatment being proposed, the consequences of both accepting the treatment or refusing the treatment and is someone who is making the decision freely, in other words, no coercion.

AMT: And why do you think it's important to put children in this…under this umbrella of access to doctor-assisted death?

LEE ANN CHAPMAN: Well you know first of all I would agree with Dr. Liben who spoke before, and we certainly urge parliament that all children should have equal access to good palliative care. And that's an incredibly important. But, in all cases where very grave and serious medical decisions are being made, The Supreme Court has already determined that young people's rights, their liberty rights, their security of the person rights have to be respected, such that an arbitrary age is not a barrier to accessing solace or relief from the same suffering that adults have been found to have, that it's based on their capacity and not on an arbitrary age marker. The capacity assessments go on day to day. Young people are asked to make very serious life and death situations and since 2009 The Supreme Court ruling, it is based on their ability to understand the same way it is for adults. And I don't think that this is a waste of resources, I strongly support good palliation. And this will be rare. These will be very rare events. But there are situations where someone finds that their suffering is intolerable. And should we deny merely based on an age marker?

AMT: Do you see this is an extension then of the child's autonomy to decide his or her own medical treatment?

LEE ANN CHAPMAN: I do. I think we can argue about whether you know an active intervention which necessarily brings about death is exactly the same, which clearly is not, as someone who says this treatment that you're proposing will save my life. I'm refusing this for a number of reasons. It is somewhat different but it still physician care, it is a service provided by the physician, and we would argue that by denying them the right you, you are denying them their rights under the Charter. And while it may be very rare, I have been approached by young people, and it is very rare, since the decision.

AMT: How old?

LEE ANN CHAPMAN: The one young person that I spoke to was almost 17 at the time.

AMT: You talk about capable, is there a cut off when even that is decided? You talk about a 17 year old, what about a 13 year old, what about a nine year old?

LEE ANN CHAPMAN: What our laws say is that capacity depends on the particular fact situation, the development of that particular person, the kind of decision that we're asking them to make, so while we may say to you know an eight year old, do what the needle in the right arm or the left arm they're capable of making that health care decision, when it is a life and death decision then we give greater scrutiny to that assessment of capacity. But that is true for adults. There are very many adults who are borderline capacity cases and we have to make those difficult decisions either because of aging process or because of their own developmental capacity. This isn't unique to young people and therefore we think it's unfair to say to young people we're going to pick this arbitrary age and it's not like voting or driving a car and The Supreme Court found this is a fundamental right under the Charter.

AMT: What happens if there's a difference of opinion between a minor and her parents?

LEE ANN CHAPMAN: Well you know that's interesting, our group always speaks to young people to see what they think in the situation. When we gave young people a questionnaire at a recent conference on this issue, 77.7 percent of them strongly believed, who believed in physician assisted suicide to anyone, believed it should be extended to young people. When asked about whether or not parents should be asked to sign, they said well do they have to sign if we are capable for any other health care decisions? Well, the answer is no, so they thought well why would they sign for this, and we talked about how important the situation is. And interestingly enough, the reasons for thinking that parents shouldn't have to sign, was that they thought that if they were competent young person and they were facing this decision and they have had decided that this was the best solution for them, they thought it would be, even if their parents supported the decision, it would be cruel and in fact very difficult to ask their parents to put that on a piece of paper. Which I thought showed a great level of sensitivity and maturity as to one of the reasons why they thought no. If they are capable like any other person who is capable, you don't ask for a guardian.

AMT: Okay, Lee Ann Chapman, thank you for your thoughts.

LEE ANN CHAPMAN: Thank you.

AMT: That is Lee Ann Chapman. She is Vice President of the Canadian Coalition for the Rights of the Child, she joined us from Vancouver. Well let's look more at the ethical implications of children's access to physician-assisted death. Dr. Eugene Bereza is the Director of the Center for Applied Ethics at McGill University Health Center. He was also part of the Quebec government's working group on its end of life care. Eugene Bereza joins us from Montreal, hello.

DR. EUGENE BEREZA: Good morning Anna Maria.

AMT: I want to take a few things into account. I should say that we're waiting for this report today. Already there are some reports out, The Globe and Mail is saying that the report is recommending the government should foresee how medically assisted dying works with adults before allowing it for children or people with mental illnesses. So it's obviously still in the discussion, even with those qualifiers. You were part of this group that was advising the Quebec government, how difficult is it to decide whether to include or exclude children?

DR. EUGENE BEREZA: I think it's a very difficult question. In fairness, I'm not sure that any of the consultation groups really spent a great deal of time or dedicated a lot of effort and energy on that specific question. I think the intention strategically was to say, can we pass such legislation in Quebec and how do we frame it in such a way that has a possibility of going through? And I suspect that one of the reasons we didn't address the children aspect is because that was felt to potentially compromise the likelihood of such a bill passing.

AMT: And what do you—so you're saying that society doesn't want to confront that?

DR. EUGENE BEREZA: I think that's the concern. It's as if people are saying well it's one thing for a competent adult…let's say you’re opposed morally to the physician-assisted dying situation, you could argue, well it's one thing for a competent adult, they should be allowed to make morally repugnant decision for themselves. Is it okay in our society for a more vulnerable clientele, let’s say children, to make such a decision? And the feeling was perhaps children shouldn't have the right to do something which is morally repugnant and potentially dangerous to them.

AMT: And of course that makes all sorts of presumptions.

DR. EUGENE BEREZA: It does.

AMT: So how do you go forward on this? There are legal challenges that could change the parameter of such laws regardless of where they start.

DR. EUGENE BEREZA: Right. So I think we have in a democratic society, mechanisms for that. They clearly are could be burdensome to those who are left out of the picture. It could be argued, I think quite compellingly, as Lee Ann pointed out that this could be discriminatory against certain groups. Some have the right and some don't, how come? And I think that is a compelling argument I mean if the whole point is—look, the fundamental rationale behind physician-assisted dying is to alleviate unbearable suffering that can't otherwise be mitigated. Well, if you believe that that's necessary, why would we restrict that to anyone? It’s as if we're saying, it's okay--we won't let a competent adult suffer too much but children can. So, I understand that argument, but the other side of the coin is there are many pragmatic considerations. The current legislation in Quebec allows for careful monitoring of how this will play out. We don't know how this will play out. We have to--it's a social experiment, it's a huge social experiment. Why don't we first approach this cautiously, see how it goes before we jump in and extended it to all kinds of different populations?

AMT: It does appear that that's what this report will recommend according to a story in The Globe and Mail today, but it does raise other questions. We're talking about the terminally ill, what about the chronically ill, what about the mentally ill?

DR. EUGENE BEREZA: So those are even more challenging. In Quebec, clearly we are more restrictive than what the Carter decision laid out, so thankfully for us, that we only had to deal with those individuals who were imminently dying. The Carter decision seems to enlarge that scope to others whose perceive their quality of life to be unbearable and as you say, that can extend to the mentally ill or other groups. And boy, that certainly raises the bar of complexity and ethical challenges there, how do you navigate those murky waters?

AMT: And even when again when we’re talking children, what about parents? Will we see another Robert Latimer?

DR. EUGENE BEREZA: Hard not to, I mean I think Dr. Liben made a very critical point there. We’re all human beings and we have strong feelings. It's quite understandable to have a parent say oh my goodness I can't stand watching my child suffer in this way. And there are some studies that would suggest that it's a third party, be it a parent or a physician or a nurse, you know, we inevitably attach our own emotional reaction to another person suffering, and more often than not we can perceive the suffering is more intense than the person themselves do.

AMT: And yet some parents might argue that they are with their child night and day and they see the suffering in a way that a third party cannot.

DR. EUGENE BEREZA: That's a very important point. I mean at the end of the day, they can argue and I think they have a very legitimate point, physicians, nurses, we’re strangers. We don't know that child anywhere near as well as the parent does. And they should be and probably they are in the best position to reflect who that child is. But, the challenge is when that happens, how do you know as a physician or nurse, what kind of parent you're dealing with? Those are difficult judgment calls.

AMT: We are out of time but you raise lots of questions that we have to keep thinking about as we see this being unfolded today. Eugene Bereza, thank you for your time today.

DR. EUGENE BEREZA: My pleasure.

AMT: That is Dr. Eugene Bereza, he's the Director of the Center for Applied Ethics at the McGill University Health Center. He joined us from Montreal. We want to hear from you. Do you think minors should have access to physician-assisted death in any circumstances? Where should Canada draw the line? Tweet us, we're @thecurrentcbc, find us online cbc.ca/thecurrent, click on the contact link. You can also find the story on our Facebook page and leave a comment on the post. This is The Current, stay with us.

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Social media can start a revolution but people have to finish it, says Wael Ghonim

Guests: Wael Ghonim

SOUNDCLIP

[cheering] Listen to that crowd, that's what they've been waiting for, Hosni Mubarak has gone.

ANNA MARIA TREMONTI: A jubilant crowd in Tahrir Square moments after the Egyptian President stepped down on February 11th, 2011. For then-Google executive Wael Ghonim, it was history in the making. His anonymous Facebook page, We Are All Khaled Said, helped launch Egypt's democratic revolution. But the hopes that he and so many other Egyptians had for their country were quickly crushed in the months and years to follow. True democracy in Egypt has been thwarted by the narrow interests of those who first won power, the Muslim Brotherhood, and those who took it, the Egyptian army. Now, five years later, Wael Ghonim is reflecting on what role social media played in the revolution and its aftermath. He joins me from Palo Alto, California. Hello.

WAEL GHONIM: Glad to be on your show and thanks for hosting me.

AMT: Well, it's good to talk to you. So, first take us back to the end of 2010, early 2011. What inspired you, sparked you to start that anonymous Facebook page.

WAEL GHONIM: Khaled Said, the one that page holds his name, was an Egyptian young man from Alexandria, 29-years old, he was basically brutally beaten up by police force in the streets of Alexandria to death. The photo of his dead body, the corpse, basically was taken and spread like wildfire on social media and I was one of those people who, while browsing my Facebook feed, saw this horrible photo, clicked on it and started reading about him and I decided that, just like many Egyptians, we are fed up with this and this has got to stop.

AMT: So, tell us more about what happened with that Facebook page, how it grew, the power it came to hold.

WAEL GHONIM: I simply started the page, I put it on and in the first three days, about 100,000 people liked the page. In fact, actually in the first day about 30,000 people liked the page and like here means followers or fans of that page. And I asked myself a question, there seems to be not just me, not 1,000 people, it's actually 100,000 people right now who care about this cause, who definitely want to stop the police violations. I started thinking about ways of how to engage these people, how to create small campaigns, initially online and then eventually offline, to put more pressure on the regime and that was the whole purpose, the sole purpose, of the page at the very beginning. We never thought this could spark a revolution, this could help make massive change in the country. We were hoping for just quick wins. We were hoping for justice for those who killed Khaled Said.

AMT: As all of these people started going on and liking it, what did the conversation become?

WAEL GHONIM: So, that's been an interesting thing about movements on Facebook. Basically, most of the people who started liking this page were people who agree with this cause and they were collaborating with each other, they were helping inform each other, they were engaged in campaigns, so we've done a few interesting campaigns. One of them was outreach to police officers who have accounts on Facebook, to reach out to them and tell them that we're not happy with the police violations, and such campaigns helped a lot to bring this movement together and make people have the feel of unity. You are much more empowered when you are part of such a big movement and we were crowdsourcing ideas from the people. When I say we, it is me and my co-admen which came in a few days after I started the page on AbdelRahman Mansour. So, one of the very interesting moments of the stage, when one of the members of the page were like, the police are banning protests and apparently I was very much against taking those apolitical people, putting them in front of the police and having them get arrested, and they would probably stay in jail for days or months. That was out of the question for me. So, this guy came up with an idea that said, why don't we all go down on our weekend, stand up in front the sea or the Nile, our backs to the street wearing black, not speak, and stay for one hour. And I thought that was a ridiculous idea. What is that? And then, after some time I started thinking maybe that actually is an interesting idea. Why don't we try and run it by the people. People loved it and the next weekend about 5,000 people fell down the streets of Alexandria. It was about five kilometres of people standing up by the sea, facing the sea, and their back to the street wearing black. That was how powerful such a movement was, the believers in the cause. And, they didn't feel like this movement was hijacked by individuals who are trying to build credit. It was just an anonymous administrator or administrators, they didn't know at the time that we’re basically running this page not seeking any credit. And they were focused on helping the justice cause.

AMT: When did it extend to Tahrir Square?

WAEL GHONIM: Just to be clear, I wouldn't really give the page credit for starting a revolution. That's actually didn't happen. What happened was that after Ben Ali, the President or the dictator of Tunisia stepped down, here is a moment where we could actually see dictators who have stayed in power in our region, who stayed in power for over 20 years, leave power because the people were demanding that. I simply looked at the feed on social media, on Twitter, and Facebook, and all Egyptians were like mocking-- like Tunisia is way better off than Egypt, so why aren't we doing what they're doing and I thought let me just go in and ask people through a status message. That was very simple, like could we get a 100,000 people in the streets of Cairo on 25th of January, which happens to be the national holiday because of the police day. And people were like, yes. A lot of people were very optimistic and some were saying we’re willing to pay whatever price for it to happen, to see our generation topple down a dictator that has been ruling us for over 30 years.

AMT: Do you think the regime of Hosni Mubarak, at the time understood the power of social media?

WAEL GHONIM: No. No, absolutely not. Basically this is one of the things when I look back and I think about social media, I thought at the very beginning that this social media cycle is the driver for change, but in fact what I see is the regime lacks understanding of social media was basically the pivotal point where that was the real drive for change.

AMT: The regime caught on to who you were. What happened to you?

WAEL GHONIM: I was put in jail. I was basically kidnapped one day before the second major protest on the 28th of January. We all know everything started on the 25th of January, so the 28th of January at around 1 AM, I was walking into one of the dark quiet streets in Cairo. Basically, one guy hit me on my head and when the guy hit me, I fell down, I found four armed guys around me, each one of them is trying to force me not to move, but not to shout or scream. They put me in a car, blindfolded me and I went to the, I don't know where I did go because I was blindfolded, I would say probably State security. And, basically I was kept there for 11 days, all the time blindfolded, all the time handcuffed. I had no access to any members of my family. They didn't know where I was because the regime killed over 300 people on the day of 28th of January, and many of my family and relatives thought I was killed.

AMT: How did you get out?

WAEL GHONIM: After a few days-- Id already told a few people that I am the admin of the page before the protests because I wanted to make sure that if something bad happens to me, there is a way out, or there is hopefully a way out. So, my friends actually started speaking to media saying that I'm the admin of the page and that they demand my release and then the Tahrir Square protesters started demanding my release. I was working at Google at the time so Google started a campaign to search for me because they had no official reports that I was actually arrested. And, all that together put a lot of pressure on the regime to respond to where I am. Eventually, they promised to release me.

AMT: In the days and months after Hosni Mubarak was forced to step down, what do you want to see happen?

WAEL GHONIM: So, our dreams are simple. It is basic needs. We wanted democracy, we wanted rule of law, we wanted to see Egypt prosper. And these basically were our dreams and we were very hopeful at the time, but unfortunately, dictators do not allow political life to prosper under their rulings, and everybody understands that. The problem is like the vacuum that gets created after a collapse of a dictator, it could actually result in so many negative outcomes and this is basically what happened in Egypt. I was hoping for our ability to unite together and I actually did deliver a message calling on all the political active players and the Muslim Brotherhood and the army, it was basically a message of let's unite and put back whatever had happened in the past and try and think about the future, and plan it in a way that does not result in the nightmare of what happened during Mubarak days.

AMT: What did you see changing in the role of social media in those days after Mubarak stepped down?

WAEL GHONIM: Well, I came to realize the hard way that basically social media is a tool, it's an amplifier. It could amplify good and amplify bad. So, it wasn't just a tool for great things like whatever we have done, which is bringing Egyptians together to combat dictators and backlash practices. It could be also used to separate people. I wouldn't give the credit for the revolution to social media but at the same time I wouldn't say Egypt got where it is right now because of social media. Both are wrong arguments in my point of view, however what I noticed is the increasing polarization was highly amplified on social media and social media definitely was a reflection of the ground but just like multiplied by hundreds of times. People were fighting with each other, it was clearly harder to reach consensus with the existence of such a tool at the time.

AMT: In a way, all these disparate voices came together on social media but then they became the same divisions which show up there, right?

WAEL GHONIM: Absolutely.

AMT: You once said that if you want to liberate a society all you need is the Internet. Do you still believe that?

WAEL GHONIM: I think that was right after the moment of what happened in seeing Mubarak leaving power. I think it was not right. I think liberating a society is a far more complex process than just providing people with access to Internet. Definitely, providing people with access to additional information is always a good thing, however just thinking that this is what people need to be liberated, I think that that was a very shallow comment that I made, I have to admit.[laughs]

AMT: Well, I think you can still make the argument that social media was a real driver in the revolution and in the push to get people to become involved. But, talk to me a little bit more of what you've learned about the limitations of social media when it comes to concrete political change.

WAEL GHONIM: I want to basically stress the fact that we're not here accusing social media of what human behavior is. Actually, human behavior is human behavior. We know that a lot of the problems we've had in Egypt are connected to polarization worldwide that we're seeing in many countries about issues. In the US, for instance, about gun control or about the refugees or any other topics. These are basically human behavior issues. However, the argument here is you could actually build systems that help make sure that such human behavior is contained and it's not as toxic and it is not as bad. When I tried to sum up what are the main problems that I see right now facing today’s social media platforms, I thought of the first one as rumours. So, basically people are spreading rumours like never before because we all have access to each other and the coffee-shop conversation that happened between three people in the past could be actually seen by millions of people today. And the second one is this notion of creating equal chambers. For example, it's very obvious in Egypt or maybe even and in the US or in Canada, where you see if you belong to a certain political group, you tend to start interacting and liking the content that your fellow liberals or conservatives are actually producing. Eventually, because the algorithms of social media are designed to show you what you actually like, it will end up showing you mostly content that represents your point of view. And, then here comes a delusional view of the world around you thinking that most of the people who are sane, who are smart, are the people who believe in what you believe and then the rest are actually not just like they have a different point of view, they're actually wrong or probably even bad. The third problem is the problem of angry mobs. People tend to treat each other behind screens in a very mean way, to say the least. We don't talk to each other in real life in such an aggressive way. Open any public discussion or any public page where such a polarizing topic is being discussed, and here comes a flood of angry mobs. This is never constructive to the dialogue. I think the fourth problem is also changing opinions is becoming very hard on social media. So, now we write our opinions in 140 characters about complex world affairs, and then these opinions stay forever and make it difficult for us to change our positions. It's not culturally acceptable yet that people change their positions on issues. And finally, which is for me, this is the most critical. Today, our social media experiences are designed to favour broadcasting over engagement. So, it's like I'm going to post my opinion rather than I'm going to discuss my opinion because my opinion with others who probably don't agree with me, and then writing shallow comments over having deep actual conversations. It's kind of like people are talking at each other rather than talking with each other.

AMT: So, you've identified a few things. One is just the very nature of social media, 140 characters on Twitter, a Facebook post that doesn't get more comprehensive. One, the medium can be a problem but then you're going further and you're talking about that disconnect and it's interesting because one of the things that happened in Egypt of course, was the takeover by the Muslim Brotherhood, and then there was another takeover. Some of that was to do with people on the ground, in the outreach on the ground. So, you're reaching lots of people but not deeply, right? On some levels, you almost both work together to do the kind of thing you want it to do.

WAEL GHONIM: Absolutely. Weak ties are useful in certain ways. However, there is nothing better than strong ties and having actual organizations on the ground. That was one of our biggest struggles. It's much easier to organize for a protest or a shorter movement than to organize a political party, and this is something that is very crucial for us to understand and this is something that I keep thinking about, like how to better and more effectively organize, on the Internet first, and then on the ground for more than just beyond the protests.

AMT: Because we've seen other revolutions in the last several years driven by social media, Occupy Wall Street, street protests in Hong Kong, Ukraine’s Maidan Revolution starting out strong, some of these others would argue that they failed to bring the change that the leaders intended.

WAEL GHONIM: I wouldn’t say social media because the fact that these people connected through a social media is the reason why change didn't happen, because I would argue that changes are far more complex. It depends on the geo-politics of the country, on the readability of the people and their ability to unite and think collaboratively for what's a better outcome than the outcome they were in. You know, no one is going to blame social media 50 years from now for anything, just like how we never talk about faxes. I'm sure like, in previous revolutions, people were using fax machines to interact and collaborate with each other and communicate messages.

AMT: Well, you know, that’s a very good point because one could argue at the same time social media may be there was an expectation that it would do all the heavy lifting, but certainly in terms of communicating and making people feel they weren't alone in their disappointment in a government, or wanting to explore something else, and even knowing where to show up to meet those people, social media is quite effective, right?

WAEL GHONIM: Absolutely, and I think it has to do with the speed, so if the argument is because a side effect of our ability to feel that we're not alone, it takes much less time to achieve that due to social media, then maybe that time is not enough for people to form stronger bonds that allow them to really think about the hard questions and to have a more strategic approach towards the change they're trying to do. I do think that there are ways where people who are designing and building social media platforms could help make the outcome better. This is something that I've been thinking a lot about.

AMT: So you have now started parlio.com to kind of address some of this. What is it?

WAEL GHONIM: Part of the lessons learned was this absence of conversation. Social media is designed in a way we're broadcasting opinion as being far better than engaging in actual conversations with people and eventually, hopefully change minds or at least understand the position of the people who are in disagreement with me. So, we wanted to build a community as something that a lot of people want to be part of something that is civil, that is thoughtful, that is meaningful, where we sit together to actually learn from each other's knowledge, and where experts are encouraged to speak up and we listen and engage and challenge their thoughts, and have them come back and respond to us. This basically inspired us back in December, 2014, to start Parlio, which is basically an online platform for conversations about complex issues and we would be hosting some of the most polarizing discussions about issues that are global or local, to communities and make sure that everybody is trying really hard to be thoughtful and respectful towards each other. What we have noticed, and this is something that we really believe in right now, that culture plays a big role. If you set up a good culture of mutual understanding, of civility, people are going to act in that way even if you don't put enough rules and regulations and systems that enforces that. Having said that, there is also the importance of thinking about the quality and not just the quantity because now we're all obsessed and I've lived through that life for a few years. Everybody's obsessed by how many likes, how many tweets, how many retweets, how many shares. Even traditional media organizations which are well established and have been there for tons of years are now thinking, is this post a viral? How can we make the title more interesting so that the user of social media clicks on it? So, this whole shift towards how many people are doing something versus who is doing something and how are they engaging with it, is not good for the society.

AMT: Okay, so I'm on your site, parlio.com. You’re talking about Apple’s rotten move, the post-Obama black voter, Q and A with America's first special rep to Muslim communities, you’ve got a couple of things. You still want clicks, you still want people involved, but you want them there longer. You want actually, people to think about things and maybe think differently?

WAEL GHONIM: Yeah, exactly. Our priority is actually quality and not quantity. So, Apple’s Rotten Move is actually a post by an author and this is one interesting thing that started happening in Parlio organically, and we're now seeing a lot more of that. Authors of articles like it say if you are someone that writes to the Washington Post or The New York Times, or any other publication that is well known, most of these people normally don't engage with the comments on the news sites and one of the reasons is, we asked them, is that it's noisy, it's toxic, sometimes there are lots of personal attacks, so they either completely not read these comments or when they read them, they don't bother to comment back. In Parlio, we have noticed that these authors come to Parlio to share their articles. They write a summary of their article and share it and then start engaging with the community in a discussion, responding to questions, and responding to people who are challenging their points of view in a very civil, environment way. And again, quantity is important. Definitely, everyone would love to have more people read them, or listen to them, or watch them. But, to focus slowly only on quantity is not good for our society.

AMT: Wael Ghonim, thank you for speaking with me today.

WAEL GHONIM: Thank you, I really enjoyed our conversation.

AMT: Wael Ghonim is one of the founders of parlio.com and the author of Revolution 2.0. He joined us from Palo Alto, California. Let us know what you think of what he's saying about revolutions and social media and how they intersect and how they don't. You can find us on Twitter, we are @thecurrentcbc, and as well you can go to the website cbc.ca/thecurrent, click on the contact link or if you're just joining us partway through go to our website download the podcast, listen online.

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Liberal MP pushes for government to study guaranteed minimum income

Guests: Robert-Falcon Ouellette

ANNA MARIA TREMONTI: Hello, I'm Anna Maria Tremonti, and this is The Current.

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VOICE 1: You know, it's the job of parents to advocate for their children. It's my job to make sure he gets the best education possible

VOICE 2: The people will decide who will win this war. If we have them, the Syrians, on our side, then we will win.

VOICE 3: I still remember the farewell cards on empty desks, and pictures of other people's kids sitting on the mantelpieces. It’s like some people had vaporized.

VOICE 4: Let us remember what the purpose of this ritual is in any form: it’s to control women. Not every cultural tradition or every ritual deserves respect.

AMT: Just some of the week that was and has been on The Current. Our Friday host Michelle Shephard is here with me to check in with all your tweets, posts, emails. Michelle Shephard, you know that name, she is an author and the Toronto Star's National Security reporter. Hello.

MICHELLE SHEPHARD: Hello, Anna Maria.

AMT: And you are also a fellow, you’re an Atkinson fellow this year.

MICHELLE SHEPHARD: I am, I am on a yearlong leave from the Star doing the Atkinson fellowship, which is given to mid-career journalists looking at an issue of public policy. So I am spending a year looking into the group that has called itself the Islamic State, and what Canada and other governments are trying to do about it.

AMT: And that's a very timely thing to be doing.

MICHELLE SHEPHARD: It’s very timely, it's a big topic too, I found.

AMT: Yeah okay. Well, we could have a whole conversation about that, but let's keep going right now. On Friday, we looked at the future prospects for the public service. The fate of an organization can sometimes hinge on the ability to bring in new blood to rejuvenate a workforce. After news broke that the average age of new hires in Canada's public service is 37, it sparked a debate about what's stopping the federal government from hiring from the youngest part of the workforce: millenials.

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DARREN TOUCH: They’re losing out on how connected we are to the world, and how understanding we are at the same time. You're losing creative ideas and the talent. That's what the government loses out on.

SCOTT BRISON: If you really want to move the needle in a big way on the issues that really matter to the future of Canada and the future of the planet, the public service is still the place to do it.

LINDA DUXBURY: Do you know how many young people work as interns? Do you know how many are on temporary position, temporary position, temporary position? Do you know how many good ones with great skills don't get the job because they don't meet the bilingual requirement?

MICHELLE SHEPHARD: That was Carleton professor Linda Duxbury. And before that, Treasury Board President Scott Brison and 21-year-old Ottawa University student, Darren Touch. Well, that segment certainly had many of you hitting your keyboards. Hannah Dubber is a co-op student at the University of Waterloo who is currently working for the public service, and she writes from Toronto: “Although I am appreciative of the opportunity, there is a lack of collaboration and most employees seem to keep to themselves. Now that I have experienced the atmosphere I am skeptical for my future with the public service if a change is not made.”

AMT: Jim McMillan just retired from a 35 year career with the public service. He writes from Port Williams, Nova Scotia: “One example of the challenges in the public service is hiring. Hiring must be fair to all and must be seen to be fair to all. It is difficult to narrow a search in order to hire quickly. Private sector organizations do not have such constraints.”

MICHELLE SHEPHARD: And finally, Chris Eaton in Kitchener, Ontario. He describes himself as a young worker with several degrees and work experience. He writes: “The public service seems like an exclusive environment rather than an intriguing workplace. Most young people are pragmatic enough to recognize that management positions are designated for later in our careers. However, this should not mean that taking notes and filing papers is the only option. There are plenty more engaging opportunities available to youth that will integrate them into the decision-making process.”

AMT: Okay, well, moving on. The idea that every Canadian should have a guaranteed minimum level of income, whether they have a job, is on the table. In the lead-up to the federal budget, the Minister of Social Development, Jean-Yves Duclos says the policy has merit for Canada to consider. To explain the government's position on guaranteed minimum income, I'm joined now by Liberal MP Robert-Falcon Ouellette. He is in Ottawa. Hello!

ROBERT-FALCON OUELLETTE: Hey, [speaking alternate language] merci beaucoup, thanks for having me.

AMT: Why are you promoting the idea of a guaranteed income?

ROBERT-FALCON OUELLETTE: Well, I sit on the Finance Committee, and I have this opportunity, this platform, in order to put forward some different ideas for our country. And because I represent one of the poorest ridings in the country, I thought it might be interesting to at least study this issue, and think about what it impact it might actually have on some of the lives of some of our poorest citizens in this country. And so for me, using the Finance Committee, it was a chance to kind of think a little bit more strategically about the direction we want the economy to go in, but also how we offer social programs in this country.

AMT: And your riding is Winnipeg Centre, right?

ROBERT-FALCON OUELLETTE: It is, yeah. It’s the second poorest riding in the country, it has 20 percent Aboriginal people, 20 percent Filipino, about four percent Muslim, and then a mix of a lot of other types of Canadians.

AMT: And in Manitoba, in the ‘70s, there was an experiment in in Dauphin, Manitoba. For four years, people were given a guaranteed income. What did we learn from that project?

ROBERT-FALCON OUELLETTE: What we discovered was, that in fact, we didn't see a very much drop in the amount of work that people were doing. And the amount that was a drop in, for instance, people working what was happening was they were mothers actually looking after their young children more, or young people were going to finish their education. So instead of young males starting work at age 16, they decided to start work at age 18, and spend those last two years finishing their high school diploma. Which I think is an admirable thing for a society like ours today.

AMT: And it was called mincome, as in minimum income.

ROBERT-FALCON OUELLETTE: Mincome, yes.

AMT: Okay. So a guaranteed minimum income would be for every person, including from infant to elderly.

ROBERT-FALCON OUELLETTE: That's right. And in fact, what it’s supposed to do is try to replace other social programs. So if you're on welfare, in fact, what you're supposed to do now is instead of getting welfare you're getting this minimum income, and then you have more options about how you want to use that income. So unfortunately, the program, the pilot project only lasted for years, but I suspect if the project had continued on for another five, eight years, what would have happened is people would have started, after getting their education, would have started working.

AMT: Now you've been public about your own experience growing up in a poor household. Would this have helped you, do you think?

ROBERT-FALCON OUELLETTE: Definitely. It would have offered more opportunity. There's times that I would have loved to have done more sports, or other types of activities, or summer camps, that we just couldn't afford. There were times when, you know, food was much more stressed. When I think it made-- Poverty is really hard. I think a lot of people fail to recognize how difficult poverty is, and the stress levels that it increases in adults. For instance, the inadequacies my mother felt as a human being, because she wasn’t able to provide the things, the most basic things, to her children. Leading to mental illness, more mental stress. And eventually, that has a negative cycle, it leads to other poor outcomes.

AMT: Okay, now, why would this be better than an increase in minimum wage?

ROBERT-FALCON OUELLETTE: Well, in fact, you have to have a job. And you know, sometimes it's the chicken or the egg. In my riding, or for instance, even with my mother, she didn't have a very good education. She wasn't well educated. And a lot of the jobs today, you need a certain level of education in order to occupy that employment. And if you have no ability to get an education, and I know we can say, oh, you know, just go back to school and you can do this and do this. Well, you know, it's harder than people think if you don't have the social supports or the social capital in order to go out and do those things. And I think there's a lot of people who are kind of stuck. So what I'm advocating is looking at having a pilot project and really actually studying it appropriately.

AMT: And this would be a pilot, you're advocating pilot project in an urban area, and in a rural area, and on reserve. Am I right?

ROBERT-FALCON OUELLETTE: Yeah, I'd like to test out what would happen on a reserve. If you give people money and tell them, we trust you, go out and craft a life for yourself. Here's the tools you have, and do what it is that you would want to do. And I suspect the vast majority of people are going to take that opportunity and actually build a life for themselves and their families.

AMT: Okay, so, I know this is being looked at this point, but you're saying it would replace other forms of government payments. Provincial welfare payments. Different kinds of child benefits. It would replace all other payments, right?

ROBERT-FALCON OUELLETTE: That's the idea, because--

AMT: [interposing] And so how much money are we talking about, any idea, if you were to do this country wide?

ROBERT-FALCON OUELLETTE: [interposing] Well, it depends where you live in the country, but if it was countrywide, I'm not sure, but if it was around 10,000 people and you gave everyone $12,000, it would be $120 million dollars for a pilot project.

AMT: And then you could study it.

ROBERT-FALCON OUELLETTE: [crosstalk] But then you're also saying money on welfare, you're also saving money on the child benefits, and many other costs. Say, if you're on a reserve, there's, you know, additional costs that come up with it, but you're just giving people the option to do what it is they would like to do with their lives. And they'll take the money, and I suspect they're going to do good things.

AMT: And so, is the pilot project going ahead for sure? Or are you still looking at the idea of the pilot project?

ROBERT-FALCON OUELLETTE: Well, I'm still fighting, or pushing this ahead. I've made it aware to the parliamentary secretary, the finance minister, I think is what they should be doing. He seemed very interested in it, the conservative critic on the Finance Committee, Lisa Raitt, was also very interested in this. Because it breaks outside of the box of the way we often offer services, and I think we've come to the limit of what we can do in the traditional welfare system for various groups in our society. And I think we have to start thinking a little bit more long term and a little bit more strategically, and not just simply fall back into our usual modes of ideology, saying, well you know, everyone has to work in this way.

AMT: Okay.

ROBERT-FALCON OUELLETTE: And perhaps be more flexible in what we're doing in our country.

AMT: Robert-Falcon Ouellette, thank you for your thoughts today.

ROBERT-FALCON OUELLETTE: [speaking alternate language]

AMT: Robert-Falcon Ouellette is the Liberal MP for Winnipeg Centre. He joined us from Ottawa.

At halfway. It's

MICHELLE SHEPHARD: Onto another story. Last Thursday, The Current looked at B.C.'s plans to address the troubling number of Aboriginal students leaving high school with Evergreen Certificates: a certification originally intended for children with special needs, and one that is not considered a proper diploma. The vice-president of the British Columbia Teachers Federation, Glen Hansman, says it means Indigenous youth are being shut out of post-secondary education and the job market.

SOUNDCLIP

GLEN HANSMAN: For whatever reason it was thought, oh these kids won’t make it all the way, or you know this is their best chance to have a piece of paper in their hands before we send them off. But it isn't going to be helpful for getting into any post-secondary institutions and most employers aren’t going to recognize it anyway. If the choice was made in grade nine or grade ten or even grade eleven to go, you know what, we're not going to keep sort of leaning on you and trying to steer you towards a full Dogwood, we're going to put you on this other pathway instead. Then a whole other series of events occurs and that sort of decision making should not be going on anymore.

AMT: Last fall, B.C.'s Auditor General slammed the practice calling it, "racism of low expectations." B.C.'s Education Ministry will now restrict Evergreen Certificates to students with special needs only.

MICHELLE SHEPHARD: There was a lot of mail on this story. Isabelle VinnI works in a literacy centre on Vancouver Island. She regularly meets young adults who have Evergreen Certificates. She writes: “Our challenge now is to find a way to motivate them enough to study more because there is nothing they can do with their diploma. But they have been told so often that they won't succeed that they have no idea what to do with their lives.”

AMT: Jo-Anne Berezanski is from the Carrier First Nation. She writes from Vancouver: “We talk about how important education is but in reality it is not what we show youth in our community. Most of our local leaders and staff have little education. Our children see this up close and personal and this impacts expectation outside the community.”

MICHELLE SHEPHARD: Don McGregor is a teacher, and he weighed in from Courtenay B.C: “The attitude is that Indigenous students are not as capable as the other students and the end result is labeling them as such. These students are not below par. If they are not learning the way we teach, perhaps we should be teaching the way they learn. These certificates have to go the way of the Dodo bird. They are an excuse to marginalize the Indigenous population.”

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No obligation to work with for-profit plasma clinics, says Canadian Blood Services

Guests: Dr. Graham Sher

AMT: Onto another update. Earlier this month, The Current heard about the controversy over a company that says it can help alleviate Canada's shortage of plasma. Last week, Canadian Plasma Resources officially opened Canada's first for-profit plasma clinic in Saskatoon. Donors will receive a $25 gift card for each donation. The plasma will be sent to a pharmaceutical plant in the U.S., where it will be used to make plasma-based medical products. Critics say paying for plasma could threaten the safety of Canada's blood supply. Canadian Blood Services manages the country's blood supply. Dr. Graham Sher is its chief executive. He joins us from Ottawa. Hello.

DR. GRAHAM SHER: Good morning, Anna Maria.

AMT: Will Canadian Blood Services be working with the new for-profit clinic in Saskatchewan?

DR. GRAHAM SHER: We have no commitment to work with Canadian Plasma Resources at the moment, and no obligation to do so, either. We always enter into contracts with any provider of products or services through an open-ended process, and we have to determine where the products and services we would acquire from any provider will meet our needs. At the moment, Canadian Plasma Resources has nothing in the market to offer. They've just opened, as you mentioned in your introduction, and so there is no plasma to be acquired. So no, at the moment, we have no working relationship with them.

AMT: And just to clarify, would you be open to using plasma collected at that clinic, if it works with one of your manufacturing partners in the U.S.?

DR. GRAHAM SHER: As we would be open to using plasma or plasma products from any qualified and licensed manufacturer around the world. And as your listeners probably know from your story last week, in Canada, we collect a significant amount of plasma to make these specialized drugs, but not enough to meet the needs in the country. And so we acquire the products from a number of commercial manufacturers around the world, but all of them have to meet regulatory standards; both of Health Canada, the regulator in this country, and the Food and Drug Administration, the regulator in the United States; and they have to meet all our procurement requirements, as well.

AMT: I want to ask about, just about the supply, then, because Canadian Plasma Resources says its Saskatoon clinic will help alleviate plasma shortages that we are currently facing in Canada. What do you think?

DR. GRAHAM SHER: So one needs to look at some numbers here. In Canada today, Canadian Blood Services collects and sends for this process called fractionation, this manufacturing process, just over 200,000 liters of plasma. That gives us about one quarter, about 25 percent, of the drugs that we need for patients in this country. The remaining 75 percent we purchase on the commercial market. Canadian Blood Services is actually in the midst of developing our own strategies to increase the amount of plasma that we collect in this country, and then can send to some of these fractionators with whom we already do business, to produce more of the drugs derived from Canadian donors.

AMT: Okay, and just so that I can clarify, the blood that is, that goes right for transfusions, though, is Canada self-sufficient on that front?

DR. GRAHAM SHER: Yes, absolutely, and that's an important point. Canada has always been, and Canadian Blood Services has always been self-sufficient in blood and in plasma and in platelets that are used for transfusion purposes. What we're talking about here is the plasma used to manufacture the specialized drugs, particularly drugs to treat immune disorders, and for burn victims, and what have you.

AMT: So if 75 percent you purchase on the commercial market, where does it come from?

DR. GRAHAM SHER: So we purchase from a number of companies around the world. As I say, they have to be licensed by Health Canada and by the Food and Drug Administration. The important point is that the plasma that goes into the manufacture of these drugs, from the companies from which we buy, is almost exclusively collected in the United States, from a very large commercial plasma operation that exists in the United States. In fact, by far and away, the largest in the world.

AMT: They have 500 for-profit clinics to collect.

DR. GRAHAM SHER: They have something in the order of 500 clinics for plasma collection, and collecting in excess of 40 million liters of plasma a year. The United States is by far and away the largest plasma collector in the world.

AMT: Are you at all concerned about their screening and safety procedures?

DR. GRAHAM SHER: No, and I think this is an important point. There's been a tremendous amount of media coverage around the safety issue, and we need to distinguish where we are in 2016 from where the industry was in 1976 and 1986. There were indeed many safety concerns three and four decades ago, but the industry has changed dramatically. And all of these plasma collectors have to go through very, very rigorous regulatory approval processes. They have multiple screening processes in place to ensure that the donors are legitimate donors. They have to be, have residency, they have to have to have a valid government ID. The plasma that is collected from donors is not used the first time it's collected, it's put into quarantine until the second donation. And then, it goes through a long list of screening tests and production processes that renders the finished product extremely safe. And there is no evidence in the last 25 or 30 years, absolutely no evidence whatsoever, that drugs made from paid owners are any less safe than those made from non-remunerated or unpaid plasma donors.

AMT: Okay, and I hear what you're saying. I do have some tape that I want you to hear that raises a few questions that I'm sure you can speak to. We sent a radio freelancer, Ellen Berkovitch, to talk to clients outside a for-profit plasma clinic in Albuquerque, New Mexico. Listen to some of what she found.

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ELLEN BERKOVITCH: So I'm standing in front of CSL Plasma, which shares a rundown strip mall with just one other tenant: an indoor flea market. Across the street is overflow parking and a storefront advertising payday loans. The neighborhood just to the east is Albuquerque's war zone; so-called because it's one of the lowest income areas of the city, and plagued by gang violence. New Mexico's unemployment rate in November was highest in the nation.

MORTICIA: I’m Morticia.

ELLEN BERKOVITCH: Morticia, can you tell me a little bit about giving plasma, what's the process like, what happens?

MORTICIA: I just go inside, and you do a kiosk screening. And then you wait in line to get screened, which they take your pressure, and your hydration and your protein level. And if you pass, then you go to the back of the building, where they stick you with a needle and you start plasing.

ELLEN BERKOVITCH: And how often do you plas?

MORTICIA: Twice a week.

ELLEN BERKOVITCH: How much to get paid for that?

MORTICIA: First one is 20, and the second one, it depends on how much you weigh.

ELLEN BERKOVITCH: And are you employed?

MORTICIA: No, I’m not.

ELLEN BERKOVITCH: So this helps.

MORTICIA: Yes, I mean, it’s easy money.

JOSHUA: My name is Joshua.

ELLEN BERKOVITCH: Can you tell me the name of the place you work?

JOSHUA: CSL Plasma.

ELLEN BERKOVITCH: What do you do?

JOSHUA: I actually prep the donors to go back and donate plasma.

ELLEN BERKOVITCH: How much do you know, when they tell you that they haven't had tats in the last year, they haven't had piercings, or they don't have HIV or hepatitis, how much do you know about them?

JOSHUA: Honestly, we don't know too much. We just make, you know, base it off judgments and what we see.

ELLEN BERKOVITCH: You work here, and you’re a donor, too.

JOSHUA: As an employee, you get $50 dollar donations, plus a bonus, whatever the bonus is that week.

ELLEN BERKOVITCH: Are you concerned at all that some of the people had a history of falling prey to addiction?

JOSHUA: I mean, everyone has a past, so I wouldn't count that against them.

ELLEN BERKOVITCH: After the plasma is donated, it’s tested for HIV and for other diseases?

JOSHUA: Correct.

ELLEN BERKOVITCH: Right here on premises?

JOSHUA: Yes, we do have a processing lab.

ELLEN BERKOVITCH: Albuquerque has four private plasma clinics: one’s a block from the homeless shelter, and others in the university district. They can easily be gotten to on foot or by bus.

AMT: Okay, that is radio freelancer Ellen Berkovitch, outside the CSL Plasma clinic in Albuquerque, New Mexico. Dr. Graham Sher, could plasma collected from that clinic be in Canadian blood products?

DR. GRAHAM SHER: Yes, it may be. Because as I say, the products that we purchase come from these manufacturers in the United States. But I think there's a couple of important points, Anna Maria, based on that clip that I just listened to. Firstly, obviously, I can’t comment on the specifics, I haven't been to that facility myself. But the industry has a belts and suspenders approach to safety. So when the employee Joshua says that it's making it off judgments on the donor’s health, I find that a little difficult to understand, because there are rigorous screening processes that every donor has to go through. And it's not, the safety profile doesn't just rely on the donors answer, whether they have HIV or not, whether they've had a recent tattoo. There are multiple screening and testing interventions that happen after the plasma is collected from a qualified donor. And again, one’s got to look at the evidence. There is no transmission of HIV, hepatitis B, or hepatitis C from any of these drugs, from any of these plasma industries, in the last three or four decades. Admittedly very different from what happened in the ‘70s and the ‘80s.

AMT: No, fair enough. You know that on this program, I spoke to Mike McCarthy, a hemophiliac who was infected with hepatitis C from tainted blood back from those days. He argues that you can't test for what you don't know. So how do you control potential mutations when you are receiving blood from people who are marginalized?

DR. GRAHAM SHER: Yes, that's a good question. And Mr. McCarthy represents a view of some patient groups. There are many other patient groups, including the National Hemophilia Society, as well as the Canadian Organization for Rare Disorders, who are strongly supportive of the paid plasma industry.

AMT: [interposing]That’s right, fair enough, yes.

DR. GRAHAM SHER: And the reason you can, to respond to your specific question, the industry, both the blood industry, Canadian Blood Services as an example, and the plasma industry, doesn't rely exclusively on testing, because you cannot test for what you don't know, as Mr. McCarthy says. But there are at least two or three steps built into the plasma fractionation process that are known as inactivation steps, where in fact, the plasma is rendered through a process that kills any living organism, any virus, any bacterium, any pathogen. So you are relying on this belts and suspenders approach. Your screening of the donor, you’re testing for the things you can know about, and then this process of purification and inactivation that absolutely deals both with the things you know about and the agents that you may not be able to test for, but are rendered inactive because of the process of killing any living organism. And that's the important belts and suspenders approach that the industry has put in place over the last several decades.

AMT: Okay, Dr. Graham Sher, thank you for your time today.

DR. GRAHAM SHER: You're very welcome, thank you for the opportunity.

AMT: That is Dr. Graham Sher, he is the chief executive of Canadian Blood Services, and he joined us from Ottawa.

MICHELLE SHEPHARD: And finally, on Tuesday we examined whether the days of the local newsrooms are coming to an end.

SOUNDCLIP

People will hang on to their subscription for a very long time before they really break faith with it. If you picked up a 1980s newspaper with, say on the weekend there are three insight sections and all local content, and now the insight section is four pages on a Saturday, you would say this is not what I used to have. But they will say I still want it. I want the crosswords, I want the horoscope, I want to read something and it's my local paper.

AMT: That’s the former Editor in Chief of the Edmonton Journal, Margo Goodhand. The Journal was hit by Postmedia lay-offs, as the debt-ridden company tries to manage its assets.

MICHELLE SHEPHARD: And this discussion brought in lots of mail. Desirae Morgan writes from Nanaimo, BC: “It’s one of my favorite things when passing through different towns to read the local papers. No matter how big or small, it says a lot about its citizens and how and what they perceive as important. Last month my local paper printed its last issue after over 100 years of publication. I'm now out of luck.” And she adds this in caps: “LONG LIVE THE LOCAL NEWSPAPER!”

AMT: Okay, and you are with the Toronto Star, so yes, long live the local newspaper!

MICHELLE SHEPHARD: [laughs] Here, here, Desirae!

AMT: [laughs] Nancy Deni from Sudbury, Ontario agrees: “I am already in mourning for the world of newsprint. Saturday mornings can never be the same without the weekend paper. The news, the crossword puzzle, the comics, my coffee getting cold as I pore over every page. It will never be the same reading the news on a device. It will be a sad, sad day for me when they stop printing newspapers altogether.”

MICHELLE SHEPHARD: But here’s Brian Baxter from Appin, Ontario, and he doesn't see it that way: “To be honest,” he writes, “most people I know who have stopped getting the paper, have done it because of late and/or unreliable delivery. The papers have less content and cost more. Most people are reluctant to pay the price. And then there is the internet. So many people only read a couple sections, sports, business, entertainment. They can go on the Internet and cherry pick for free. I don't think there is a way to fix this.”

[Music: Sting]

AMT: Time to give credit where credit is due. The Current is produced by: Idella Sturino, Howard Goldenthal, Ines Colabrese, Lara O'Brien, Julian Uzielli, Sarah Grant, Pacinthe Mattar, Sujata Berry, Liz Hoath, Marc Appollonio, Catherine Kalbfleisch, Willow Smith, Karen Chen, Rana Sowdaey and Karin Marley.

MICHELLE SHEPHARD: The Current's writer this week is Shannon Higgins. Our web producer is Lisa Ayuso. Our technicians are Carole Ito and Jennifer Rowley. Our senior documentary editor is Joan Webber. Our senior producers are John Chipman in Toronto and Cathy Simon in Vancouver. The acting executive producer of The Current is Richard Goddard.

AMT: As always, we want to hear from you. Let us know what you think about the show by tweeting us @TheCurrentCBC. Find us on Facebook and comment on our daily posts, or email us by clicking on the contact link at cbc.ca/TheCurrent. Michelle Shephard is the Friday host of The Current this week. And that's our program for today. I’m Anna Maria Tremonti, I’m back Monday, thank you for listening to The Current.

[Music: End theme]

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Feb. 25, 2016 episode transcript

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