Brace yourself: there are more than a few hypotheticals in what follows, some connected dots that you can’t really guarantee would connect in real life.
But here goes.
Anne Norris is on trial, charged with murdering Marcel Reardon. That she killed him is not in doubt; she attacked him with a hammer and hit him in the head repeatedly. The question now is whether she was criminally responsible for her actions.
Norris is clearly a troubled woman. The jury in the case has heard a litany of witnesses talk about her years of mental problems, her diagnoses from a number of professionals, her behaviour, both on and off of a variety of medication.
Much of the testimony so far has argued that, when she wasn’t taking her medication, Norris believed she was regularly being attacked while she slept. She believed she was being beaten. She believed she was being sexually assaulted.
She has said she was scared that Reardon was going to attack her, so she attacked him first.
But buried in all of the evidence that’s been presented is a small detail that has been bothering me for much of this week.
It’s up to the jury to decide if Norris was or wasn’t criminally responsible, to balance what she’s said to mental health professionals about her condition with the deliberate nature of her actions, such as her disposing of evidence from the attack in the harbour.
It’s a decision I’m glad I’m not being asked to make.
But buried in all of the evidence that’s been presented is a small detail that has been bothering me for much of this week.
Anne Norris’ condition had been deteriorating.
She wasn’t taking her medication, her father Gary Norris testified, saying that Anne was afraid the pills would make her sleep so deeply that she wouldn’t be able to fend off the nighttime attackers she believed would come.
The Norrises sought other approaches; they looked at off-island treatment.
They also looked at ways to ensure Anne Norris kept receiving her medication.
One option was a once-a-month injection of the medication Abilify Maintena, instead of anti-psychotic pills. Anne Norris agreed to take the injection, but there was a hitch.
As Dr. Kellie LeDrew, Norris’ psychiatrist, said on the stand, “We addressed with her the importance of taking medications, and discussed her poor choices. We also discussed the possibility of her taking her medication in the form of a long-acting injection. We did apply for coverage but it wasn’t covered under the prescription drug program, and it’s quite expensive.”
Finding an alternative for daily pills is significant: conservative estimates suggest that, in the past, somewhere between 50 and 60 per cent of schizophrenia patients, for example, don’t fully follow guidelines for taking their oral medication. Injections for several conditions, some biweekly, some monthly, get rid of that issue. (But, admittedly, not without introducing some issues of their own — with daily oral medications, patients showing side-effects can be taken off their medication quickly, for example. It takes longer for issues that arise from the injected versions to wane.)
The question of the availability of an injectable treatment didn’t have much traction in the courtroom; there’s no real reason it should have. The court is dealing with what did happen, rather than what didn’t need to happen.
But stop for a moment and think about costs and false economy: yes, injectable name-brand drugs can be ruinously expensive (in the case of Abilify Maintena, apparently $494.96 a shot). But what price is there going to be for court time, lawyers’ fees, and the list goes on — let alone the potential that one cost might be a human life? What about the costs of wherever it is that Norris ends up? Would it not have been better for everyone — and maybe, in the long run, cheaper — for there to have been earlier and more effective treatment?
The province apparently added the drug to the list of medications that the provincial drug program covers (in cases with special approval) in December 2016 — seven months after Reardon’s death.
It might have made a difference — it might not. But it wasn’t even tried.
The jury’s troubling over what happened, how, and why. And that’s as it should be.
They’re never going to have to ask themselves the troubling question: what might have been.
But someone should.
Russell Wangersky’s column appears in 39 SaltWire newspapers and websites in Atlantic Canada. He can be reached at [email protected] — Twitter: @wangersky.
