When Safety Promotion Impairs Access to Care: Lessons From Endoscopy Across Canada

An informal review of existing conscious sedation policies across Canada shows that, following endoscopic procedures, many sites require that a patient be accompanied home and cared for by a support person. Though well-intended, these policies may act as a barrier to care for vulnerable persons or result in unnecessary hospital admissions. We argue that equity requires more flexibility, creativity and risk tolerance in the application or interpretation of safety-related rules in particular situations. Unexamined common practices can sometimes pull against our responsibility to promote greater equity and access to care. Revisiting these policies and practices could reduce inequities in healthcare accessibility.