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D/Q. 0. 06N/ 0/ 0:0 0^0 0<$1 1e`1U>1U*2^ -2w92 1u=2 722 0c2NG34I3]3l3 mn3\\YORK_UNIVERSITY\q_hrts_hp4000tnV,,,,V0(@ Z6Times New Roman RegularX(\$CEUS.,*+ (_2623  ..*G+G (_25   /%` ` hp x /23  ../%` ` hp x /   *8+8 (_24  ," hp x ,23  ..," hp x ,  *5+5 (_23 ` ) hp x )23  ..) hp x ) ` *2+2 (_22  &hhp x &23  ..&hhp x &  */+/ (_21  #p x #23  ..#p x #  *,+, (_20 h  p x 23  .. p x h *)+) (_19  pp x 23  ..pp x   *&+& (_18   x 23  .. x   *AA (_17  5+ ` hp x 523  Ԁ5+ ` hp x 5  *GG (_16   /%` ` hp x /23  Ԁ/%` ` hp x /   *88 (_15  ," hp x ,23  Ԁ," hp x ,  *55 (_14 ` ) hp x )23  Ԁ) hp x ) ` *22 (_13  &hhp x &23  Ԁ&hhp x &  *// (_12  #p x #23  Ԁ#p x #  *,, (_11 h  p x 23  Ԁ p x h *)) (_10  pp x 23  Ԁpp x   (&& &_9   x 23  Ԁ x   (AA &_8  5+ ` hp x 523  5+ ` hp x 5  (GG &_7   /%` ` hp x /23  /%` ` hp x /   (88 &_6  ," hp x ,23  ," hp x ,  (55 &_5 ` ) hp x )23  ) hp x ) ` (22 &_4  &hhp x &23  &hhp x &  (// &_3  #p x #23  #p x #  (,, &_2 h  p x 23   p x h ()) &_1  pp x 23  pp x   &&& $_   x 23   x   0AA.Normal  5+ ` hp x 55+ ` hp x 5  <AA:Definition T  5+ ` hp x 55+ ` hp x 5  <AA:Definition L , 5+ ` hp x 5  5+ ` hp x 586Definition(hh&H1  5+ ` hp x 5      5+ ` hp x 5  (]]&H2  5+ ` hp x 5  5+ ` hp x 5  (]]&H3  5+ ` hp x 5  5+ ` hp x 5  (]]&H4  5+ ` hp x 5 XXX 5+ ` hp x 5  (]]&H5  5+ ` hp x 5  5+ ` hp x 5  (]]&H6  5+ ` hp x 5  5+ ` hp x 5  2DD0Address  5+ ` hp x 55+ ` hp x 5  8MM6Blockquote , , 5+ ` hp x 5   5+ ` hp x 5,*CITE,dl*CODEK8<6X9`(Courier NewKSA\  `&Times New RomanS42Emphasis64Hyperlink    <:FollowedHype    4go2Keyboard K8<6X9`(Courier NewKSA\  `&Times New RomanS <:Preformatted  /%  ,Kk %#/K8<6X9`(Courier NewKSA\  `&Times New RomanS/%  ,Kk %#/  <:zBottom of 75(X7    5+ ` hp x 5?B%2A`Arial?  SA\  `&Times New RomanS76(X75+ ` hp x 5  &  d d4)1dxd'dxd<:zTop of For79(X7    5+ ` hp x 5?B%2A`Arial?  SA\  `&Times New RomanS76(X75+ ` hp x 5  <6X9`(Courier New4)2dxd0KS.SampleK8<6X9`(Courier NewKSA\  `&Times New RomanS0.Strong 8dl6TypewriterK8<6X9`(Courier NewKSA\  `&Times New RomanS42Variable: 8HTML MarkupB      2 0CommentB   35;AGMSY_11.1.1.1.1.1.1.1.\  `&Times New Roman%2A`Arial|/ 3#37=CIQYag1.a.i.(1)(a)(i)1)a)Ei)(;3$2#  0  .3  0  u/+003|xU \!CEUS.,  _ HUMANRIGHTSCOMMITTEE  _Fabrikant_Ԁv.Canada  CommunicationNo970/2001 X 6November2003 , | _CCPR_/C/79/D/970/2001*  P ADMISSIBILITY      Submittedby:ValeryI._Fabrikant_Ԁ(Theauthorisnotrepresentedbycounsel) z  Allegedvictim:Theauthor H Stateparty:Canada f Dateofcommunication:3April2000(initialsubmission) 4 TheHumanRightsCommittee,establishedunderarticle28oftheInternationalCovenantonCivil  andPoliticalRights,  Meetingon6November2003 X Adoptsthefollowing: *z   Decisiononadmissibility   5 1.Theauthorofthecommunicationis_Mr.Valery_ԀI._Fabrikant_,aCanadiannational,whohasbeen #" servingalifesentencesince1993forfourcountsofmurder,atthe_Archambault_Ԁfederalpenitentiary $# inSainte-Anne-des-Plaines,Quebec.HeclaimstobeavictimofaviolationbyCanadaofarticles s% $ 6,7and10oftheInternationalCovenantonCivilandPoliticalRights.Heisnotrepresentedby \&!% counsel. E'"& Factsaspresentedbytheauthor )g$( 2.1InMay1998,theauthorsufferedaheartattack._Angiography_Ԁshowedthatfourofhisarteries *9&* wereblocked-twoalmosttotally-andallegedlyindicatedtheneedforintervention.Accordingto +"'+ theauthor,thereisnoavailabletreatmentinQuebec,butthereisinBritishColumbia1.Healleges , (, thathehasbeenincontactwithadoctortherewhoiswillingtoperformtheoperationbutthatthe -(- prisonauthoritiesrefusetotransferhim.Helodgedaseriesofinternalcomplaintswhichhesays  havebeenignored.  2.2On23August1999,theauthorfiledamotioninFederalCourtseekingamandatoryinjunction k forthedeliveryofurgentmedicalcare.On14September1999,theapplicationwasdismissed.On T 1November1999,theauthorclaimsthatallhislawsuitsinFederalCourt(unspecified)werestayed. =  TheauthorappealedtheSeptemberdecisiontotheFederalCourtofAppeal,butdiscontinuedhis & v proceedingson14February2000.  _ 2.3On23February2000,inthelightofallegedlydeterioratinghealth,theauthorappliedtothe  1  QuebecSuperiorCourtforurgentreliefinvokingtheCanadianCharterofFundamentalRightsand    Freedoms.On29February2000,themotionwasdismissedonthegroundsofresjudicata.On16   June2000,theCourtofAppealdismissedtheauthor'sappeal,onthegroundsthattheSuperiorCourt   hadnojurisdiction.On23November2000,theSupremeCourtdeniedtheauthor'sapplicationfor   leavetoappeal. n  Thecomplaint @ 3.1TheauthorclaimsthatthefailureoftheStatepartytoprovidehimwithnecessaryandavailable b medicaltreatmentthreatenshisrighttolifeunderarticle6;hefurthercontendsthatthis K communicationalsoraisesissuesunderarticles7and10oftheCovenant. 4 Stateparty'ssubmissionontheadmissibilityandmeritsofthecommunication  4.1ByNote_Verbale_,of29November2001,theStatepartyprovideditssubmissiononthe  admissibilityandmeritsofthecommunication.Itsubmitsthatthecommunicationisinadmissible q forlackofsubstantiationandincompatibilitywiththeprovisionsoftheCovenant. Z 4.2Onthefacts,theStatepartysubmitsthatin1991,beforehisincarceration,theauthorhadaheart ,| attack,andaprocedureknownasangioplastywasthenperformedonhim.InMay1998,theauthor e suffereda"myocardialinfarction".Hewastreatedbyacardiologistwhorecommendedthatthe N authorundergobypasssurgery.Theauthorrefusedtoundergothisoperationandinsistedonhaving  7 angioplasty.From15May1998uptothedateofsubmission,theauthorwasevaluatedbyatleast !   twelveCanadianheartspecialistswhoallconcludedthatangioplastywasnotappropriateinhiscase " ! andthatheshouldbetreatedeitherbybypasssurgeryorbymedication.Despitethisoverwhelming #" consensusofopinions,theauthordidnotagreewiththespecialistsandinsistedonreceiving $# angioplasty.Heiscurrentlybeingtreatedwithmedication.TheStatepartysubmitsthatithasdone t% $ everythingpossibletoprovidehimwithallnecessaryandappropriatemedicalcare. ]&!% 4.3TheStatepartysubmitsthattheauthorhaspursuednumerouscasesagainsttheCorrectional /(#' ServiceofCanada(CSC)throughtheCanadianlegalsystem,andagainstitsemployees, )h$( sub-contractingphysiciansandphysicianswhohavetreatedhim,seekinganorderfromanycourt *Q%) orphysicians'disciplinarycommitteetotransportortransferhimtoBritishColumbiawherehe *:&* couldallegedlyreceivetheangioplastythathedemands,orsanctioningthemfornotdoingso.In +#'+ 2001(datenotprovided),inAttorneyGeneralofCanadav._Fabrikant_,theAttorneyGeneral , (, requestedtheQuebecSuperiorCourttoissueaninjunctionprohibitingtheauthorfromfilingany -(- furthercomplaintstotheapplicabledisciplinarybodiesagainstanynurses,doctorsorlawyers  dealingwithhim.AsofthedateoftheStateparty'sresponse,nodecisionhasyetbeenrenderedby  theCourt.  4.4Onadmissibility,theStatepartysubmitsthatnospecificviolationsoftheCovenanthavebeen T identifiedbytheauthor.Inhisletterof3April2000,herequeststheCommittee's"help"inreceiving =  angioplasty.Heclaimsthatbybeingdeniedthisparticulartreatment,heiseffectivelybeingplaced & v on"deathrow."Asevidenceinsupportofhisrequestfor"help",theauthorsubmitsthelettersof  _ threeAmericandoctorswhoaffirmed,withouthavingexaminedhim,thatitwouldbepossibleto  H performangioplastyonhim.Itsubmitsthathefailedtorefertotheopinionsofmorethan12  1  Canadianspecialistswhoadvisedhimthathewasnotagoodcandidateforangioplastyandthathe    wouldbenefitmorefrommedicationorbypasssurgery.Moreover,hefailedtoaddresstheopinions   ofthecourtsthatdismissedthesamedemandforhelpinreceivingangioplasty,andoftheprovincial   medicaldisciplinarybodythatdeterminedthatthemedicalcareandadvicehehasreceivedwas   providedinaccordancewiththehighestprofessionalstandards. n  4.5TheStatepartysubmitsthatinessence,theauthorisrequestingtheCommitteetodeterminethe @ factualmedicalissuewhetherheshouldreceiveangioplastyasopposedtoothermedicaltreatment. )y TheCommitteeisbeingrequestedtochoosebetweentheconflictingmedicalopinionsofnumerous b expertphysicians,andisbeingaskedtosidewiththephysicianswhoseopinionsareconsistentwith K theauthor'spreferredtreatment. 4 4.6Inaddition,theStatepartysubmitsthattheauthorhasnotassertedanyconnectionbetweenhis  demandforangioplastyandanypotentialviolationoftheCovenant.Therehasbeennodenialof  medicaltreatmentandinfacttheauthorhasrepeatedlyrefusedthetreatmentrecommendedtohim.  NoCovenantprovisioncouldbeinterpretedasguaranteeingtheauthorthemedicaltreatmentofhis q choice.TheStatepartysubmitsthattheauthor'scomplainthasnotbeensufficientlysubstantiated Z andthatthereforethecommunicationshoulddeclaredtobeinadmissibleasnotconstitutinga C "claim"withinthemeaningofarticles1and2oftheOptionalProtocol. ,| 4.7TheStatepartyalsoarguesthattheauthor'sclaimsareincompatible_ratione_Ԁ_materiae_Ԁwiththe N provisionsoftheCovenant,underarticle3oftheOptionalProtocol.Itsubmitsthattherequestof  7 aprisonertoreceivemedicaltreatmentofhischoice,inparticularagainstoverwhelmingmedical !   adviceagainstthattreatment,isnota"right"thatis"setforth"intheCovenant. " ! 4.8Onthemerits,theStatepartysubmitsthat,althoughtheauthorhasnotspecifiedwhichCovenant $# rightsheisallegestohavebeenviolated,itpresumeshisclaimwouldbeassessedasanalleged t% $ violationofarticles7and/or10oftheCovenant.TheStatepartyarguesthatnoneofthedoctors ]&!% consultedinCanadaispreparedtorecommendorcarryoutangioplastyontheauthor,forthevery F'"& reasonthatitisnotintheauthor'sinterests.Inthecircumstances,theStatepartysubmitsthatthis /(#' isnotacaseofdenialofmedicaltreatment;butrather,theStatepartyactingintheauthor'sbest )h$( interestandprovidinghimwiththetreatmentrecommendedbynumerousheartspecialists. *Q%) 4.9TheStatepartysubmitsthattheauthorreliesonthestatementsofthreeAmericansurgeonswho +#'+ claimedthatitwaspossibletoperformangioplastyonhim,insupportofhisviewthatangioplasty , (, ishisbestoption.Thesesurgeonsbasedtheiropinionsonamerecopyofhis_angiogram_,anddidnot -(- havetheopportunitytoexaminehim.TheauthorisconvincedthataCanadianphysician,Dr.Hilton  fromBritishColumbia,iswillingtoperformangioplastyonhim.Intheauthor'sperception,theonly  obstacletohisreceivingangioplastyistheunwillingnessoftheCSCtotransferhimfromQuebec  toBritishColumbiatoreceivethetreatment.TheStatepartysubmitsthatareviewofthe k correspondenceindicatesthatDr.Hiltonrecommendssurgeryandnotangioplastybutthatheis T willingtoevaluatetheauthorinhisclinictodetermineoptionsforthebesttreatmentfortheauthor. =  IntheStateparty'sview,Dr.Hiltondoesnotconsiderangioplastytobeintheauthor'sbestinterests. & v Norhasheagreedtoperformangioplastyontheauthor.  _ 4.10TheStatepartysubmitsthattheauthorhasrepeatedlyappliedforatransfertoWilliamsHead  1  Penitentiary,thenearestfederalpenitentiarytoVictoria,BritishColumbia.On25October1999,the    receivinginstitutionrefusedhisrequestbecauseof:(a)theauthor'srefusaloftreatmentatMontreal's   HeartInstitute(whichisoneoftheforemostmedicalfacilitiesinCanadaandtheworld)without   adequateexplanation;(b)thefactthatDr.Hiltonhadrepeatedlyadvisedagainstthetreatmentand   consideredthatitwouldnotbesuccessfulinthelongrun;and_(c_)thedistancebetweenWilliams n  HeadPenitentiaryandthenearesthospital;andthephysicalstressoftheproposedtransfer.A W  subsequentrequestforavoluntarytransferandescortedtemporaryabsenceformedicalreasonswas @ deniedon23May2000,primarilybecausetherewasnochangefromthepreviousapplication. )y 4.11TheStatepartyreferstothefindingsofthemedicaldisciplinaryboard,afteranactionbrought K bytheauthoragainsthisphysician,whichfoundnofaultwiththetreatmentprovidedtotheauthor 4 andalsoreferstotheevidenceofanexpertcardiologistwhoopinedthattheauthorhadconsistently  receivedmedicalcareandadviceofthehighestprofessionalstandards.  4.12Finally,theStatepartyarguesthatthefactthattheauthordoesnotagreewiththespecialists'  opinionsdoesnotconstituteinhumantreatmentorlackofrespectfortheauthor'sinherentdignity q whichcouldbesubsumedunderarticles7or10,paragraph1,oftheCovenant. Z Author'scomments ,| 5.1On2August2002,theauthorprovidedhiscommentsontheStateparty'ssubmission.He N submitsthathedidnotspecifywhicharticlesoftheCovenanthewasallegingwasviolatedashe  7 thoughtthatthiswouldbeobvious,namelyaviolationofarticle6oftheCovenantduetoadenial !   ofmedicalcarewhichthreatenedhislife,andviolationsofarticles7and10.Heexplainsthathe " ! refusedbypasssurgeryasthosewhorecommendeditwerenotsurgeonsthemselvesandhehad #" receivedtheopinionoftwoheartsurgeonsinQuebecwhodidnotrecommendit.Heaccusesboth $# thejudiciaryandthe"professionalorders"inCanadaofcorruption. t% $ 5.2TheauthorexplainsthatheisnotaskingtheCommitteetopassamedicaljudgmentonwhich F'"& treatmentisappropriateforhimbutarguesthat,assuminghehasadoctortoperformaprocedure /(#' andhasthemoneytopayforithimself,heshouldhavethesamerightsasordinarycitizenstosuch )h$( medicaltreatmentasheconsidersmostappropriate.Fortheauthor,thepossibilitythattheprocedure *Q%) mightbetooriskytoperformisamatterforthepatientandthedoctorreadytoperformittodecide. *:&* 5.3Inaddition,theauthorprovidesanupdateonhissituation,statingthaton12December2001, , (, hewastransferredtoBritishColumbiatoreceiveangioplastywhichwasperformedon7January -(- 2002.Angioplastywasalsoperformedon19July2002.Heclaimsthatthefactthatthisprocedure  waseventuallyperformedprovesthathiscomplaintagainstCanadaisvalid.Headdsthathewould  bepreparedtowithdrawhiscomplaintiftheStatepartycanfindadoctortoopentheremaining  threeblockedarteries(apparently,angioplastyonlymanagedtoopenoneartery)orgranthimaccess k tosuchadoctorifheshouldfindone,andifitacceptsthatprisonersthemselvesandnotprison T doctorsshouldbepermittedtodecidewhichmedicalproceduretheyundergo. =  Stateparty'sfirstsupplementarysubmissionandtheauthor'scommentsthereon  _ 6.1On19March2002,theStatepartyconfirmsthatpursuanttotheadviceofanotherspecialist,  1  angioplastywasperformedontheauthoron7January2002.Thisspecialisthadstatedthat"Itwould    bepertinenttorepeatthecoronary_angiography_Ԁinhis[theauthor's]caseinordertoobtainanswers   tothepatient'squestionsaswellasthoseoftheattendingphysicians.Althoughconservativemedical   treatmentisoftenefficaciousincontrollinganginapectoris,itdoesn'tappearadequatefor   controllingthe_ischemia_Ԁinthiscase,sothatthepossibilityofthepatientbeingatriskofdeathis n  real."Heconcluded"Irecommendacoronary_angiography_Ԁwithdilation,ifindicated,onanelective, W  intermediate-termbasis(thatis,withinafewweeks)."Furthertothisrecommendation,theauthor @ wastransferredtoBritishColumbia.Followingthetreatment,on14January2002,Dr.Hilton,the )y surgeonwhoperformedtheoperationwrote,"88.Ibelieveheisnowsafe."On22January2002, b theauthor'sreturntoQuebecwasapproved. K 6.2TheStatepartysubmitsthatastheauthorhasnowreceivedthetreatmentthathadformedthe  basisofhiscommunicationanyallegedinconsistencywiththeCovenanthasbeencorrectedandthe  authorcannotclaimtobeavictimofanyviolationofhisrightsundertheCovenant.Theissues  raised,therefore,aremootandthecommunicationshouldbedeclaredinadmissibleunderarticles  1and2oftheOptionalProtocol.Inthealternative,theStatepartysubmitsthatifthecommunication q isheldtobeadmissible,ithasprovidedaneffectiveremedytoanyoftheallegedviolationsofthe Z Covenant. C 6.3Inhisresponseof13May2002,theauthordeniesthathisclaimismootandcontendsthat e accordingtothedoctorwhoperformedtheangioplastyitwouldhavebeenmoresuccessfulifthe N procedurehadbeencarriedoutthreeyearsearlier.  7 Stateparty'ssecondsupplementarysubmissionandtheauthor'scommentsthereon " ! 7.Inafurthersubmissionof15October2002,theStatepartyrespondstotheauthor'srequestto $# haveadditionalangioplastytoopentheremaining3blockedarteriesandhisrequestthatprisoners, t% $ andnotprisondoctors,shouldbeallowedtodecidewhichmedicalproceduretheprisonerwill ]&!% undergo.Onthelatterissue,theStatepartysubmitsthatCommissioner'sDirectiveNo.803entitles F'"& prisonerstorefuseconsenttorecommendedtreatment,butdoesnotentitleprisonerstothemedical /(#' treatmentoftheirchoice,particularlywhentheirchoiceisagainsttheadviceofthephysicians )h$( responsiblefortheircare.Itreiteratesthatthedemandofaprisonertoreceivethemedicaltreatment *Q%) ofhischoiceisnotarightsetforthintheCovenantandaccordinglythisdemandisincompatible *:&* withtheCovenant.Ontheformerissue,itsubmitsthaton19July2002,theauthordidreceivea +#'+ furtherangioplastyanda_coronography_.Inthecircumstances,theStatepartysubmitsthatthe , (, communicationisinadmissiblepursuanttoarticles1and2oftheOptionalProtocol. -(- Ї8.On24January2003,theauthorreaffirmedthathisclaimisnotmoot,evenifhehashadtwo  angioplastiessinceJanuary20022,asthisproceduredoesnotcurehim-hisheartdiseaseis  progressingandfurtherangioplastieswillbenecessary.Heclaimsthatcurrentlyallcardiologists  atthe_Cit_Ԁdela_Sant_Ԁhospitalarerefusingtoseehimunlessheisbroughttotheemergencysection. k Heclaimsthattheyarepunishinghimforfilingcomplaintsagainsttheprisondoctors.Atthetime T ofwritingheclaimsthatheneedsanotherangioplastywhichwillhavetobeperformedinBritish =  Columbia,buttheprisondoctorsareagaincontinuetorefusetotransferhim.Heclaimshislife & v continuestobeindangerandtheprisonauthoritiesarerefusingtoprovidemedicalcare.  _ IssuesandproceedingsbeforetheCommittee  1  9.1Beforeconsideringanyclaimcontainedinacommunication,theHumanRightsCommittee   must,inaccordancewithrule87ofitsrulesofprocedure,decidewhetherornotitisadmissible   undertheOptionalProtocoltotheCovenant.   9.2Astotherequirementofexhaustionofdomesticremedies,theCommitteenotesthattheState W  partyhasnotchallengedtheadmissibilityonthisground. @ 9.3TheCommitteenotestheauthor'sclaimthatheisbeingdeniedmedicaltreatmentinbeing b refusedatransfertoBritishColumbiatoundergosurgeryknownas"angioplasty".Itobservesthat, K theauthorwastransferredtoBritishColumbiaonthreeoccasionsforthepurposesofundergoing 4 angioplasty-afactwhichtheStatepartyclaimsrendersthecommunicationmoot.Inhisfinal  commentstotheCommittee,theauthorclaimsthatheneedsangioplastyagainandthathewill  requiresuchtreatmentregularlyinthefuture.Withoutconsideringtheissueofwhetheradetainee  hasarighttochooseorrefuseaparticularmedicaltreatment,theCommitteeobservesthatatany  ratetheStatepartyremainsresponsibleforthelifeandwell-beingofitsdetainees,andthatonat q leastthreepreviousoccasionstheStatepartydidtransfertheauthortoBritishColumbiatoundergo Z therequestedprocedure.Inaddition,theCommitteenotesthatinsufficientinformationhasbeen C providedtosuggestthattheauthoritieshaveeverfailedtodeterminethemostappropriatetreatment ,| inaccordancewithprofessionalmedicalstandards.Thus,onthebasisoftheinformationprovided, e theCommitteefindsthattheauthorhasfailedtosubstantiateforpurposesofadmissibilityhis N allegationthattheStatepartyhasviolatedanyarticlesoftheCovenantinhisregard.The  7 communicationisthereforeinadmissibleunderarticle2oftheOptionalProtocol. !   10.TheHumanRightsCommitteethereforedecidesthat: #" (a)Thecommunicationisinadmissibleunderarticle2oftheOptionalProtocol; t% $ (b)ThisdecisionbecommunicatedtotheauthorandtotheStateparty. F'"& ___________________________ )h$( [AdoptedinEnglish,FrenchandSpanish,theEnglishtextbeingtheoriginalversion.Subsequently *:&* tobeissuedalsoinArabic,ChineseandRussianaspartoftheCommittee'sannualreporttothe +#'+ GeneralAssembly.] , (,  -(- *ThefollowingmembersoftheCommitteeparticipatedintheexaminationofthepresent  communication:Mr._Nisuke_ԀAndo,Mr._Prafullachandra_Ԁ_Natwarlal_Ԁ_Bhagwati_,Mr.Alfredo_Castillero_  _Hoyos_,Mr.Franco_Depasquale_,Mr.Maurice_Gll_Ԁ_Ahanhanzo_,Mr.Walter_Klin_,Mr.Ahmed  _Tawfik_Ԁ_Khalil_,Mr._Rajsoomer_Ԁ_Lallah_,Mr.Rafael_Rivas_Ԁ_Posada_,SirNigel_Rodley_,Mr.Martin k _Scheinin_,Mr.IvanShearer,Mr._Hip;lito_Ԁ_Solari_Ԁ_Yrigoyen_ԀandMr.Roman_Wieruszewski_. T PursuanttoRule84,1(a)oftheCommittee'srulesofprocedure,Mr.Maxwell_Yalden_Ԁdidnot & v participateinadoptionofthedecision.  _ Notes    1.Theauthorprovideslettersfromthreesurgeonswhoclaimthatonthebasisofhismedicalchart   theywouldbeabletooperateandaletterfromanotherdoctorwithadifferentopinion.   2.Theauthordoesnotprovidethedates. W  N