CMA apology is first step toward healing medical harm to Indigenous people, advocates say

Advocates are optimistic about a historical apology for the harms Indigenous people have experienced in health care — but they say those harms are not “distant parts of history.”

“The harm from racism in the medical profession continues today, including within ourselves, our family members and our community members,” said Dr. Marcia Anderson, vice dean of Indigenous health, social justice and anti-racism at the Rady Faculty of Health Sciences at the University of Manitoba.

Forced and forced sterilization, medical experimentation, and arrests of children are documented parts of the health care system’s harmful effects on Indigenous communities, and recent cases such as those of Brian Sinclair and Joyce Echaquan have kept the issue in sharp focus.

Dr. Alika Lafontaine was the first Indigenous president of the Canadian Medical Association (CMA) and served in this role from 2022 to 2023. He was born and raised in Treaty 4 territory in southern Saskatchewan and is Métis, Oji-Cree and Pacific Islander. ancestry.

After years of internal work — searching through more than 150 years of documents and archives to identify racist and outdated language and practices — he sought to change the way Indigenous health care is delivered.

For him, this starts with the truth.

Lafontaine led the association to an official apology in September, presented by current CMA President Dr. Joss Reimer, for her role in harming Indigenous people in the health care system.

“For the first time, a national medical advocacy group with the gravitas of the CMA is going to say these things happened,” Lafontaine said. Unconditional host Rosanna Deerchild.

“It lowers the threshold of how hard people have to work to be heard.”

The apology acknowledged the harmful effects of certain medical treatments, including sterilization and experimentation, in addition to the Indian hospital system – segregated hospitals, which isolated indigenous patients and caused lasting trauma.

History of forced and forced sterilization

While Anderson — Cree Anishinaabe with family roots in Norway’s House Cree Nation and Peguis First Nation — has heard stories from family members who have experienced harm in the health care system, she has also witnessed it firsthand.

In her first year of medical school, she spent a summer in Nunavut. There, Anderson saw a young Inuk mother who was concerned about infertility.

After reviewing her chart, Anderson realized she had an IUD: a semi-permanent form of birth control.

“She was really surprised. She didn’t know this IUD was in there. It was clear to me at that time that she had not given informed consent,” Anderson said.

Later, she would learn about the history of forced sterilization in Canada, and much more recent Senate investigations and class action lawsuits in Saskatchewan surrounding forced sterilization.

Some of the anti-Indigenous biases at work in healthcare are so deeply ingrained that they seem like perfectly reasonable explanations-Dr. Marcia Anderson

“I remember reading through some of the cases from the class action lawsuit in Saskatchewan where women were described as being told things like, ‘If you don’t do this, your kids will be arrested, or you won’t leave.'” to be able to see your children,” she said.

Anderson continued to see examples of overt racism.

During her third year of medical school, she said an older resident told her, “The best thing for Canada would be if the indigenous population stopped reproducing.”

In her current role as an educator, Anderson continues to raise awareness about racism in healthcare – and how even seemingly benign instances have a harmful cumulative effect.

The importance of naming racism

A focus of the CMA work is changing the way racism is handled in complaints. Whether against doctors or hospitals, a lack of specific language in the association’s standards means that racist interactions can be classified as unprofessional communications.

“What often happens is that something that is clearly racism gets recategorized as communication, or being overwhelmed at work or other things,” Lafontaine said.

“If there is no norm to break, they should try to put a round peg in a square hole.”

LOOK | CMA apologizes for its role in medical harm to indigenous peoples:

Canadian Medical Association apologizes for harm to Indigenous peoples

The Canadian Medical Association held a ceremony in Victoria to publicly apologize for the harm the medical profession has caused to Indigenous peoples, including abuses suffered during the residential school era.

He is calling for changes to the way racism is defined in the CMA Code of Ethics and Professionalism, saying this would have a ripple effect with many tribunals citing the CMA standards.

Anderson also criticizes the way racism is addressed in healthcare, and believes that naming racism is an important step.

She says Indigenous patients are often wrongly labeled as drug addicts, homeless, non-compliant or inappropriate users of the healthcare system.

“Our systems are not well set up to receive these complaints safely, and they often don’t have the expertise to truly evaluate or analyze them,” she said.

“Some of the anti-Indigenous biases at work in health care are so deeply ingrained that they seem like perfectly reasonable explanations.”

Moving forward, starting with the truth

Marion Crowe understands when people say access to health care can be difficult for anyone, but says the experience is different for Indigenous people who have experienced unwanted treatments, a lack of education about trauma-informed care and blatant ignorance.

“This has not happened to the rest of the population and there is something very horrible to recognize, acknowledge and learn from,” said Crowe, a Cree from the Piapot First Nation in Treaty 4 territory in southern Saskatchewan.

Crowe has worked to eradicate racism in health care her entire life – from the mailroom at Health Canada, where she started her career, to her role as CEO of the First Nations Health Managers Association. She is also involved with Rise Above Racism, an awareness campaign started after the death of Joyce Echaquan.

She welcomes the CMA’s apology, but says it came overshadowed by several recent examples of harm suffered by indigenous people.

Last month, a photo of an Indigenous elder lying on the floor of a Thunder Bay hospital circulated on social media.

“I think it is especially important for people like me, who see these experiences first hand, to share them, to amplify them, but also to work together – to ensure this never happens again and that there is zero tolerance for racism,” she said. .

The apology has since become Crowe’s North Star, pointing the way to real change in the system. But she doesn’t know if her father would accept it.

“He is the last living person from horrific experiments that took place at Fort Qu’Appelle Indian Hospital. He sits listening to that apology in a hospital room with half a lung on each side of his body,” Crowe said. “He’s in his sixties.”

There is a documented history of medical experimentation on indigenous children.

Crowe’s father was subjected to tuberculosis treatments, but there is also evidence that nutritional policy was shaped by experiments on nearly a thousand children in residential schools in the 1940s and 1950s.

While the actual impact of the CMA apology remains to be seen, Crowe sees this as a first step. She believes that if the CMA makes changes, other organizations will follow suit.

She says she has hope for the system and great respect for the Indigenous health leaders whose life’s work is to end racism in health care. For her, it’s about putting the system in order for the next seven generations.

Anderson is also optimistic, despite what she’s been through.

“One thing that makes me hopeful is that some pieces of a puzzle are coming together. We’re not just working on one thing and hoping it will make a difference,” she said.

“There are these coordinated actions at the national level, and then also here at the provincial level.”