Alex Wilson from the Opaskwayak Cree Nation is brought to tears during a presentation while attending the Canadian Medical Association's ceremony at the Victoria Conference Centre in B.C., Sept. 18 to formally apologize for harms to Indigenous Peoples.Chad Hipolito/The Globe and Mail
The Canadian Medical Association has publicly apologized for the role of its organization and the profession it represents in contributing to past and continuing harms to Indigenous people in the health care system.
The formal apology was delivered Wednesday afternoon in Victoria to a group of about 200 attendees, including survivors, local and national Indigenous leaders and members of the organization’s Indigenous Guiding Circle, a working group convened two years ago to advance health care allyship with First Nations, Inuit and Métis people.
CMA president Joss Reimer, former chief medical officer for the Winnipeg Regional Health Authority, told the audience that the medical profession had failed to uphold the highest standard of care to Indigenous patients.
“The Canadian Medical Association is deeply sorry for the harms First Nations, Inuit and Métis Peoples have experienced and continue to experience in the Canadian health system,” Dr. Reimer said.
“The racism and discrimination that Indigenous patients and health care providers face is deplorable, and we are deeply ashamed. As the national voice of the medical profession, we are sorry for the actions and inactions of physicians, residents and medical students that have harmed Indigenous Peoples.”
In preparing for the apology, the CMA spent nearly four years reviewing more than 150 years of archives, social-media accounts, parliamentary debates and committee records, turning up evidence of harms that are well known to Indigenous people and historians, but less so to the general public.
At Wednesday’s ceremony, Paula Cashin, a CMA Indigenous board member and Mi’kmaw physician, said the review found that the Indian hospital system “embedded systemic racism and discrimination into the Canadian health system by fostering racial segregations where Indigenous patients received substandard and unsafe care.”
This included medical experimentation on Indigenous children in residential schools, to study the effects of malnourishment and withholding necessary care, and on Indigenous adults, to test experimental tuberculosis vaccines and treatments. Some Indigenous women, men and two-spirit people underwent forced sterilization, with some reports suggesting this happened as recently as 2019, Dr. Cashin said.
She added that the CMA also fell short of ethnical norms and standards by failing to report circumstances preventing doctors from providing Indigenous patients the highest standard of care, and failing to inform itself of the realities faced by Indigenous people in health systems and residential schools despite advocates drawing attention to them.
The organization promised to accompany the apology with sustained action. This includes pledging to act against anti-Indigenous racism in health care, reviewing its code of ethics and professionalism, and working with Indigenous patterns to create and implement a “ReconciliACTION plan” to advance Indigenous well-being.
Alika Lafontaine, who is of Métis, Oji-Cree and Pacific Islander ancestry and served as the CMA’s first Indigenous president in 2022-2023, told the audience that the apology marks the first page in a new chapter in the organization’s history.
“It’s a chapter that we hope First Nations, Inuit and Métis Peoples can write with us together, as we work toward a health system that provides you with the right care, at the right time, in the right place, in a good way,” said Dr. Lafontaine, an anesthesiologist in Grande Prairie, Alta.
Denise McCuaig, a Métis elder and health care executive, said what she got from the apology was “hope that all of the efforts we’ve had as Indigenous leaders and professionals across Canada, that it is going to make a difference,” she said.
“We’ve reached a point in time in our history where we can be hopeful that things will be different. That commitment to learn, unlearn and relearn is really strong.”
Before the formal apology, Inuk elder Martha Peet lit a seal oil qulliq, a traditional soapstone oil lamp. Métis elder Jimmy Durocher expressed gratitude to the CMA for the apology, saying that truth must always come before reconciliation.
A video told the story of Sonny MacDonald, a Métis elder who, at seven years old, was taken from his community to receive treatment for tuberculous. He remained “incarcerated” at Charles Camsell Indian Hospital in Edmonton for two and a half years, the video told, and he enduring abuse and isolation.
On the floor next to attendees’ chairs were tissue boxes and tear bags – brown paper bags in which people traditionally discard tissues used to wipe away tears, to be burned in a sacred fire.
The CMA’s apology to Indigenous people is the second by a Canadian medical organization in as many years. The College of Physicians and Surgeons of Manitoba apologized in January, 2023, for “failing to adequately address Indigenous-specific racism by medical practitioners,” and for the “intergenerational trauma, suffering, poor health outcomes, and death that this has caused.”
Several reports over the years have identified widespread anti-Indigenous racism in Canadian health care systems. In 2020, former judge Mary Ellen Turpel-Lafond released In Plain Sight, which found “widespread systemic racism against Indigenous people” in B.C.’s health care system that resulted in “a range of negative impacts, harm and even death.”
The report found extensive profiling of Indigenous patients based on harmful stereotypes, including that they were often presumed to be intoxicated or were drug-seeking. This resulted in poor quality of care, including disparaging comments by health care workers, the minimization of concerns, rough treatment and medical mistakes, the report says.
University of Manitoba law professor Brenda Gunn, in her undated report, Ignored to Death, highlighted the case of Brian Sinclair, an Indigenous man who in 2008 died of complications from a treatable bladder infection while in the emergency department of Winnipeg’s Health Sciences Centre, where he had been ignored for 34 hours.