Canadian Medical Association

For Indigenous patients, health care involves navigating a system that has broken their trust over and over again. But every provider can make a difference.

“As providers, we must reflect on the role we can play in creating a culturally safe system and then start,” said Canadian Medical Association President Dr. Alika Lafontaine.

In a virtual one-hour discussion about the importance of cultural safety in health care, Indigenous panellists reflected on rebuilding trust with Indigenous patients in a system where they’ve been neglected and harmed.


Author and journalist Tanya Talaga framed the conversation: “As we know, health is a basic human right, but across Canada, First Nations, Inuit and Métis Peoples and communities face unacceptable health disparities due to the legacy of colonialism and systemic racism.

“Improving health outcomes for Indigenous Peoples must start with Indigenous voices leading the way.”

This was the first session in the CMA’s Fireside Chat series, bringing together Indigenous patients, providers and leaders to talk about how we can move forward, together, on reconciliation.

Panellist Denise McCuaig, executive director of healthcare transformation and capacity building at Healthcare Excellence Canada, explained that cultural safety is defined by the person who receives the service, not by the intent of the provider.

“A culturally safe experience is about choice,” she said. “[As Indigenous People], so much of our lives, our choices have been removed. If you think of residential school survivors, they had no choice in the clothes they wore, when or what they would eat, in their expression of faith, or their use of language … and that’s just one example.”

Physicians and other health care providers can create culturally safe environments by confronting their own biases and listening to patient experiences.

While the journey of reconciliation is lifelong, Dr. Lafontaine explained that as “the absence of harm and hostility,” cultural safety can be implemented in health care immediately.  

“Health care providers hold a lot of power, but that is something that is given, not earned. Cultural safety is using that power to help people get what they need. Cultural safety is the act of treating the person across from you as human, respecting their lived experiences, and behaving with the absence of hostility.”

This series is part of the CMA’s commitment to taking tangible action on reconciliation in health care and working in allyship with Indigenous Peoples on Indigenous-led health reform. Join us for upcoming sessions on May 24 and June 12.

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