On Sept. 18, 2024, the Canadian Medical Association (CMA) apologized for its role, and the role of the medical profession, in past and ongoing harms to First Nations, Inuit and Métis Peoples in the health system.
In presenting the apology, CMA President Dr. Joss Reimer spoke of the CMA’s commitment to accountability, and to working with Indigenous Peoples to do better in the spirit of humility and reciprocity.
We have not lived up to the ethical standards the medical profession is expected to uphold to ensure the highest standard of care is provided to patients and trust is fostered in physicians, residents and medical students. We realize we have left Indigenous Peoples out of that high standard of care.
The apology was delivered at a ceremony in Victoria, BC, on the traditional territory of the lək̓ʷəŋiʔnəŋ speaking people of Songhees and Xwsepsum Nations and shared publicly via livestream.
We recognize this apology may reopen wounds and retraumatize First Nations, Inuit and Métis individuals, families and communities who have experienced harms in the health system. For anyone who requires additional support, please use this list of culturally safe resources:
THE INDIAN RESIDENTIAL SCHOOL CRISIS LINE: 1-866-925-4419
The crisis line is available 24 hours a day for anyone experiencing pain or distress as a result of a residential school experience.
HOPE FOR WELLNESS HELPLINE: 1-855-242-3310, OR CHAT ONLINE AT HOPEFORWELLNESS.CA
The Hope for Wellness Helpline offers immediate help to all Indigenous peoples across Canada in the following languages: Ojibway, Cree, Inuktut, English and French. They provide 24/7 culturally grounded assessment, referrals, counselling and support in times of crisis, including suicide intervention.
SUICIDE CRISIS HELPLINE: CALL OR TEXT 9-8-8 (TOLL-FREE)
The Suicide Crisis Helpline provides a safe space to talk, 24 hours a day, every day of the year. This service is available in English and French.
Indigenous learners and physicians who train and work in the Canadian medical system face unique challenges. This experience can be compounded by efforts made by different groups across Canada toward truth and reconciliation, which can be triggering and cause a range of emotions.
Support is available through the CMA’s new wellness and healing resource guide for Indigenous physicians and learners. This guide was developed in collaboration with the Indigenous Physicians Association of Canada.
Putting our words into action
The apology is an important step in the CMA’s reconciliation journey, but it is not the end point. Rather, it is the beginning of a new chapter focused on ongoing learning and action.
Guided by Indigenous Peoples, the CMA has developed a ReconciliACTION plan that outlines how we will advance Indigenous health and wellbeing, inspire the medical profession’s journey to truth and reconciliation, and advance internal reconciliation at the CMA.
Confronting our past
As part of the apology process, and to better understand both the CMA’s role and the role of physicians in harms caused to Indigenous Peoples, the CMA conducted an in-depth review of more than 150 years of archives. Our review — published in the Historical and Ethical Review report — included our Code of Ethics, governance structures and social media content.
The CMA also published a list of selected resources, such as recent articles, reports and discussion papers, related to the harms experienced by Indigenous Peoples living in Canada. These resources are intended to provide additional context and are by no means exhaustive.
A separate review of the content of the Canadian Medical Association Journal is underway, in partnership with the National Collaborating Centre for Indigenous Health. The results of that review will be shared in 2025.
Our ongoing research has uncovered the use of outdated, racist terms, the disrespect and disregard for Indigenous Peoples that are implicit and explicit in systemic racism, and more.
Walking the path of truth and reconciliation together
Our journey of reconciliation is being informed by Indigenous CMA board members, Indigenous staff, the Indigenous Guiding Circle, which includes Indigenous leaders, Elders and Knowledge Keepers, and conversations with national Indigenous organizations. The work of co-creation with First Nations, Inuit and Métis Peoples continues to develop, as we focus on the action part of our reconciliation journey.
The path to an apology
Learn more about our journey of reconciliation and how we’re advancing Indigenous health:
Video transcript
Dr. Alika Lafontaine, CMA president (2022-23)
34 hours.
That’s how long Brian Sinclair waited in the ER for care.
A First Nations man from Winnipeg, Brian died without being assessed or treated.
Brian’s story is one of many.
A tragic reminder that First Nations, Inuit and Métis people continue to face racism, neglect, and abuse in Canada’s health care system.
As part of its path to an apology, the Canadian Medical Association is examining its 150-year history, an honest reflection on medical harms both past and present.
Recognizing truth is essential to support healing, improve Indigenous health and reconcile the ties between health professionals and Indigenous patients.
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Learn more: cma.ca/apology
Watch: theunforgotten.cma.ca
Video transcript
Dr. Alika Lafontaine, CMA president (2022-23)
Devalued and dismissed.
In Canada, that's how Indigenous Peoples can feel with physicians and the health care system when it comes to their own health and well-being.
The Canadian Medical Association believes that health equity for Indigenous communities must start with Indigenous voices leading the way.
In June 2022, the CMA convened an Indigenous Guiding Circle - a group of 16 First Nations, Inuit and Métis Elders, leaders and Knowledge Keepers, including Indigenous CMA representatives like me.
Together, with our diverse perspectives, in a circle with an equal voice, we surfaced key themes to guide the CMA towards meaningful reconciliation in health care.
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Video transcript
Dr. Santanna Hernandez, CMA board member
When I decided to become a doctor, I didn’t know any Indigenous physicians, and rarely did I see myself represented in health care leadership.
So, it was an incredible honour, in 2023, to witness the election of Dr. Alika Lafontaine as president of the Canadian Medical Association, their first-ever Indigenous president.
As an Indigenous medical student, it gave me hope for the future of medicine and for the cultural safety of Indigenous Peoples.
As part of its journey of reconciliation, the CMA is making Indigenous health a priority, and that means creating a new culture in medicine where First Nations, Inuit and Métis physicians and medical learners are represented and supported within the profession.
On committees and in boardrooms, in medical schools, at the patient’s bedside, and beyond.
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Video transcript
Dr. Sarah Williams, CMA strategic advisor, Indigenous health
Health is a basic human right. But across Canada, First Nations, Inuit and Métis face unacceptable health disparities due to the legacy of colonization and ongoing racism. We must do better.
With guidance from our Indigenous Guiding Circle, the Canadian Medical Association co-created an Indigenous health goal to clearly define the work ahead of us. It acknowledges that for real improvements in Indigenous health we need a health system that’s free of racism and discrimination, that upholds Indigenous Peoples’ right to self-determination, respects Indigenous world views and healing practices, and provides equitable access to care that’s culturally safe and trauma informed.
Advancing this goal, in allyship with Indigenous Peoples, is a CMA priority and a critical step toward meaningful reconciliation.
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Learn more: cma.ca/apology
Video transcript
Dr. Alika Lafontaine, CMA president (2022-23)
Many Indigenous Peoples will not seek medical care, even at the risk of life and limb. The health care system has earned that mistrust, at Indian hospitals, through forced medical experimentation, through forced sterilization, and through ongoing racism.
In September, the Canadian Medical Association will make a public apology as the national voice of physicians, for past and present harms to First Nations, Inuit and Métis peoples in Canada.
Dr. Joss Reimer, CMA president
That means taking a hard look at our role, and the role of the medical profession, both through action and inaction. The truth will be uncomfortable for us, as physicians. And it should be. Our apology will be offered in humility in the hope we can build trust, and that in allyship w/ Indigenous Peoples, can advance Indigenous health and achieve a better future.
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Learn more: cma.ca/apology
Video transcript
Recognizing and reflecting on how Indigenous Peoples experience health care is essential for meaningful reconciliation.
By failing to use our position of influence to prevent harm, or report it, the Canadian Medical Association, and the medical profession, have kept Indigenous Peoples from receiving the highest standard of care.
By failing to address systemic racism in health care, we share in the failure to create an accessible and equitable system for all.
The CMA will do better. We will take responsibility for what we could have done, but didn’t.
And together with Indigenous Peoples, we will move forward in a respectful and positive way.
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Learn more: cma.ca/apology.
Frequently asked questions
Why is it important for the CMA to issue a formal apology on behalf of physicians?
The CMA’s 157-year history, and the history of the medical profession, is Canada’s history – including systemic racism, neglect and abuse. As the national voice of Canada’s physicians, it’s important that we deliver this apology. The CMA believes in creating a more accessible, equitable health system, including reconciliation in health care – a formal apology to Indigenous Peoples is a critical step in that work. Truth must come before reconciliation, and part of that truth is acknowledging the medical harms experienced by First Nations, Inuit and Métis Peoples, both past and ongoing.
What has the CMA learned about its role in the harms to Indigenous Peoples?
Our research has uncovered the use of outdated, racist terms, the disrespect and disregard for Indigenous Peoples both implicit and explicit in systemic racism, as well as the devastating impacts of Indian hospitals, forced medical experimentation, forced sterilization and child apprehensions. The apology statement will outline our role in these harms, through actions or inactions, recognize the impact on Indigenous Peoples and underscore our commitment to support Indigenous-led solutions to improve health outcomes. Our findings will be shared in greater detail on Sept. 18.
Are other medical organizations working on an apology?
Many organizations representing physicians are undertaking similar work. The College of Physicians and Surgeons of Manitoba has already issued an apology, and we understand that provincial and territorial medical associations are keen to initiate a similar journey. In addition, physicians are on their own journeys of reconciliation and are looking for guidance on how to rebuild trust and strengthen their relationships with Indigenous patients and communities.
How will the CMA support Indigenous physicians during the apology process and beyond?
The CMA, in partnership with the Indigenous Physicians Association of Canada (IPAC), has developed a Wellness and Healing Resource Guide for Indigenous physicians and learners. This guide contains a variety of resources available from coast to coast to coast that Indigenous physicians and learners can consider accessing if they need help or would like support in maintaining their wellbeing. Additional health and wellness resources for Indigenous physicians and learners can also be accessed on a dedicated space in the Physician Wellness Hub.
The CMA is planning to provide resources for Indigenous Peoples and their families who may be triggered or retraumatized by the apology. There will also be wellness supports available on site for people attending the apology ceremony in person.
How will the CMA keep Indigenous Peoples up to date on the progress of the action plan?
The CMA will track progress against the commitments outlined in our action plan, including regular updates of our Indigenous health initiatives on our website. We will continue to seek knowledge and guidance from Indigenous partners as we implement and update our action plan, including sharing progress made to-date.
How were Indigenous Peoples involved, engaged and consulted in this process?
Our path to an apology has been an Indigenous-informed, inward-looking process. Our work has been informed by Indigenous CMA board members, Indigenous staff, reconciliation advisors, the Indigenous Guiding Circle, which includes Indigenous leaders, Elders and Knowledge Keepers, and conversations with national Indigenous organizations.
Will Indigenous Peoples be centred in the ongoing work needed?
The CMA will continue to centre Indigenous Peoples in its work on Indigenous health. The real work of co-creation with First Nations, Inuit and Métis Peoples continues to develop, as we focus on the action part of our reconciliation journey. As we have worked alongside and included Indigenous Peoples throughout this process, we acknowledge that all Indigenous Peoples have their own perspectives and experiences and will have their own thoughts and feelings about the apology and the actions that will follow.
How can I view the apology ceremony?
A group of invited guests are gathering in person for the apology ceremony on Sept. 18. People interested in viewing the ceremony online can access the CMA’s livestream and a schedule of events at cma.ca/apology. There will be simultaneous interpretation in French. A recording will be available the following day on the CMA YouTube channel.
How is the CMA helping other medical organizations undertake their own journey toward reconciliation?
The CMA is engaging physicians and medical learners, and the organizations that represent and train them, to share our work on reconciliation, inform them of past and ongoing medical harms and underscore the importance of an apology. We are making resources available to them, hosting webinars and sharing our learnings to help inform their respective work.
How can physicians and medical learners get involved in the CMA’s work on reconciliation?
- Learn more about our work at cma.ca/indigenous-health
- Follow our reconciliation journey and access the livestream for the apology ceremony at cma.ca/apology
- Stay tuned for future resources to support physicians’ journeys to reconciliation
Resources
The Unforgotten: A five-part film exploring the health and wellbeing of Indigenous Peoples in Canada
