On Sept. 18, 2024, the Canadian Medical Association (CMA) will apologize for its role, and the role of the medical profession, in harms to Indigenous Peoples in the health system. We asked a group of Indigenous physicians, who work within that system while trying to care for their communities and themselves, what the apology means to them — and why it matters.
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Dr. Ojistoh Horn
Our people have been telling stories of their interactions with the medical system in Canada with increasing urgency and have been violently gaslit.
The Indigenous woman I stood beside as she went into painful sepsis had been dumped from a cab onto the street outside of the emergency room, left on a cot overnight with no evaluation or care, and was triaged to be seen only at the end of the next busy day. She was terrified, and when she saw me, another Indigenous sister, she burst into tears, and told me the last stories of her life. I listened to her, but it was far too late to help her.
Our people have been telling stories of their interactions with the medical system in Canada with increasing urgency and have been violently gaslit. This apology is the first, vital step in acknowledging the CMA’s role, and the health care system’s complicity, in the genocide of Indigenous people.
The next steps will include supporting Indigenous physicians as they work with our people and the medical system to create a new, holistic way of providing care and a better experience for all. We must support our own specialists — those who understand our plant medicines, our languages and spiritual practices, our doulas and midwives, and who carry out the ceremonies that invigorate our relationship with the land, water, air, with our ancestors, and with the “faces of those yet unborn,” our collective future.
The CMA needs to promote provincial, federal and Indigenous community governance structures to commit to a common goal that supports a better health care system for all. Focusing on the wellbeing of our most vulnerable, including those with special needs, will create the spaces for them to find their gifts, thrive and be healthy.
The Haudenosaunee have an early wampum belt describing how we supported settlers to Turtle Island. If we keep at the center of our minds the wellbeing and care of the most vulnerable people of our population, then together we will assure the wellbeing and care of everyone.
Dr. Horn is Kanienkeha:ka (Mohawk) from Kahnawake, where she lives with her family. She works as a family physician in Akwesasne — where her father is from — which includes territory in southern Ontario and Quebec.
Dr. Ryan Giroux
An apology cannot be taken back.
One of the teachings from my Elders is that once you say or do something, you can’t take it back. When it comes to the history and current realities of First Nation, Inuit and Métis people in Canada, there have been many things that have been said or done that have hurt our people, including discriminatory actions and policies from organizations like the CMA. These things are part of what has happened and the legacy of their impact has reverberated through our communities.
However, another teaching from my Elders is that all of us on this land are Treaty people. What is meant by that is that we all have a responsibility to care for each other and contribute to healthy reconciliation. To do this, apologies and accompanying action are key in renewing the relationship between Indigenous and non-Indigenous peoples. As the national organization for physicians in Canada, a CMA apology recognizes its role in the harms done to our people, and guides institutional and personal actions to move forward with reconciliation. And much like the discriminatory actions and policies, an apology cannot be taken back.
Dr. Giroux is a member of the Métis Nation of Alberta, with his paternal roots in Fort Chipweyan and mixed European heritage on his mother’s side. He is a general pediatrician in Toronto.
Dr. Alexa Lesperance
We cannot expect that patients will feel safe receiving care if the people being trained to provide that care are experiencing racism and harm.
Apologies are an important first step of recognizing harm. I am grateful for the Indigenous leadership within the CMA who have put a lot of effort and hard work into catalyzing this process. Frankly, a lot of people will have the sentiment that this apology isn’t enough. System change is a slow process, but it does require paradigm shifts like this.
What I’m looking forward to are the CMA’s next steps to support Indigenous people who are currently in medical systems, that at this very moment still cause harm. This includes Indigenous people working as physicians already and our future physicians in medical training. We cannot expect that patients will feel safe receiving care if the people being trained to provide that care are experiencing racism and harm.
Dr. Lesperance is an Anishinaabe bear clan kwe/woman originating from Whitefish Bay First Nation in Treaty 3 Northwestern Ontario and Rocky Bay First Nation located in the Robinson-Superior Treaty area. She is a family physician.
Dr. Evan Adams
Physicians are not exempt from self-examination of their role in harms against Indigenous Peoples.
The lives of Indigenous people in Canada have been powerfully shaped by racism. The In Plain Sight report, for example, begins to describe just how pervasive — and harmful — racist experiences are in the health care system. Physicians are not exempt from self-examination of their role in harms against Indigenous Peoples historically in Canada — and must be, as health leaders, at the forefront of taking action to remedy past harms and ensuring equity going forward.
Dr. Adams is a Coast Salish family physician from the Tla’amin First Nation near Powell River, BC, and a CMA advisor.
Dr. Nel Wieman
Discriminatory treatment based in anti-Indigenous racism must stop.
In my work as the chief medical officer at the First Nations Health Authority, I am aware that First Nations people experience harms in the medical system from physicians in various ways on a daily basis. This discriminatory treatment based in anti-Indigenous racism must stop.
The CMA apology is a good first step to acknowledging these harms. But for the words to come alive and be truly meaningful, the apology must be followed by collective and individual actions to do better. First Nations people have a right to greater health and wellness and this can be achieved if we work together in partnership and culturally safe ways with physicians and other health care providers across Canada.
Psychiatrist Dr. Wieman is Anishinaabe (Little Grand Rapids First Nation, Manitoba). She lives, works and plays on the unceded Coast Salish territory of the Musqueam, Squamish and Tsleil-Waututh First Nations, in Vancouver.
