Canadian Medical Association issues historic apology for mistreatment of Indigenous people
Miles Morrisseau
The Canadian Medical Association — the largest and oldest group representing medical professionals in Canada — issued a sweeping apology for the historical and ongoing mistreatment of Indigenous people.
In a ceremony held in Victoria, British Columbia, on Wednesday, Sept. 18, association President Dr. Joss Reimer apologized for the "ongoing and past harms" to Indigenous people, including Institutional racism and segregation, forced sterilization and experiments on adults and children.
"The Canadian Medical Association is deeply sorry for the harms First Nations, Inuit and Métis peoples have experienced and continued to experience in the Canadian health system," Reimer said.
"The racism and discrimination that Indigenous patients and healthcare providers face is deplorable, and we are deeply ashamed."
The apology followed an extensive examination of past practices with multiyear reviews of archives, social media accounts, parliamentary debates and community records. An ethics review of the records was also completed using the association's code of ethics and professionalism for the medical profession.
"The historical review revealed that the CMA contributed to systemically embedding and upholding anti-Indigenous racism and healthcare thus creating an unsafe environment for Indigenous peoples, patients and communities," the report noted.
There were 29 segregated Indian hospitals across Canada, mostly in Ontario and in the western provinces. They were often run by churches in tandem with residential schools, operating for more than 100 years from the late 1880s until the 1990s.
Indigenous people were institutionalized without their consent and Canadian law under the Indian Act made it a crime for First Nations people to refuse hospital admission, the report found.
"The Indian hospital system embedded systemic racism and discrimination in the Canadian healthcare system by fostering racial segregation and conditions where Indigenous patients received substandard and unsafe care," the association said. "Patients were subjected to abuse, experimental treatments and forced and coerced sterilization."
The apology included acknowledgement of a history of experimentation that was done on children in residential school and on adults in Indian hospitals to an extent that remains unknown.
"Medical experimentation was conducted on Indigenous children in residential schools including studying the effects of malnourishment and withholding necessary care," stated the CMA. "Medical experimentation was conducted on Indigenous adults including studying the effects of nutritional interventions and testing experimental tuberculosis vaccines and treatments. We still do not know the full extent of medical experimentation on Indigenous children or adults."
Assembly of First Nations National Chief Cindy Woodhouse Nepinak issued a statement welcoming the apology.
"Today marks an important turning point in the long history of discrimination, abuse and neglect inflicted on First Nations peoples through the medical system," said Woodhouse Nepinak. "We have seen how systemic racism in healthcare has led to mental, emotional and physical harm for First Nations and the many tragic cases that could have been prevented."
The national chief praised the association's action plan for reconciliation in healthcare.
"Their leadership can spark change for many more health service providers and medical professionals," she said. "We will continue to support the organization's work toward a more equitable health system from coast to coast to coast."
The Society of Rural Physicians Canada posted support for the CMA's apology, as well, and past president Sarah Lesperance added an apology based on her experience working with Inuit communities in Canada's north.
"As a physician who has spent my career working in Inuit Nunangat, as well as in Mi'kma'ki, I have seen the profound effects of colonialism, medical experimentation, and ongoing racism," Lesperance said. "We offer our apology for the role we have played, either actively or by being passive onlookers, as harm has been committed by the medical profession to First Nations, Inuit and Métis individuals and communities."
Lesperance worked in northern Canada and learned history that was "shameful" and with "racist policies" that put additional burdens on caregivers and medical staff.
"My desire to be involved in this day is also deeply personal," Lesperance said. "For many years, I worked as a tuberculosis physician in Nunavut. The history of TB in Inuit Nunangat is a shameful one. Boats such as the C.D. Howe would travel the Arctic in the summers, testing individuals who, if found to have evidence of TB, would be forcibly removed from their communities, and brought to a TB sanitorium for treatment in southern Canada. Many were never seen again."
The fight against TB remains an ongoing issue, and for those on the ground the Indigenous red tape and institutional racism continues to hinder the success.
"The work was challenging for us all, as racist policies, colonial structures, and lack of willingness of governments to provide adequate resources to eliminate TB continue to perpetuate harms to the clients we served," said Lesperance. "I personally felt powerless and voiceless in the face of these structures, and wish I could have done more to speak out, both in support of ... our team, the clients, and communities. Given my position of privilege, I am sorry that I did not."
Inuit were forced to relocate to tuberculosis sanatoriums far from their homes without community support, without their informed consent and against their wishes. Many patients died and their remains were never returned home.
In the apology, the CMA acknowledged that the organization failed to meet its own standards of conduct.
"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," Reimer said. "We realized we have left Indigenous people out of that high standard of care."
The association plans to rebuild the healthcare system to better serve Indigenous clients and to commit to an ongoing effort at reconciliation.
The association identified Indigenous healthcare goals that they believe will transform the health care system: to ensure that the system is free of racism and discrimination; uphold Indigenous People's right to self-determination; to value, respect and hold safe space for Indigenous worldviews, medicine and healing practices; and provide equitable access to culturally safe, trauma-informed care for all First Nations, Inuit and Métis peoples.
