Far from being only embodied by insults or physical violence, discrimination can also be present in the medical sector. A reality denounced through the project “REMEDions to medical racism”, which was born at the Saint-Michel Legal Clinic.
The case of Joyce Echaquan, this Atikamekw woman denigrated by medical personnel at the Joliette hospital, and who died shortly after, is a convincing example of medical discrimination, recalls the spokesperson for the program, Dr Wolf Thyma, psychiatry resident and law graduate.
“An absolutely tragic story” which no one would have known about if the main interested party had not filmed herself, deplores the one for whom the only rejoicing is that this case will have allowed many people to open their eyes to the phenomenon.
But if the story of Mme Echaquan made an impression, it would only be the tip of the iceberg, while “a lot of other incidents” have taken place before, deplores Wafaa Ghlamallah, project coordinator and law student at the University of Montreal.
Due to certain stereotypes and prejudices associated with certain communities, members who belong to them are more likely to be victims of medical errors. Even if she does not realize it, the caregiver who has internalized these prejudices could ignore or minimize certain concerns or symptoms mentioned by her patient.
And this, even if the patients do not always realize that they are discriminated against. “We often tend to think that the doctor has the absolute truth, underlines Mme Ghlamallah. We do not question his words, even if sometimes we feel that there is something wrong. Many people realize what they have been through when they see that a loved one has not received the same treatment. »
Misconceptions, real problems
A former D teacherr Thyma had claimed before him that “black patients were unreliable” and that they “exaggerated their emotions”.
Such beliefs, unfounded moreover, have real impacts on the condition of patients. “It can mean that a black person, or a racialized person, will be taken less seriously when they go to the hospital, he explains. Health professionals will still do their job, but they may push their [recherches] because they will think the patient is exaggerating. »
Another prejudice against people of African origin is that they feel less pain; in doing so, they sometimes receive lower doses of painkillers or anesthetics, illustrates the doctor.
“If the patient sees his symptoms ignored or diminished by the medical staff, he will not be adequately cared for,” notes Ms.me Ghlamallah. There are also serious medical errors that result from these unconscious biases, all things that would not have happened if the doctor had taken the problem seriously in the first place. »
In addition to a bad diagnosis or a minimization of the seriousness of it, medical racism can have significant psychological sequelae in the victims, but also in their loved ones, insists Dr. Thyma, who himself lost his father in circumstances “traumatic” because of the discriminatory treatment to which he and his family were subjected by the medical personnel in charge.
“It’s an experience that marks, which is traumatic for victims of medical discrimination,” he said. They may lose confidence in the health care system and even be afraid to return to the hospital, for fear of reliving the same thing that happened to them or their loved one. »
This bypassing of the system can insidiously lead to other health conditions going undetected, creating a vicious cycle that does no good, the spokesperson adds.
A study conducted at the University of Ottawa looked at the factors explaining the fact that black, Arab or indigenous people, among others, were less likely to have been vaccinated against COVID-19. Among the findings of the study, episodes of medical racism emerged among the causes of this refusal to be vaccinated, which was accompanied by distrust of the health system.
“We looked at different factors and we also crossed certain variables to see their influence, explains Jude Mary Cénat, associate professor at the School of Psychology of the Faculty of Social Sciences. We found that even among people with good health literacy, when they experienced medical discrimination, these people were the most distrustful of the healthcare system.
“A previous study indicated that 53.1% of members of black communities had experienced discrimination in the health system, raises Mr. Cénat. In our study, we arrived at almost 50%, which confirms that these are not isolated cases, that it is not the story of a single person. »
The result: the pandemic wreaked more havoc on black people, who were 2.2 times more likely to die from COVID-19 than white people.
One project, three parts
On May 19, the Saint-Michel Legal Clinic will hold an exhibition at Tohu highlighting certain testimonies of victims of medical racism.
It will be the same breath of the official launch of its program REMEDions, which will offer a support service to patients who are victims of such discrimination, by offering them psychological and legal support.
Explanatory documentation on the phenomenon of medical discrimination will also be produced by the project team, in order to raise awareness and equip both patients and health professionals to deal with the issue.
“Often people don’t even know where to start,” says Dr.r Thyma. Some victims don’t always realize the fact that they have experienced medical discrimination, and sometimes it’s something so personal and traumatic that they don’t feel able to talk about it. »
The resident physician in psychiatry hopes that explaining the existence of the phenomenon will ensure that those who have experienced it will be able to speak about it freely. This will also help document the issue.
Above all, underlines M.me Ghlamallah, the clinic does not want to point fingers. “This is not an adversarial project, on the contrary: we want to restore a bond of trust between health personnel and users, and to highlight this issue,” she says.