“I can guarantee you that there will be at least one case in the next six months where someone will not be allowed on the plane. For what ? Because anyone who is agitated, drugged or under the influence of anything will not be allowed on board, under any circumstances, it will not happen. And it happens all the time. » This statement, from former Minister of Health Gaétan Barrette, responded to the concerns of a citizen questioned by the repeated delays in repealing the non-accompaniment rule within Évacuations aéromédicales du Québec (EVAQ). This rule, which was an unofficial rather than official policy, systematically prevented a child’s parent from accompanying the child on the hospital plane during transfers from remote regions in Quebec to pediatric centers in Montreal or Quebec City. .
Mr. Barrette’s comments, recorded without his knowledge, were made during a pre-election visit in 2018 while the Hold My Hand campaign was in full swing. This campaign ultimately put an end to this draconian rule which disproportionately affected the Cree and Inuit communities of northern Quebec. CBC and Duty made these remarks public on June 21, National Indigenous Peoples Day, and newsrooms across Quebec and Canada picked up the news.
Gaétan Barrette apologized, but Indigenous activists, leaders and politicians still called for his immediate resignation, claiming that his statement perpetuated anti-Indigenous stereotypes, particularly towards Nunavikois, or Nunavimmiuts, as they call themselves. Mr. Barrette remained Minister of Health until the defeat of the Liberal Party in the elections of 1er October 2018.
As an emergency pediatrician who only practices in a hospital environment, the message sent to the health and social services network shocked me: if a Minister of Health, a specialist doctor moreover, can make remarks with complete impunity perpetuating anti-Indigenous stereotypes, doesn’t that give legitimacy to the opinions of other people in the network who might have discriminatory biases? At a more structural (or even systemic) level, are such views being integrated into health care policies without us even realizing it?
Since the violent and avoidable death of Joyce Echaquan, a 37-year-old Attikamek woman and mother of seven children, at Joliette hospital on September 28, 2020, I ask myself these questions every year as September 28 approaches. In fact, when I was summoned to the “Recommendations section” of the public inquiry by coroner Géhane Kamel into the death of Mme Echaquan, in the spring of 2021, I asked the following question during my testimony, referring precisely to the words of Mr. Barrette: “Could we have prevented the death of Joyce Echaquan if, as a society, we had intervened in a significant way in 2018 to end racism in healthcare? That is to say, if we had sent the message that no discriminatory remarks or behavior will be tolerated in the context of our work as caregivers, would we have been more attentive in the care provided to Ms.me Echaquan rather than despising her? Unfortunately, we will never know the answer. »
Three years later, the question remains unanswered.
On September 18, during a ceremony broadcast live, the Canadian Medical Association (CMA) apologized for its role and that of the medical profession in the past and present harm caused to First Nations peoples, Inuit and Métis people within the Canadian health system. The CMA is not an organization that represents all physicians in Canada (as of December 31, 2023, there were 54,127 “members”, while the most recent data counted 96,020 physicians in Canada in 2022). Several nevertheless welcomed a step in the right direction, while others expressed reservations.
In an opinion piece published in Healthy Debate On Wednesday, Dr. Suzanne Shoush, from the St’atl’imx First Nation, openly criticized the CMA that its excuses “ring hollow” due to ignorance of the social determinants of health that particularly influence life of Indigenous people, including structural elements, such as the Indian Act.
Regardless, it is important to note that the process that led to this apology was triggered following the death of Joyce Echaquan. Moreover, in its official apology, the CMA “strongly supports the adoption of the Joyce Principle”. However, here in Quebec, the province where she died, the government still refuses to do the same, even though several orders and unions in the health sector have already done so.
In his very first interview (granted to The Press) since he concluded, five years ago almost to the day, that Indigenous people are victims of “systemic discrimination” in Quebec public services, Jacques Viens, the former president of the Commission of Inquiry on relations between Indigenous people and certain public services, mentioned that Quebec’s relations with the First Peoples “has never been a priority”. According to him, “had it not been for the tragic event of the death of Joyce Echaquan, well, our report would have gone to the shelf like many others before”.
Call to action 74 of its voluminous report encouraged the government of Quebec to “modify the Act respecting health services and social services […] to embed the notion of cultural security, in collaboration with indigenous authorities.” I already indicated in this section last year that this collaboration is sorely lacking, which eventually led to the suspension of work on Bill 32 (PL32). Just a few weeks ago, Quebec Solidaire MP Manon Massé raised this issue again with work on PL32 which has resumed since the start of the parliamentary term.
On June 21, 2018, challenged by a question from a CBC journalist, Gaétan Barrette again apologized for his comments, not without adding, in a slightly exasperated tone: “Now, can we move on to something else? ? » The problem is that Canadian medical culture, including in Quebec, has long encouraged the dehumanization of indigenous people by maintaining colonial relations based on domination.
This is why I concluded, during my testimony at the coroner’s inquest, that “ultimately, it is medical colonialism which is the cause of Joyce Echaquan’s death, and, As a society, we all have a responsibility to ensure that such preventable deaths never happen again.” So we can’t just “move on” because his wrongs continue to recur instead of being righted. And that there can be no healing without reparation.
Today, September 28, marks the fourth anniversary of the death of Joyce Echaquan. Gatherings in his memory will take place in several cities, including Montreal. During the Memorial Vigil in memory of Joyce Echaquan organized on September 28, 2021 in Montreal, Carol Dubé, Joyce Echaquan’s spouse, said: “I listened to my leader and he said that we are in unceded territory, but why do we have to go and knock on the government’s door to get justice? » Today, in 2024, this question also remains unanswered.