CMA issues apology for harms to Indigenous Peoples in health care system

CMA commits to actionable steps in ReconciliACTION plan to address systemic racism in health care

CMA issues apology for harms to Indigenous Peoples in health care system

The Canadian Medical Association (CMA) formally apologized to First Nations, Inuit, and Métis Peoples for its role, and the role of the medical profession, in past and ongoing harms in the health care system. 

The apology, delivered in Victoria on Wednesday, followed nearly four years of reflection on the association’s history and its actions. 

As reported by The Globe and Mail, this process involved a comprehensive review of more than 150 years of CMA archives. The review revealed evidence of harm that is well-known to Indigenous Peoples and historians but less so to the general public.  

These included the use of outdated, racist terms in CMA communications and the participation of some doctors in forced medical experiments and sterilizations of Indigenous patients.  

The association also acknowledged the role medical professionals played in the apprehension of Indigenous newborns in hospitals, as well as their involvement in Indian hospitals, which provided segregated and underfunded care to Indigenous Peoples until the 1980s. 

Alika Lafontaine, the CMA’s first Indigenous president, explained in an interview with The Globe and Mail that while the CMA did not own or fund segregated health care systems like Indian hospitals, the actions or inactions of physicians sustained discriminatory government health policies.  

“Take child apprehensions, for example, right? If not for the role of medical professionals, it would be incredibly difficult for folks from government agencies to come and apprehend children. They depended on birth alerts in order to know when to come in,” Lafontaine said.  

Birth alerts were used to notify hospitals and child-welfare agencies that additional assessment was required before discharging newborns to parents deemed high-risk, a practice that disproportionately affected Indigenous women and women of colour. 

During the September 18 event, CMA President Joss Reimer addressed Indigenous Peoples directly, stating, “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.”  

Reimer also apologized, saying, “We are sorry. We are sorry we have lost your trust and for the harms you, your ancestors, your families, and your communities have experienced.” 

According to the CMA website, the apology ceremony was held on the traditional territory of the lək̓ʷəŋiʔnəŋ-speaking people of Songhees and Xwsepsum Nations. It included over 225 guests, Indigenous leaders, and survivors. 

CMA leadership outlined the steps taken toward the apology, acknowledging the organization’s role in the mistreatment of Indigenous Peoples through action or inaction. 

Paula Cashin, CMA board vice-chair, emphasized that this apology is only a starting point, “We at the CMA will own and continue to build on our understanding of the organization’s history, and moving forward, we commit to doing our part to create a better future.” 

The apology comes in the wake of a similar statement made by the College of Physicians and Surgeons of Manitoba in January 2023 and follows high-profile apologies from the federal government and Pope Francis for the mistreatment of Indigenous children in residential schools.  

Less attention has been paid to Indian hospitals, where the CMA acknowledged the role of medical professionals in contributing to the segregation and poor care provided to Indigenous patients

In addition to the apology, the CMA announced its ReconciliACTION plan, which outlines concrete steps to address systemic racism and improve health care for Indigenous Peoples.  

The plan includes co-creating initiatives with Indigenous partners to promote equitable care, revising the CMA’s Code of Ethics to address racism and discrimination, and increasing Indigenous representation within the organization. 

Lafontaine underscored the significance of the apology, stating, “Today, we turn the first page of a new chapter in the CMA’s history. It's a chapter that we hope First Nations, Inuit and Métis Peoples can write with us together, as we work toward a health system that provides Indigenous Peoples with the right care, at the right time, in the right place, in a good way.” 

Lafontaine said to The Globe and Mail he acknowledged the challenges ahead, saying, “I think the challenge with any sort of apology is how do you make it authentic, and then how do you make sure you turn that authenticity into people actually doing things that actually change things?”