Response to the Canadian Medical Association’s Apology to Indigenous Peoples

TREATY ONE TERRITORY – WINNIPEG, MB — Keewatinohk Inniniw Minoayawin Inc. (KIM Inc.) acknowledges the apology issued by the Canadian Medical Association (CMA) on September 18, 2024, regarding the harms caused to First Nations, Inuit, and Métis Peoples by the medical profession. This apology is a crucial and long-overdue recognition of the profound systemic racism Indigenous Peoples have faced—and continue to face—in healthcare across Canada.

We appreciate the leadership shown by Dr. Alika Lafontaine, a past president of the CMA and the first Indigenous president of the organization, who has been instrumental in advancing this dialogue. His courage and commitment to truth and reconciliation within the health system have been pivotal in bringing this apology forward. We also acknowledge the leadership of current CMA President Dr. Joss Reimer for offering an apology, demonstrating a commitment to accountability, and fostering a culture of openness within the organization. This act of sincerity is a vital step toward healing and building trust with those affected.

“Now that the apology has been delivered it’s time for meaningful action that changes the experience of patients, families and communities in the places they receive care. The Canadian Medical Association has stated its intent to support and expand partnerships with Indigenous communities and stakeholders doing this work, and I’m looking forward to where First Nations, Inuit and Metis Peoples lead this work as it moves forward in a good way.” – Dr. Alika Lafontaine, former President CMA (2022-2023).

The CMA’s apology is a step in the right direction, acknowledging the historical and ongoing harm caused by physicians, residents, and medical students toward Indigenous Peoples. The CMA’s expressed shame over these failures and the statement’s emphasis on rebuilding trust and accountability aligns with the ethical responsibilities of healthcare providers. Still, the work must now begin in earnest. The CMA has outlined three key action areas:

• ReconciliACTION Plan: The CMA commits to partnering with Indigenous Peoples to advance reconciliation in healthcare, guided by the teachings of Elders, Knowledge Keepers, and Indigenous partners.
• Historical and Ethical Review: A review of more than 150 years of the CMA’s archives has uncovered instances of systemic racism and the exclusion of Indigenous voices in healthcare. This honest self-examination is necessary to acknowledge the past and move forward.
• Commitment to Learning and Action: The CMA recognizes that it is on a learning journey, acknowledging that mistakes will be made but pledging to learn from these mistakes and continue in partnership with Indigenous Peoples.

Therapeutic Encounters are Where Forgiveness Must Originate

Dr. Barry Lavallee, KIM Inc. CEO stated, “The First Nations patient relationship with a physician provider is foundational to a therapeutic encounter and must be free of First Nations specific racism. This is a sacred relationship from which wellness should arise. The uniqueness of this concept when applied to First Nations patients fosters a dialogical relationship in which both patient and provider commit to learning – which is conscientization. This is about knowing oneself at a deeper level and having the courage to change. Physicians and medical learners must stop seeing us through a racialized lens coloured by socially created stereotypes. The patient / physician relationship is necessarily unequal in power; the use of this power / influence by the physician is necessary to impart change that will benefit the patient. However, when embedded with First Nations specific stereotypes, predictably lead to unnecessary death, maiming, and suffering. In this context, forgiveness must come from the Physicians’ painful realizations that will stem from new learning and finally, forgiving themselves.”

At KIM Inc., we are departing from the typical healthcare model where physicians and other providers have been traditionally centred. First Nations sovereignty and the strategies we will utilize to implement a new model will ensure that physicians working in the First Nations communities are held to the highest standards by the very people they serve.

Through this approach, KIM Inc. aims to finally establish trust, foster accountability by physicians and other providers, and ensure that the people receive the healthcare they deserve, free from racism.
This new model will not only benefit First Nations patients but also serve to educate and strengthen the medical profession as a whole. By working in partnership with First Nations and First Nations organizations, physicians will gain a deeper understanding of their role in a new trauma informed First Nations centred healthcare system.