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Providing Culturally Safe Care for Indigenous Peoples

This past week, the Health and Health Care Implications of Systemic Racism on Indigenous Peoples in Canada fact sheet was released. One of the co-authors of the report was Dr. Michael Green (left), professor of family medicine at Queen’s University. The fact sheet was prepared by the Indigenous Health Working Group of the College of Family Physicians of Canada (CFPC) and Indigenous Physicians Association of Canada.1

Dr. Green and his colleagues have identified systemic racism as a major barrier to positive relationships between family physicians and Indigenous patients and their care. Though it is directed at physicians, the fact sheet is pertinent to all healthcare professionals; it is an appeal to address an important and often-ignored issue. Over the past week, the fact sheet has received a great deal of media attention and on Tuesday, Dr. Green was interviewed on CBC’s Ontario Morning. Click here to listen to the interview.

The Health and Health Care Implications of Systemic Racism on Indigenous Peoples in Canada fact sheet opens with a story; a tragic account of an individual who did not receive the care that he desperately needed.

The Case of Brian Sinclair

Racism in the Canadian health care system can be fatal. This reality is clear in the case of Brian Sinclair, a 45-year-old Indigenous man who visited the emergency room of the Winnipeg Health Sciences Centre in 2008. Mr Sinclair was referred to the ER by a community physician for a bladder infection. While he waited, Mr Sinclair vomited on himself several times, and other ER visitors pleaded with nurses and security guards to attend to him. Following a 34-hour wait, Mr Sinclair died of the bladder infection in the waiting room without ever receiving treatment. The Sinclair family, their legal counsel, and local Indigenous leaders asked a provincial inquest into the matter to strongly consider the ways in which Mr Sinclair’s race, disability (Mr Sinclair was a double amputee and had suffered some cognitive impairment), and class resulted in his lack of treatment and subsequent death. In February 2014, the Sinclair family withdrew from the provincial inquest due to frustration with its failure to examine and address the role of systemic racism in his death, and in the treatment of Indigenous peoples in health care settings more broadly.”1*

*Full references from the quote can be found in the Health and Health Care Implications of Systemic Racism on Indigenous Peoples in Canada fact sheet.

In order to understand Brian Sinclair’s case, of course, we have to first adjust our perceptions, and the fact sheet challenges us to do just that. It asks us to grasp the concept of systemic racism, and to see how systemic racism impacts health and the quality of healthcare that one can access.

In its recommendations for physicians, the fact sheet calls for the provision of ‘culturally safe care’ by addressing personal biases and power relations between the service user and service provider. It recommends validating the patient’s way of knowing and being, and seeing them as a partner in the decision-making process.

In other words, to treat Indigenous patients in the same way that we should treat all patients: with respect and dignity.

In December 2015, the Truth and Reconciliation Commission released its final report. The report contains 94 recommendations, many of which have some bearings on Universities and health professional schools.2 In fact, seven of the recommendations provide a specific call to action for the issue of Aboriginal health.

Queen’s University has recently established a task force with broad representation, to address the Truth and Reconciliation Commission report in general, as well as its specific calls to action. The Faculty of Health Sciences will be involved in this task force, as well as being involved with provincial and national organizations that are similarly developing strategies to address the serious issues tabled in the Truth and Reconciliation Commission’s final report.

Thank you to Jen Valberg, Communications Coordinator for her assistance in preparing this blog.

Please share your thoughts by commenting on the blog, or better yet, drop by Macklem House…my door is always open.



Leda Raptis

Mon, 06/26/2017 - 14:13

Very interesting story, thanks for posting it. However, I found the title hard to understand.
Sinclair DID ask for treatment, his culture did not prevent him from doing it, as the title seems to imply. (It brings to mind eg Jehova’s witnesses). OUR culture has the problem in his case.

Leda Raptis

Thank you for your comment, Leda. You’re right, in that what the title does not encompass (but the fact sheet does point out) is that in some cases it is systemic racism that prevents a person from receiving the care that they are seeking. It is a very complex issue with many sides.



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