Canada Letter: Doctors “deeply ashamed”

Indigenous patients faced abuse, experimental treatments and other harms in Canada's health system, which still has disparities.

View in browser|nytimes.com September 21, 2024 Canadian Doctors Group Apologizes for Health Harms to Indigenous People By Vjosa Isai The former home of Joyce Echaquan, an Indigenous woman who was mocked and neglected by staff members in a Quebec hospital while she died. Hubert Hayaud for The New York Times The medical researchers poked and prodded their unwitting patients. Using sharp instruments, they removed skin from some and grafted the bits onto others in the group of Inuit patients in Igloolik, a hamlet in the Canadian high Arctic. The Inuit people were exposed to the extreme cold and to pain inflicted by doctors, who were testing their sensory responses in a six-year study that ended in 1973. Fifty years later, the patients, who include a man who went on to be the premier of Nunavut, have mounted a legal fight but are still awaiting answers. Medical experiments are among the more extreme examples of the mistreatment of Indigenous people in Canada at the hands of physicians. But the ways that the country's health care system fails Indigenous patients isn't just in history books. Indigenous people today have worse health outcomes when it comes to illnesses like diabetes and asthma. They are more likely to die from preventable causes and have shorter life expectancies than other Canadians. Infant mortality rates in Indigenous communities are at least twice as high as in most of Canada, and numerous reports have found evidence of racism and prejudice affecting their care. An organization representing more than 100,000 physicians and medical trainees in Canada formally apologized this week for the role that doctors had played in those disparities. "The racism and discrimination that Indigenous peoples and health care providers face is deplorable, and we are deeply ashamed," Dr. Joss Reimer, president of the Canadian Medical Association, said during a ceremony in Victoria. "We have not lived up to the ethical standards the medical profession is expected to uphold," she added. The ceremony followed four years of work by the organization, which combed through its archives dating back 150 years, as well as parliamentary records and other evidence. It then compiled that information into a report covering the profession's ethical failures. Malnourished children at residential schools were subjected to nutritional experiments, the report said. Sick students also received experimental tuberculosis vaccines or invasive lung surgeries for the disease, even after antibiotics became the standard treatment. Some students at Indian residential schools were used for medical experiments. Amber Bracken for The New York Times Patients faced abuse and forced sterilizations, said Dr. Paula Cashin, a Mi'kmaq physician in Newfoundland and a board member of the association. Many were sent to "Indian hospitals," many of which were originally tuberculosis sanitariums. When Indigenous people were ordered to the hospitals, they would face arrest if they refused to comply. Leaving the facilities before being discharged was also illegal. "Although most Indian hospitals are now closed, the country is still in the process of moving away from the segregated, racist health care model that the Indian hospital system perpetuated," Dr. Cashin said at the ceremony. Many Indigenous people were held at those facilities against their will. One of the patients was Sonny MacDonald, a Métis man from Fort Chipewyan, Alberta. As a young boy, he was sent by plane to Charles Camsell Indian Hospital in Edmonton for tuberculosis treatment. After a difficult lung surgery, he remained at the hospital for about three years, enduring sexual abuse by a staff member. He was the subject of unexplained experiments. On one occasion, he was fitted with a cast over both calves that held his legs apart, preventing him from walking. "I was just like a prisoner," Mr. MacDonald said in a video excerpt played at the ceremony. "One day, out of the blue, they said, 'We're sending you home,'" he recalled. "One of the biggest joys in my life is leaving that hospital." Mr. MacDonald, a celebrated carver, died in 2021. His story appears in "The Unforgotten," a video series funded by the Canadian Medical Association that documents the legacy of the country's racist health policies. The consequences reverberate in present-day health care. Racism and prejudice were partly to blame, a Quebec coroner found, in the death of Joyce Echaquan, an Indigenous woman who was mocked and neglected by hospital staff members during a medical emergency in 2020. [Published in 2021: After Video of Abusive Nurse, Canada's Indigenous Seek Health Overhaul] After the apology, the association will review its ethical and professional codes to better combat anti-Indigenous racism. The journey to the apology was an emotional one for Indigenous people who have concealed their suffering for years, often in solitude, said Dr. Alika Lafontaine, the Canadian Medical Association's first Indigenous president. "What I feel in this moment today is not isolation," Dr. Lafontaine said. "I feel solidarity, I feel empathy, I feel hope that things can be different." Trans Canada Chief Rosanne Casimir of the Tk'emlups te Secwepemc Nation. Amber Bracken for The New York Times Three years after evidence was found of possible graves at about 80 former Indian residential school sites, many Indigenous communities are grappling with the difficult choice of whether to create memorial sites or to exhume the remains. They must also deal with a chorus of conservative Catholic and right-wing activists who question the existence of unmarked graves at the schools. Cathy Merrick, the first woman elected to lead the Assembly of Manitoba Chiefs, dedicated much of her life to fighting against injustices faced by Indigenous communities. She died this month at 63. Prime Minister Justin Trudeau's Liberal Party lost a long-held seat in a special election in Montreal, deepening calls for Mr. Trudeau to step down. As cowboy culture reaches a fever pitch, cities like Calgary are rethinking how land that had prime uses for livestock and cattle processing could be a hotbed for new developments. Karsten Wall, a filmmaker in Winnipeg, wanted to break the mold of standard nature documentaries in her short film about Canada geese. You can watch it here. A new weight loss supplement launched by Kourtney Kardashian claims to work like Ozempic. But experts like Joe Schwarcz, director of the Office for Science and Society at McGill University, say there is no evidence that these products can replicate the results of prescription weight loss drugs. The Canadian filmmaker Guy Maddin's political satire "Rumours" appears in The Times's list of 39 movies to watch this fall. The Toronto International Film Festival wrapped up earlier this week, giving one of its top prizes, the People's Choice Award, to "The Life of Chuck," an adaptation of a Stephen King novella. Canada has no shortage of beautiful places to take in fall foliage, and Bas-St.-Laurent in Quebec made the recent list compiled by The Times's Travel section. A case of Chinese political meddling has emerged in New York, pointing to a familiar playbook of foreign interference by the country, as also seen in Canada. Canada's interest rate cuts have been among the highest in the world as inflation continues to fall. Vjosa Isai is a reporter and researcher for The New York Times in Toronto. How are we doing? We're eager to have your thoughts about this newsletter and events in Canada in general. Please send them to nytcanada@nytimes.com. Like this email? 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