Dr. Alika Lafontaine, past president of the Canadian Medical Association, sits at Maskwôtêh Park near the Grande Prairie Regional Hospital in Grande Prairie, Alta. on Sept. 14. Lafontaine will be at the Canadian Medical Association’s apology to indigenous people for the historic harm done to them by the medical profession.Jesse Boily/The Globe and Mail
When leaders of the Canadian Medical Association began thinking of making a public apology to Indigenous people, they wanted to be clear-eyed about why they were saying sorry.
That led to a nearly four-year process of looking into the organization’s past and present in preparation for a landmark apology ceremony set to take place in Victoria on Wednesday afternoon.
“Racism, discrimination and colonization live at this abstract level where people kind of know what folks are talking about, but they often project their own ideas about what it means, instead of having more concrete foundations,” Alika Lafontaine, a past president of the CMA, which represents physicians across the country, told The Globe and Mail in an interview. “So the CMA did a review of its full history.”
The CMA’s search of more than 150 years of archives turned up evidence of harms that are well-known to Indigenous people and historians, but less so to the general public. Researchers found the CMA used outdated, racist terms in its communications. They also concluded that some doctors participated in or failed to stop medical experiments on Indigenous patients, and forced sterilizations of Indigenous women as well as the apprehension of Indigenous newborns at hospitals.
The CMA’s apology to Indigenous people will be the second by a Canadian medical organization in as many years. The College of Physicians and Surgeons of Manitoba apologized in January of 2023 for “failing to adequately address Indigenous-specific racism by medical practitioners,” and for the “intergenerational trauma, suffering, poor health outcomes, and death that this has caused.”
The CMA’s apology also comes after high-profile apologies from the federal government and Pope Francis for the mistreatment of Indigenous children in Canadian residential schools.
Less attention has been paid to the damage done by Indian hospitals, the segregated and underfunded health facilities for Indigenous people, some of which operated into the 1980s in Canada. The CMA is expected to mention them during the ceremony, alongside the practice of dispatching Inuit tuberculosis patients to southern sanitoria in the 1950s and 1960s. Prime Minister Justin Trudeau apologized for that practice in 2019.
Indian hospitals are “as big a story and as connected a story as the Indian residential school system,” said Mary Jane Logan McCallum, a University of Winnipeg history professor and Canada Research Chair in Indigenous People, History and Archives.
Dr. Lafontaine, an anesthesiologist in Grande Prairie, Alta., who served as the CMA’s first Indigenous president in 2022-2023, said the CMA felt it was important to say sorry for the medical profession’s sins, even in cases where doctors were simply carrying out government policy.
“The CMA didn’t own health systems. The CMA was not a funder of segregated care like Indian hospitals,” Dr. Lafontaine acknowledged. But he said the actions or inactions of physicians often 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.”
Birth alerts were used to notify hospitals and child-welfare agencies that a more thorough assessment was needed before a newborn was discharged to a parent deemed high-risk. Some provinces still used birth alerts as recently as 2021, despite critics saying they unfairly targeted Indigenous women and women of colour.
Ian Mosby, a history professor at Toronto Metropolitan University, published evidence in 2013 that about 1,000 malnourished students at six residential schools were subjected to nutrition experiments run by doctors between 1948 and 1952. Some children were fed experimental flours and vitamins without their knowledge or consent, while others were allowed to nearly starve as controls for the tests.
“The nutrition experiments were not this one-off,” Dr. Mosby said. The tests were made possible by the control that paternalistic white officials had over Indigenous people in much of the 19th and 20th centuries. “When we think of what the CMA is apologizing for,” he said, “a lot of it has to do with the power that these doctors held over Indigenous people’s lives.”
Dr. Lafontaine said the CMA’s apology will be delivered in five parts. The first two will lay out the high-level findings of the historical review and set the context of the apology. The apology itself will be delivered by Manitoba doctor Joss Reimer, current president of the CMA.
Then, Dr. Lafontaine said, the organization will promise action in the final parts of the ceremony.
That would include working to stamp out the anti-Indigenous racism in health care that lingers in the 21st century. It could also encompass actions that improve health outcomes for First Nations, Métis and Inuit people, who lag behind other Canadians on most key health indicators.
Just last month, the First Nations Health Authority in British Columbia reported that life expectancy for status First Nations peoples in the province declined by six years between 2017 and 2021 as a result of the toxic-drug crisis and COVID-19. Both hit Indigenous people harder than most other Canadians.
“I think the challenge with any sort of apology is how do you make it authentic,” Dr. Lafontaine said. “And then how do you make sure you turn that authenticity into people actually doing things that actually change things?”
With files from Xiao Xu and The Canadian Press