In a historic precedent, the Canadian Medical Association (CMA) issued a formal apology on Wednesday to Indigenous Peoples from across Canada, for its history of human rights abuses and neglect.

The 157-year-old association had a lot to answer for. 

“We have not lived up to the ethical standards the medical profession is expected to uphold to ensure the highest benefit of care is provided to patients and trust is fostered in patients, right in physicians, residents and medical students, we realize we have left Indigenous peoples out of that high standard of care,” said Dr. Joss Reimer current President of the CMA.

The apology itself was plain and direct. 

“To Indigenous Peoples living in Canada, we apologize to you. We are sorry. We are sorry we have lost your trust and for the harms that you, your ancestors, your families and your communities have experienced, we acknowledge there are ripple effects on future generations. We take ownership of the CMA’s history, and we are committed to righting our wrongs and rebuilding our relationship on a foundation of trust, accountability and reciprocity,” said Reimer to the 200 guests gathered from across the country. 

The apology was a damning acknowledgement of a colonial and white supremacist system that consistently prioritized doctor’s incomes and advancement over the health and wellbeing of Indigenous people. The system also engaged in practices contrary to the ancient Hippocratic Oath to “abstain from all intentional wrong-doing and harm, especially from abusing the bodies.

Those harms have included forced sterilizations of women and men, medical experimentation on Indigenous children in residential schools, family separation, neglect, birth alarms and infant apprehensions. 

Delegates were welcomed to the Victoria Conference Centre by Esquimalt Chief Jerome Thomas, Elder Jimmy Durocher and Inuit Elder Martha Peet, who lit a Qulliq (a soapstone seal blubber oil lamp) and told the story of the centrality of the lamps to her childhood. Durocher, 84, addressed the room first in Red River Michif before switching to English.

The CMA posted the full apology to its website. 

‍CMA says apology was years in the making

“In preparation for this apology, the CMA underwent a multi-year process to review its archives, social media accounts, parliamentary debates and committee records,” said Dr. Paula Cashin, Canada’s first Indigenous radiologist and nuclear medicine physician.

“An epic review of these records was completed on the basis of the CMA code of ethics and professionalism and other key codes and norms that outline the ethical and professional commitments and responsibilities of the medical profession.” 

Over a hundred years ago, medical health inspector Dr. Peter H. Bryce tried to sound the alarm on the conditions of children in Saskachewan’s residential schools and the rampant presence of tuberculosis in those schools but was silenced by his superiors at the Department of Indian Affairs government. His publication The Story of a National Crime, a record of the “health conditions of the Indians of Canada.” His efforts to bring much-needed awareness and to care for the children in residential schools, he writes, “met active opposition of Duncan Campbell Scott, the superintendent of Indian Affairs, and “no action was taken.”

Survivors of these harms often don’t share their experiences because they don’t believe people are ready to receive them and are afraid that in sharing them, they will endure further harm.

History of racist views toward Indigenous Peoples

“The [Canadian] medical system has a history of exhibiting and accepting racist colonial and paternalistic attitudes toward Indigenous Peoples,” Cashin said. “Many indigenous peoples suffered mistreatment and lack of care. In many cases, this led to ongoing health issues and death.”

The intensity of feeling in the room immediately following the apology was palpable. There were tears. Tissue boxes were passed and people were encouraged to reach out to trauma specialists available to support them.

For Alika Lafontaine, who has witnessed other reconciliatory gestures and apologies, the message was clear. “Sorry means stop. We acknowledge there is a lot of heavy work ahead of us,” said Lafontaine, the first Indigenous president of the CMA and one of the primary movers in bringing the apology to fruition.

“Any actions must be done in partnership and reciprocity with Indigenous People,” he said. He identified the CMA’s Indigenous Guiding Circle as a north star and key contributor to the advent of the historical moment and the future of its reconciliatory plans and efforts.

That plan focuses on three principles:  

1. Advancing the health of Indigenous Peoples 
2. Supporting journeys to truth and reconciliation in a review of its code of ethics, processes and recruitment policies and supporting partners in walking their own paths of reconciliation
3. Promoting internal reconciliation for employees and leadership through policy and systems reviews and deepening its understanding of human rights international and constitutional law, and treaties

The CMA will also fully adopt Joyce’s Principle of equitable access, ensuring no discrimination within all social and health services and the right of Indigenous Peoples to enjoy the best physical, emotional and spiritual health. 

“Our health is our wholeness as Indigenous People. It is everything we are,” said Lafontaine. “Today we turn the page of a new chapter in CMA history.”

Toolkit given to CMA to learn

Following the apology, a medicine bundle was given to the CMA on behalf of Indigenous Peoples by Yuxwelupton Qwal’Qaxala (Bradley Dick) and Elder Terri Barnhard.  

“The bundle, for us, is a toolkit for the CMA to learn—not by reading books, that’s the easy work,” said Mel Hardy, from Rocky Bay, Ont. “The gift is a gift of giving because of the medicines that are in there.”

“What I have witnessed from our Indigenous families, First Nations, Métis and Inuit is grace,” said Terri Barnhard. “What I have heard and what has landed for my heart is a commitment to acknowledge through changed behaviour and changed practices and learning to walk with us as our communities as individuals as nations. 

“What this will require is love, love, compassion and empathy in order for us to walk together.” 

Apology never too late

Denise McCuaig, health leader for the Métis Nation, said an apology is never too late. “We’ve reached a point in time in our history where we can be hopeful. That commitment to unlearn and relearn is really strong.” 

To her, what was different about the apology from the CMA was its vulnerability. “That was very powerful because we have to remember that the beauty of the medical profession is that they touch the people, they’re more close than any politician or institution can be,” said McCuaig. 

‍