Medical publication says the country’s health-care system must respect aboriginal healing traditions

A leading Canadian medical publication says the country’s health-care system must respect aboriginal healing traditions and do a better job of making First Nations, Métis and Inuit people feel welcome in conventional treatment.

uthors Lisa Richardson, an internal medicine specialist who is a leader of the University of Toronto’s office of indigenous medical education, and Matthew Stanbrook, a respirologist and deputy editor of the CMAJ, write that indigenous Canadians continue to feel unwelcome or unsafe in our medial institutions, and in some cases are being ignored or left to die.

“To make medical treatment acceptable to our aboriginal patients, the health care system must earn their trust by delivering respect,” they write. Medical professionals “must ensure that our aboriginal patients, their families and communities feel welcome, are comfortable self-identifying and aboriginal, and do not fear judgment based on stereotypes.”

The authors point to the heavily publicized case of an 11-year-old Haudenosaunee girl, known publicly as J.J., who has acute lymphoblastic leukemia and whose mother pulled her out of chemotherapy last fall saying they would instead rely on a traditional healer.

Doctors at McMaster Childrens Hospital in Hamilton asked a court to have the girl taken away from her family, saying she would not survive a year without the chemotherapy. But a judge refused, saying the Constitution protects the native mother’s right to treat her child with traditional aboriginal medicine.

The authors of the CMAJ editorial say that, although some people took issue with the judge’s ruling, “it appears to have been a thoughtful decision addressing a complex area of law.”

Anna Banerji, a pediatrician who specialized in indigenous and refugee health, chaired a conference on indigenous health in Toronto in November. One of the recurring messages at that meeting was that First Nations, Métis and Inuit people often feel out of touch and unwanted in hospitals and doctors’ offices.

“There is a real disconnect between the needs of indigenous people and what mainstream medicine does, for multiple reasons,” Dr. Banerji said in a telephone interview. “There are serious issues of mistrust based on hundreds of years of discrimination, broken promises, broken treaty obligations.”

The editorial says it is wrong to blame the physicians at McMaster who sought to remove J.J. from her family saying the medical team were, no doubt, driven by fear for the child’s life. But, they say, “such action holds a unique horror for Aboriginal people, given the legacy of residential schools.”

Dr. Banerji said there must be a compromise between the different streams of medicine and more cultural competency on the part of health-care providers. In addition, she said, there needs to be more understanding of issues like poverty that affect health and are more prevalent among the indigenous population.

Dr. Richardson said she was compelled to write the editorial because the bigger picture of why so many aboriginal patients have poor experiences in the health-care system was being lost in all of the media coverage around the case of J.J.

But, the good news, she said, is there are places in the country, especially British Columbia, where indigenous input is having a positive effect and medical schools are taking the indigenous reality into consideration. “I think we have a real willingness at the level of leadership of faculties of medical education to make change.”

GLORIA GALLOWAY – Globe and Mail



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