Judge says forcing aboriginal girl to stay in chemo is to ‘impose our world view on First Nation culture’

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Mr.Tea
Judge says forcing aboriginal girl to stay in chemo is to ‘impose our world view on First Nation culture’

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Mr.Tea

I'd be curious to know what people think of this situation.

"SIX NATIONS, Ont. — ­ For Laurie Hill, resident of Canada’s largest aboriginal community, it’s just wrong to suggest that modern medicine is the only way to treat cancer and other serious diseases.

She stands firmly behind the Six Nations neighbours who took their 11-year-old daughter with leukemia out of chemotherapy, and are treating her with traditional, but unproven, native methods and other alternative health-care instead.

“There’s a fear of [aboriginal remedies] or denial of it. If things can’t be quantified or qualified, to them it’s irrelevant,” said Ms. Hill, as she shopped at Ancestral Voices Healing Centre Thursday. “Who are they [doctors] to say she will make it with their treatments. Just because they have a degree, that makes them more knowledgeable?”

Her perspective on what seems to be a widening cultural divide received some recognition from a surprising quarter Thursday: ­the judge deciding whether the cancer-stricken girl should be forced back into chemotherapy.

As an extraordinary court case in nearby Brantford moved toward an end, a lawyer for McMaster Children’s Hospital argued that child-welfare authorities should have used their power to require the young woman to stay in treatment. With chemo, childhood leukemia now has a survival rate in the range of 90%, and remains a likely death sentence without it, experts say.

But Justice Gethin Edward of the Ontario Court of Justice suggested physicians essentially want to “impose our world view on First Nation culture.” The idea of a cancer treatment being judged on the basis of statistics that quantify patients’ five-year survival rate is “completely foreign” to aboriginal ways, he said.

“Even if we say there is not one child who has been cured of acute lymphoblastic leukemia by traditional methods, is that a reason to invoke child protection?” asked Justice Edward, noting that the girl’s mother believes she is doing what is best for her daughter."

http://news.nationalpost.com/2014/10/16/judge-says-forcing-aboriginal-gi...

 

swallow swallow's picture

Well, the Post's framing of the issue is hatebait, and I think any disucssion should start with a reminder of the mandate for this forum not to be used for a place to bash First Nations perspectives. 

I also think it's worth framing discussion starting from a more balanced article, which makes it clear that the lawsuit is between a hospital and Brant Family Services, which determined there is no threat to the child justifying an over-ride to aprential decision-making power in this case. 

[url=http://www.brantfordexpositor.ca/2014/10/16/justice-closing-arguments-st... Expositor[/url]

Timebandit Timebandit's picture

I don't think the parents' belief in traditional First Nations medicine should matter any more in this case than it does in the case where the child's parents are from a religious sect who do not believe in medical treatments - Jehovah's Witness comes to mind.  There have been cases where such children have received mandated treatment in spite of their parents beliefs.

Bottom line, this little girl is being given a death sentence.

6079_Smith_W

Perhaps it shouldn't, but it is not the same.

And that's not saying I don't agree with your assessment, but sovereignty means sovereignty. It is galling that the proof of that comes at a cost like this.

 

 

swallow swallow's picture

Again, the case seems to be the hospital vs. Brant Childsren's Services, who see no reason based in child welfare to support the hospital's desire to overturn the mother's decision.

Also, the judge has not made a final ruling; he is listening to arguments and posing useful questions. 

I can only recommend once again reading a link other than the National Post, whose agenda I assume is clear. I provided one link above. Perhaps there are others. But please, don't' simply accept the "facts" as the Post gives them. 

6079_Smith_W

@ swallow

I appreciate the warning. I did read the two sources, and others, before i spoke.

I should say, this case reminded me, more than anything, of one not relevant to First Nations issues - that of Tracy Latimer.

 

 

swallow swallow's picture

Oh, I know you always read and think before posting judiciously, Mr Smith. But you know the direction threads like this can take.....

[url=http://www.brantfordexpositor.ca/2014/10/22/court-closing-arguments-to-c... arguments continue; judge to rule in November[/url]

abnormal

Timebandit wrote:

I don't think the parents' belief in traditional First Nations medicine should matter any more in this case than it does in the case where the child's parents are from a religious sect who do not believe in medical treatments - Jehovah's Witness comes to mind.  There have been cases where such children have received mandated treatment in spite of their parents beliefs.

Bottom line, this little girl is being given a death sentence.

Pretty much sums it up.

 

Slumberjack

It's a conundrum isn't it?  If this were an issue involving JW parents and their child for instance, many would likely say the state has an obligation to elevate the health and well being of the child over other considerations as determined by the parents, but because the history of the Crown ordering the removal of First Nations children from the care of their parents and communities (ostensibly for their own good) has produced tragic consequences, the state itself becomes ensnared in a legal and moral quandary of its own making.  I would be surprised if the court ultimately decides in favour of the parents in this case.

swallow swallow's picture

[i]If[/i] not undergoing chemotherapy is automatically a death sentence - debatable, but we don't have the facts - that would still not constitute a "death sentence" at this time, since no rulign has been made. Contrary to the Post's claims, the judge will rule in November, and has not done so as yet.

Timebandit Timebandit's picture

Sorry, swallow, I meant that if the ruling is made against the hospital. The doctors are pretty adamant that there is zero chance that child is going to survive without treatment, and at least some chance for her to live a normal life span with it. A ruling in favour of the parents denying her a treatment would be, IMO, a death sentence.

6079_Smith_W

@ swallow.

Thanks. I did say that I wasn't disagreeing with TB's assessment (and didn't say, but I'm not trying to jump the gun on the process), but simply underscoring that this is not the same as any other case of protecting the rights of ths child.

And I think it bears remembering, not just because we are in the aboriginal issues forum. SJ summed it up nicely.

And in case my reference to Latimer isn't clear, I am not a fan. One can recognize that there should be provisions for assisted suicide, and still see that he took matters into his own hands and killed his daughter unnecessarily.

 

Sineed

The girl has ALL, an acute leukemia that can kill within days of onset. And yes; the mortality rate is 100% without treatment.

What Timebandit said.

Sineed

I had to rush off earlier and would like to comment more completely.

It's precisely these sorts of cases - and there are many - that motivate my intense dislike of the whole alternative medicine movement. When I was a young pharmacist watching the increasing prominence of alternative remedies, I thought meh; these products are useless, but if people want to waste their money, that's their right. But what has happened is that these products, initially promoted to treat mild, self-limiting illnesses like seasonal allergies, have gained legitimacy in the marketplace and our culture, and now they are being promoted to treat serious illnesses, from cancer to Ebola.

The child is being treated at the Hippocrates Health Institute in Florida http://hippocratesinst.org/the-institute/about-hippocrates. Not very culturally specific, IMO.

Note how they call it the "Comprehensive Cancer Wellness Program." I guess if they called it treatment, the FDA would land on their necks.

jas

Slumberjack wrote:

It's a conundrum isn't it?  If this were an issue involving JW parents and their child for instance, many would likely say the state has an obligation to elevate the health and well being of the child over other considerations as determined by the parents, but because the history of the Crown ordering the removal of First Nations children from the care of their parents and communities (ostensibly for their own good) has produced tragic consequences, the state itself becomes ensnared in a legal and moral quandary of its own making. ..

These were my thoughts as well. Very tricky situation given the history of government agencies and FNs.

Are there stats somewhere that can show us that survival rates for conventional treatments for this (or other kinds) of cancer far surpass those for non-conventional or no treatment? 

6079_Smith_W

I think we can safely assume death sentence.

jas

I wouldn't assume anything about it until I see some data. The term "death sentence" does though, I'll admit, have a nice rhetorical punch to it.

Sineed

Chemotherapy versus death from cancer

Dr. David Gorski, oncologist wrote:

Yes, chemotherapy can make you feel nauseated and make you throw up. It can make your hair fall out. It can temporarily depress the immune system. It can cause bleeding complications, such as GI bleeding. It can cause kidney damage. It can cause heart damage. It can cause lung damage. It can cause nerve damage. It can make you lose weight. It can even result in your death from complications. In short, it is not something to be used lightly. Unfortunately, the disease it’s meant to fight is a formidable foe indeed. It is your own cells, and all too often the difference between the toxicity of chemotherapy against the cancer and against normal cells is not that large.

But what does cancer do? How do cancer patients die? They suffer and die in protean ways. Cancer can do everything chemotherapy can do (with the exception of hair loss) and more. I’ve seen more patients than I care to know suffer and die from cancer. I’ve seen family members suffer and die from cancer, most recently my mother-in-law last year.

<snip>

Dying from untreated cancer can mean unrelenting pain that leaves you the choice of being drugged up with narcotics or being in agony.

Dying from untreated cancer can mean unrelenting vomiting from a bowel obstruction. It can mean having a nasogastric tube to drain your digestive juices and prevent you from throwing up. Alternatively, it can mean having to have a tube sticking out of your stomach to drain its fluids.

Dying from untreated cancer can mean bleeding because you don’t have enough platelets to clot. The bleeding can come in many forms. It can be bleeding into the brain, in essence a hemorrhagic stroke. It can mean bleeding from the rectum or vomiting blood incessantly....

http://www.sciencebasedmedicine.org/chemotherapy-versus-death-from-cancer/

What ALL looks like

Quote:
On August 16, 1947 ... the child of a ship worker in the Boston yards fell mysteriously ill with a low-grade fever that waxed and waned over two weeks without pattern, followed by increasing lethargy and pallor. Robert Sandler was two years old...

Ten days after his first fever, Robert's condition worsened significantly. His temperature climbed higher. His complexion turned from rosy to a spectral milky white. He was brought to the Children's Hospital in Boston. His spleen, a fist-sized organ that stores and makes blood (usually barely palpable beneath the ribcage), was visibly enlarged, heaving down like an overfilled bag. A drop of blood under Farber's microscope revealed the identity of his illness; thousands of immature lymphoid leukemic blasts were dividing in a frenzy, their chromosones condensing and uncondensing, like tiny clenched and unclenched fists...

Over the next month Sandler turned increasingly lethargic. He developed a limp, the result of leukemia pressing down on his spinal cord.  Joint aches appeared, and violent, migrating pains. Then the leukemia burst through the bone in his thigh, causing a fracture and unleashing a blindingly intense, indescribable pain...he was withdrawn, listless, swollen and pale, on the verge of death.

From The Emperor of All Maladies: A Biography of Cancer by Dr. Siddhartha Mukherjee.

The poor little bean received chemo that induced a temporary remission, and though he did die the following year, his temporary recovery was unprecedented in the history of leukemia and helped spur the research that lead to today's curative treatments.

Rather than forcing the child into treatment, I think a frank discussion of the consequences of treatment/no treatment with the child's mother is less paternalistic, would be more effective, and help her support her daughter through the treatments for ALL, which are undeniably brutal.  Having worked in healthcare for a while, I wouldn't be surprised if nobody explained what untreated leukemia looks like. Healthcare workers can be crap at communication sometimes.

Sineed

jas wrote:

I wouldn't assume anything about it until I see some data. The term "death sentence" does though, I'll admit, have a nice rhetorical punch to it.

No problem.

http://www.merckmanuals.com/professional/hematology_and_oncology/leukemi...

Quote:

Acute leukemia occurs when a hematopoietic stem cell undergoes malignant transformation into a primitive, undifferentiated cell with abnormal longevity. These lymphoid cells (acute lymphocytic leukemia [ALL]) or myeloid cells (acute myelocytic leukemia [AML]) proliferate abnormally, replacing normal marrow tissue and hematopoietic cells and inducing anemia, thrombocytopenia, and granulocytopenia. Because they are bloodborne, they can infiltrate various organs and sites, including the liver, spleen, lymph nodes, CNS, kidneys, and gonads.

Basically, these primitive cells replace the normal working cells of your blood, and you need these to live.

Quote:
Survival in untreated acute leukemia generally is 3 to 6 mo.

jas

Thanks, Sineed, for providing an explanation for your use of the term "death sentence", and for the quote regarding the life expectancy for untreated ALL from pharmaceutical giant Merck.

It appears from a few sources that a number of factors will determine prognosis (most of which we wouldn't know for this girl), but that chemo for this type of cancer does produce high success rates in children. Have not seen any mention of long-term (> 5 year) outcomes.

It's a sticky situation, all right. Since many people in health crises do turn to natural and alternative therapies, many of which have shown success in disease prevention and amelioration, and since FNs have their own medical traditions based in natural remedies, the mother is clearly not being negligent in this case. She is simply contravening conventional opinion. Not an easy position to take.

I'm a little confused though. Would it be the case below, reported on by CBC last spring? If so, the article mentions that she had 11 weeks of chemo treatment prior to pulling out.

http://www.cbc.ca/news/aboriginal/first-nations-girl-chooses-traditional...

cco

Quote:
“I know that what I have can kill me but … Jesus came into my room and told me not to be afraid, so if I live or if I die, I am not afraid.”

Sounds very traditional to me.

jas

Re: my above post: No, incredibly, not the same case. Just the same circumstances and hospital.

http://www.cbc.ca/news/aboriginal/makayla-sault-earlier-first-nation-chi...

However, Makayla's case clearly shows the girl's own decision in this.

 

jas

cco wrote:
Sounds very traditional to me.

Yes, to me too. But I'm not FN.

Sineed

Jas wrote:
It's a sticky situation, all right. Since many people in health crises do turn to natural and alternative therapies, many of which have shown success in disease prevention and amelioration, and since FNs have their own medical traditions based in natural remedies, the mother is clearly not being negligent in this case. She is simply contravening conventional opinion. Not an easy position to take.

I woudn't call the mother negligent either; just misinformed. And it's especially a tragedy considering how the facts are unequivocal in this case. For me, the difficulty lies in convincing skeptical parents that they are doing the right thing by subjecting their children to these extremely brutal treatments. The treatment course for ALL is one of the most harrowing in all of cancer. Psychological support for patients and families is crucial in cancer care, and that's where supportive care comes in.

But unfortunately, alternative treatments have not been found to help prevent or treat cancer.

jas wrote:
Thanks, Sineed, for providing an explanation for your use of the term "death sentence", and for the quote regarding the life expectancy for untreated ALL from pharmaceutical giant Merck.

The universal lethality of leukemia was established before Big Pharma existed. But if you have evidence that people can survive without functional blood cells, do share.

 

Slumberjack

jas wrote:
 Very tricky situation given the history of government agencies and FNs.

I believe the legal deliberations are a sort of spectacle at this point.  Does anyone think the court is going to open the door and have tradition, culture, or religious beliefs override the opinion of medical authorities, that are licenced as authorities of the state, given all of the organizations who would line up behind such a decision?

6079_Smith_W

cco wrote:
Quote:
“I know that what I have can kill me but … Jesus came into my room and told me not to be afraid, so if I live or if I die, I am not afraid.”
Sounds very traditional to me.

Sovereignty is sovereignty.

It isn't for us to set the terms, and especially not to insist that people live in some pre-Columbian museum if they want to have control over their own lives.

And again, I am not pointing this out to say I think this child should be allowed to die, but rather to point out that this situation is difficult enough as it is.

 

jas

Slumberjack wrote:
Does anyone think the court is going to open the door and have tradition, culture, or religious beliefs override the opinion of medical authorities, that are licenced as authorities of the state, given all of the organizations who would line up behind such a decision?

Well, the judge in this case has indeed opened that door, and, in this case, for good reason.

jas

Sineed wrote:

But unfortunately, alternative treatments have not been found to help prevent or treat cancer.

And of course, this is not true. There is plenty of anecdotal evidence, as well as some medical data on the efficacy of various alternative therapies.

While we're at the verge of thread digression, I'll plug the thread already started here on this topic: Health and mental health across cultures

onlinediscountanvils

jas wrote:
However, Makayla's case clearly shows the girl's own decision in this.

And for me, that trumps everything else.

Unionist

I don't believe parents should be allowed the power of life or death over their children, so I take parents' beliefs, faith, culture, scientific knowledge, whatever, with a grain of salt - as one piece in the puzzle.

A larger question for me is this: If society (as I believe) has a duty to protect its members, even if it's against their parents - which society is that? Canada? Humanity as a whole? The First Nation to which a child belongs? Or the "faith" community?

 

6079_Smith_W

Legally, it is Canada (the relevant province, actually), unless someone has better information.

 

Slumberjack

Unionist wrote:
I don't believe parents should be allowed the power of life or death over their children, so I take parents' beliefs, faith, culture, scientific knowledge, whatever, with a grain of salt - as one piece in the puzzle.

A larger question for me is this: If society (as I believe) has a duty to protect its members, even if it's against their parents - which society is that? Canada? Humanity as a whole? The First Nation to which a child belongs? Or the "faith" community?

If I'm summarizing this correctly, a society that has progressed in terms of advancements in pharmacology has earned the right to impose it's will?  Or in other words, a secular attitude reinforced by a technology authorized by the state is where this right is derived from, to abborgate all of the variables you have made a list of.

Unionist

SJ, what do you think of my point that decisions about children's medical care shouldn't belong to their parents?

 

Sineed

Slumberjack wrote:

If I'm summarizing this correctly, a society that has progressed in terms of advancements in pharmacology has earned the right to impose its will?  Or in other words, a secular attitude reinforced by a technology authorized by the state is where this right is derived from, to abborgate all of the variables you have made a list of.

So you believe parents have the right to deny life-saving interventions to their children?

onlinediscountanvils

Patients should have the right to refuse medical treatment.

NDPP

The most graphic indication of just how deeply we have already 'imposed our world view' is an elderly white man in a high backed chair pronouncing Canadian law on chemotherapy vs Jesus upon this indigenous cancer patient

6079_Smith_W

@ NDPP

Actually, I don't think it serves anyone well to turn this into a battle royale, dumping on any of the parties here. Even though no decision has been made yet, someone does have to make that decision. It is just how it is.

Yes, the government has the final say when it comes to "the good of the child". So while yes, parents should have control over what happens to their children, and that is even more crucial for First Nations people than for the rest of us, it only goes so far according to the law.

I don't envy the position that judge is in at all, and I expect it is a very difficult decision, given its precedent setting nature, the fact that the mother doesn't recognize the court, and the fact that the girl is 11, and while not an adult, old enough to speak for herself in some things. And of course, that she is facing almost certain death.

jas

NDPP wrote:

The most graphic indication of just how deeply we have already 'imposed our world view' is an elderly white man in a high backed chair pronouncing Canadian law on chemotherapy vs Jesus upon this indigenous cancer patient

Actually, we don't know that's it's about religious beliefs. The quote about Jesus (which was only one quote out of an interview) was from the Makayla case. And even in that case, the stated desire was to return to an indigenous care model.

People here will hone in on the religious aspect because that's what they want to find. Regardless of the party's religious leanings, as far as we know, it has nothing to do with the treatment decision in this case.

Unionist

onlinediscountanvils wrote:

Patients should have the right to refuse medical treatment.

They should, and they do, as far as I know. My question relates to parents.

 

jas

Unionist wrote:

They should, and they do, as far as I know. My question relates to parents.

Yes, that's what this is about. Fifty years ago, conventional wisdom was that native kids should be educated in missionary schools. Should parents have had the right to make education decisions for their children, even it meant not receiving an education?

And what if it's not just parents, but entire communities also supporting that decision? Should communities have the right to determine their own care models?

Maysie Maysie's picture

Yes, parents have the right to make medical decisions on behalf of their minor children. Are these decisions sometimes terrible decisions (in the opinion of others)? Yes. But some parents also physically and sexually abuse their children. And until they get caught and stopped, they continue to do so.

What's fascinating about this sad case is that Canadian settler judgement and the colonial ("We know what's best for you") mindset sure are selective when deciding what is and isn't a "horrible problem" in the Aboriginal community.

No potable water? Yawn.

High rates of suicide in remote communities? Whatevs.

Mouldy trailers for housing? Who gives a shit.

Schools and community centres in need of drastic repairs? Clearly they have mis-managed their community and need no intervention.

An individual family making a medical decision about their child? However much anyone inside or outside the community approves or disapproves? Oh My God, sound the alarm! Alert the media! Go to court! Crisis! Crisis!

In this case, having settlers, with their/our colonial mindsets, bicker over a single issue, a single example, is very typical, historical, hypocritical and pretty gross. 

Re. residential schools: Yes, it's better to NOT be educated in the settlers' ways than to be removed from your family, told your language and belief system are evil, told you're stupid, be beaten, raped, and sometimes murdered. I thought that would be obvious.

jas

Maysie wrote:

Yes, parents have the right to make medical decisions on behalf of their minor children. Are these decisions sometimes terrible decisions (in the opinion of others)? Yes. But some parents also physically and sexually abuse their children. And until they get caught and stopped, they continue to do so.

What's fascinating about this sad case is that Canadian settler judgement and the colonial ("We know what's best for you") mindset sure are selective when deciding what is and isn't a "horrible problem" in the Aboriginal community.

To be fair, the "Father knows best" proponents here think that Father knows best for all communities, not just racialized ones. Ironically, they have adopted this attitude from the very same religious mentalities they claim to despise.

Brilliant points though, and imo, settle the issue.

swallow swallow's picture

Maysie cuts to the heart of the bigger issue brilliantly. The Post, for one, is simply trying to whip up assimilationist hysteria. 

There is an Innu tent (shaputuan) set up this week near my workplace. [i]See us,[/i] the message goes from those spending the week in it. [i]See that we exist, that we still exist. See us as a people. And once you have, then let us be.[/i] And if we are going that way, like Smith has said, it means really listening and seeing, not making that conditional. 

Especially when the Children's Aid Society (now Brant Familyt Services), a highly interventionist organization, sees no reason to intervene. Especially when the child advocate says the 11-year old girl in question wishes to refuse treatment, and does not have enough information to say she in unable to make that determination herself. It's tricky, the advocate says. Yes, it's tricky. 

The court case is between different organziaitons in settler society, not against the Six Nations family. That's something, I guess. 

swallow swallow's picture

The community was attacked and battered at Six Nations, but not entirely crushed: it survives and has mechanisms to make decisions. I am thinking that the idea "parents decide" is (like the nuclear family) far more settler-colonialist than Six Nations - where clan mothers, uncles (mother's brother), established child advocacy institutions on-res, or some other mechanism, might have some claim to play a role. But who's to say they are not actually doing so in this case? Again, we dont know. 

jas

Unionist wrote:

Yes, they should.

But not a pair of parents making unfettered decisions for "their own" children - whether about health care, or education, or any other necessities of life. Not in a human society, IMO.

So you would agree with the position the Six Nations have taken?

Quote:
Next door at Six Nations, Chief Ava Hill said her band will continue to support the 11-year-old’s right to pursue traditional healing, including launching an appeal if the court decides in favour of the hospital.

“We’re going to support any of our community members in a decision to look after their own kids …,” she said. “We feel we have the right to use our own medicines.”

http://www.theglobeandmail.com/life/health-and-fitness/health/ontario-ho...

(PS: I understand you are undecided on which level of community should be able to make these self determinations. I'm just pointing out that your position opens up such a vast grey area that it would make it almost impossible to establish any self-determinate vs. intervention standards.)

onlinediscountanvils

Unionist wrote:

onlinediscountanvils wrote:

Patients should have the right to refuse medical treatment.

They should, and they do, as far as I know. My question relates to parents.

Well, if a patient's wishes are respected, their parents' wishes are irrelevant.

And thanks, Maysie, for that reality check.

Unionist

onlinediscountanvils wrote:

Well, if a patient's wishes are respected, their parents' wishes are irrelevant.

Sure, if the patient is mature enough to have wishes based on a decent amount of information.

If a 2-year-old needs a blood tranfusion because it has lost blood and will die without one, I think we need some other recourse than the patient's or the parents' wishes. Would you agree? I'm just not sure what that recourse should be in all circumstances. What I [b]am[/b] sure about is that it shouldn't be the inviolable right of the parents to decide.

onlinediscountanvils

My mistake. I assumed we were talking about Makayla Sault.

6079_Smith_W

Good coverage of this on today's episode of CBC "White Coat Black Art" - especially the last interview.

And yes, thanks Maysie. Though what does make this case important is that it will set a precedent. But the second-guessing and concern? Not really helpful, nor our business.

 

 

Sineed

Dr. Brian Goldman of CBC's "White Coat Black Art" addressed this case, and Makayla Sault, on his show this morning.

http://www.cbc.ca/radio/whitecoat/pastepisodes/makayla-s-choice-1.2809211

Sounds like the hospital bungled in its communications with both families. Dr. Goldman interviewed a representative from Six Nations, who said many of the things summarized by Maysie in post 41. As I mentioned previously, the treatment for ALL is one of the most harrowing in all of cancer care. When the children and their families started to express their doubts about the treatment on the basis of the horrible side effects, the hospital got all ham-fisted, threatening to assume custody of the kids if treatment wasn't continued. Naturally, the FN communities react with horror, and the National Post gets all "people are sacrificing their children on the altar of cultural correctness" kind of thing, like offering proper science-based medical care in a culturally sensitive way isn't possible, so people better give up on their antiquated cultures if they don't want their kids to die. Ridiculous.

And it all could have been avoided. There's no reason why modern medicine and traditional cultural healing practices can't exist side by side. At the institution where I work, we do this all the time. It's a matter of listening to the patients' concerns and showing respect for their perspectives.

The FN healers to whom I have spoken advocate for this side-by-side approach rather than exclusivity for one or the other.

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