photo: flickr/Jasleen_Kaur

Please support our coverage of democratic movements by clicking here to become a monthly supporter of rabble.ca.

Brian Sinclair died in the emergency department of the Health Sciences Center in Winnipeg in September 2008. He had been referred there by a family physician. After being ignored by emergency room staff for thirty-four hours, he died of complications of a treatable bladder infection. This week, almost six years later, the inquest into his death is wrapping up. What recommendations will come out of the inquest remains to be seen, but problems with the process itself meant that key issues did not get the attention they deserved. This is a shame, because this case provided an important opportunity to talk about an issue that is too often ignored: systemic discrimination in our health care system. 

At a public forum held in Winnipeg this past April, it was clear that the harmful assumptions and negative stereotypes that were a factor in Brian Sinclair’s death are part of a widespread problem. Participants shared their own negative experiences as Aboriginal patients in the health care system. Health researchers explained that discriminatory assumptions frequently have significant effects on the range of decisions made in healthcare, including diagnostic and treatment decisions, and argued that it is incumbent upon the healthcare sector to acknowledge and counteract the negative effects of discrimination and racism in healthcare. 

At the inquest, many of the emergency room staff called as witnesses repeatedly said they were confident that racism was not a factor in how Brian Sinclair was treated because they “treat everyone the same”. The problem with this statement is that it ignores that racism is a foundational aspect of Canada’s colonial history. While some colonial structures have eased up or been somewhat rearranged, racist attitudes and beliefs about Aboriginal peoples have largely remained. There is no reason why the healthcare system can assume it is exempt from all the racist stereotypes and judgemental attitudes towards Aboriginal people. The Brian Sinclair case is not the first or only time that the healthcare community has been implicated concerning its treatment of Métis, Inuit and First Nations peoples. 

While Indian health services under the federal government has a long history of racially segregating and providing substandard health care for status First Nations peoples, provincial governments have a similar history of neglecting and racializing health care for Métis, Inuit and non-status First Nations peoples. This history has a profound legacy in our mainstream healthcare system today, and cases in which First Nations patients are neglected, patronized and otherwise treated as if they do not belong make this clear. Sadly, the failure to name and address racism in Manitoba allows for the repetition of this cycle and is often connected to a desire to make our past appear less violent and unjust than it really was. 

In response to the narrow focus of the Brian Sinclair inquest, leaders from the Aboriginal community, physicians and nurses, legal and academic scholars, and health researchers have come together to form an Expert Working Group. Our goals are to:

a) raise awareness of systemic discrimination in healthcare, and the harm this causes patients, and

b) engage health care policy-makers, professionals and educators in addressing the negative impacts of racism and discrimination in the health care system, and

c) foster dialogues to promote greater health equity for all Canadians. 

The Expert Working Group argues that the inquest facilitated staff at the healthcare system to vent their problems and working conditions, but it prevented Aboriginal representatives from examining the racialized conditions that lead to Sinclair’s death. The inquest continues to do so by continuously undermining an analysis of systemic discrimination/racism as a major factor in this case. While problems with ER are urgent, substantial and obviously must be addressed, these were not the only factors at work in Sinclair’s death. 

In the coming months, we will be developing recommendations to address the issue of systemic discrimination and build working relationships with healthcare professionals, educators and students in medical and nursing schools. We are determined to ensure that the opportunity to learn from the tragedy of Brian Sinclair’s death is not lost. 

This op-ed was composed by: Dr. Annette Browne, Professor Brenda Gunn, Dr. Emma LaRocque, Dr. Barry Lavallee, Dr. Josée G. Lavoie, Dr. Mary Jane Logan McCallum and Dr. Brenda Restoule are all members of the Expert Working Group. 

photo: flickr/Jasleen_Kaur

Please support our coverage of democratic movements by clicking here to become a monthly supporter of rabble.ca.