Indigenous Traditional Knowledge Remains Marginalized in Canada’s Healthcare System
As Canadians, we often take for granted that we have the right to decide what happens to our bodies. From diet and nutrition, to the courses of medication that we take or the surgeries that we undergo, we are accustomed to having a say in how we are treated and to being supported in those choices by our healthcare providers. Ric Richardson, a Métis man and the Mayor of the Métis community of Green Lake, Saskatchewan, is using his personal experiences to expose just how far this perception can be from the truth, particularly when it comes to Indigenous peoples who opt for treatment that involves traditional medicines and practices. Ric’s own story is also a powerful example about how the rights spelled out in UNDRIP are implicated in healthcare. Canada has committed to fully implementing UNDRIPS, having finally removed its permanent objector status in May of 2016.
On February 13, 2017, Ric was diagnosed with terminal lung cancer. He attended the Saskatoon Cancer Centre to determine the availability of treatment options. An oncologist informed Ric that his only option was chemotherapy and that he was to be scheduled for a PET Scan. On April 6, 2017 Ric met with a radiation specialist at the Saskatoon Cancer Centre, who recommended a combination of radiation and chemotherapy. After carefully considering the range of negative side effects that come from both forms of treatment, Ric decided to reject chemotherapy and embrace traditional Indigenous medicines, which his wife, Rose, knows extremely well. While this decision was respected by his family physician, Dr. Babkis of the Meadow Lake Associate Clinic, the Saskatoon Cancer Centre construed Ric’s choice as a refusal of treatment. They informed him because he had chosen traditional medicine, no care, or monitoring of the progression or regression of his cancer would be offered – The Centre refused to even track whether his treatment was working or if the cancer was getting worse. Ric has since developed a plan of action that involves moving forward in a positive and collaborative manner with the Agency. A representative from the Agency has expressed appreciation for the challenges involved in building a more integrated approach to healthcare and healing that engages both traditional and conventional “modern” medicines.
Ric’s wife, Rose Richardson, is a well-respected Métis elder and medicine woman with a degree in education. She has lived in Northern Saskatchewan most of her life, speaks Cree fluently, and acquired her intergenerational Traditional Knowledge and medicine teachings from her mother and others in her community. Rose has been recognized as an “elder validator” by Christine Belcourt in her book Medicines to Help Us. Rose is frequently called upon to speak at different gatherings because of her Traditional Knowledge (TK), as she is one of the few medicine persons left in Canada who continues to preserve, protect and promote Indigenous cultural beliefs and practices as a medicine person.
In 2016, Canada adopted the United Nations Declaration on the Rights of Indigenous Peoples (UNDRIP). At the time, Carolyn Bennet, the Minister of Indigenous and Northern Affairs said that Canada is “now a full supporter of the declaration, without qualification” and that Canada “intend[s] nothing less than to adopt and implement the declaration in accordance with the Canadian Constitution.”
With its adoption, the UNDRIP now binds Canada and its provinces to ensure Indigenous peoples have the right to:
- full enjoyment of all human rights (Article 1)
- not be subject to the forced assimilation or destruction of their culture (Article 8)
- belong to an Indigenous community in accordance with their customs and traditions without discrimination (Article 9)
- practice cultural traditions and customs (Article 11-12)
- practice traditional medicines and health practices “without any discrimination to all social and health services.” (Article 24
Rights to healthcare are also prescribed by the treaties in place throughout Canada, which Canada has a Constitutional obligation to uphold in its relations with Indigenous peoples. In CIGI’s Special Report: The Internationalization of Indigenous Rights UNDRIP in the Canadian Context, Chapter “Indigenous Health Governance and UNDRIP,” Bonita Beatty reviewed Treaty 6 (which covers most of modern-day Saskatchewan) and explained how it may be interpreted to support rights to culturally-appropriate health care:
Federal responsibility over First Nations health is broadly identified in the medicine chest clause of Treaty Six (1876), even though the federal government rarely acknowledges Aboriginal and treaty rights in health funding agreements, preferring to address them as policy position (Boyer 2003). While the scope of federal responsibility has been a matter of ongoing debate between federal and provincial governments, First Nations interpret the provision to mean comprehensive medical services, the full “basket” or, in Cree, “mewut” (Cardinal and Hildebrandt 2000). Further, First Nations hold that the section 35 Aboriginal and treaty rights in the Canadian Constitution include health rights (Boyer 2003). At the time of treaty negotiations, the elders and leaders were worries about the future of their descendants following European colonization, which devastated Aboriginal communities and traditional ways of life.
Ric’s UNDRIP and aboriginal rights, as outlined above, were infringed when he was refused care or even basic monitoring of the progression of his cancer after he opted to utilize traditional medicine and practices. While the situation has since been rectified by the Saskatchewan Cancer Agency, it raises important questions about the way Western medicine fails to acknowledge or respect Indigenous rights at a system-wide level and suggests greater need for Indigenous health institutions and practitioners.
These institutions and mechanisms must be Indigenous-led and rooted in the same Traditional Knowledge and practices which are used to heal. In the Special Report from CIGI, Bonita Beatty argued that under UNDRIP, Canada is obliged to uphold both individual and collective health rights of Indigenous peoples, empowering them to build and maintain their own health institutions and systems toward improving their well-being.
There are already some examples of how these institutions might work. For example, the Southwest Ontario Aboriginal Health Access Centers are “innovative, Aboriginal specific, Indigenous informed health care agencies” which provide health and social services to First Nations, Metis and Inuit communities throughout Ontario from a “holistic Aboriginal health framework which is often referred to by Aboriginal people as “the good life” or as restoring the “good mind”.” These services include
- traditional healing
- primary health care
- health promotion services
- cultural programs
- community development initiatives
- social support services.
The model of care recognizes Aboriginal rights to determination in health, and Aboriginal traditional healers and healing approaches, and blends them with culturally competent, Western clinical practices to address prenatal and maternal care, primary care, mental health, addictions and chronic disease prevention and management.
While it is important that there are healthcare institutions built from the foundation of Indigenous traditions and traditional knowledge of medicines, these institutions are not available to all who would like to use them services for a range of reasons. In these cases, it is imperative that Western medical services respect and work with Indigenous traditional medicines and practices and those, like Rose, who have deep knowledge, while also ensuring that there is greater accountability within the healthcare profession for the response to those who opt for traditional remedies. Ric’s case is a living example of Martha Jackman’s argument for a human rights approach to healthcare accountability. Jackman suggested institutions must be created with enforceable mechanisms to require governments to respect health care rights:
what is required, moving forward, is not only the recognition that healthcare is a fundamental right, but the creation of institutions and mechanisms capable of enforcing that right at both the access to care and system performance levels.
Human rights accountability also calls for enforceable mechanisms for requiring governments and their delegates to explain and justify their decision-making; for imposing sanctions or ordering remedies where governments’ action or inaction violates right to health care guarantees; and for enabling the participation of affected individuals and groups throughout.
Ric’s story originally appeared in CBC and was detailed here with his permission.