Practicing Medicine to Eliminate Anti-Indigenous Racism Part 1: Understanding and acknowledging racism exists

Following 16 months of development by a working group and several consultations with Indigenous organizations, individuals, registrants, partners and the general public, the Standard of Practice – Practicing Medicine to Eliminate Anti-Indigenous Racism was approved in December 2024. The Standard will be implemented as early as June 2025.

Racism directed against Indigenous Peoples in the health care system is researched, well-documented, and reported on both provincially and federally (the Standard includes contextual information and resources outlining this information).

Anti-Indigenous racism has impacts of varying degrees. In the most egregious of cases, it can end people's lives or result in delays to medical care that is essential for Indigenous people to be healthy and well.

Anti-Indigenous racism manifests across medical practice interpersonally through physician-patient interactions and is organizationally embedded through policies, procedures, and the structures that support the provision of health care. CPSM recognizes we are no exception, and for that reason, we have committed to actions. The Standard of Practice – Practicing Medicine to Eliminate Anti-Indigenous Racism is one of those actions.

The Standard is structured into three main principles. The first step is defining what anti-Indigenous racism looks like and what it feels like in the health system.

Key concept #1 of the Standard: Understanding what anti-Indigenous racism is, acknowledging it exists and its negative impacts on the health of Indigenous people.

The following provisions are covered under this section of the Standard to familiarize yourself with:

The mere exposure to racism causes psychological strain on the individual.

Psychological strain can lead to stress, feelings of loss of control, insomnia, fatigue or exhaustion, sadness, poor concentration and memory problems, irritability, and/or aggression. Because racism is often experienced as violence, it can trigger trauma responses in the person who is targeted. It can also manifest physiologically in the form of high blood pressure, heart disease, gastrointestinal problems, headaches, and back or neck pain.

Racism can trigger trauma responses in the person who is targeted.

To cope or manage racist experiences, individuals may develop adaptive and maladaptive strategies. These responses occur on a spectrum and can include everything from a reluctance to seek help until there is a crisis or leaving the emergency department without full assessment and treatment.

Systemic racism constrains and, at times, prevents access to health care.

The systemic barriers experienced by Indigenous peoples are diverse, ranging from racist institutional policies and geographic barriers to access and resource inequities, including poverty, food insecurities, and lack of safe housing. Further deterrents include the psychological strain resulting from racism received from other institutions and/or during medical treatment. CPSM recognizes ongoing examples of Indigenous-specific racism which lead to substandard care, including, but not limited to:

Failing to respect traditional medicine and/or acknowledge Indigenous health care practices as complementary to conventional medicine.

• Accepting or advancing stereotypical perceptions of Indigenous Peoples vis-à-vis alcohol, illicit drug consumption, or socioeconomic status.
• Inadequate treatment of pain based on racial profiling.
• Failing to demonstrate interest, respect, or humility understanding the context of patients’ Indigenous teachings, communications, lived experiences, and circumstances.
• Failing to take into account the reality of an Indigenous person’s social circumstances and adapt medical treatment plans accordingly. For example, advising care when knowing there may be a lack of access to that care in the patient’s community or refusing to provide care based on the patient's missed appointments, which may be beyond the control of the patient.

Support for the implementation of the Standard

Successful implementation of the Standard will rely on the Restorative Practices Program, which will launch simultaneously when the Standard goes into effect later this spring.

For some, this Standard may a shift in human behaviours which we recognize may lead to discomfort resulting from self-reflection and insight. The program is designed to be restorative in addressing, fixing, and preventing further harm.

The process is intended to empower individuals to do better and to alleviate the fear that engaging with CPSM will automatically and immediately lead to discipline.  

We look forward to sharing more details about the Restorative Practices Program launch soon.