Experts from within and without Indigenous communities say the coroner's report into Joyce Echaquan's death validates what they've been saying for years: that systemic racism in Quebec health care must be acknowledged and addressed.
Coroner Géhane Kamel's top recommendation in her report is that the province recognize such racism exists and take concrete action to eliminate it.
The report, released Friday, also says racism and prejudice contributed to the Atikamekw woman's death, although the cause of death — pulmonary edema — was ruled accidental.
Echaquan died last September at a hospital north of Montreal, moments after she recorded footage of herself in hospital as health-care staff hurled racist remarks at her.
Premier François Legault has repeatedly denied the existence of systemic racism in Quebec.
Sen. Michèle Audette, a former commissioner on the National Inquiry into Missing and Murdered Indigenous Women and Girls, said she was happy the report made recognizing the existence of systemic racism a priority.
"I was hoping to read something like this," she said. "Those words resonate in my heart, in my spirit. They're very important."
She says recognition will ensure racist policies aren't recreated in new programs or laws. "I think it's a legal imperative that we need to say that it exists here, and it exists anywhere else here in Canada," Audette said.
Innu surgeon Dr. Stanley Vollant, who works at Montreal's Notre-Dame hospital and who testified at the Echaquan inquiry, said the report's recommendations give Indigenous people more tools to convince the Quebec government to acknowledge the existence of systemic racism.
He urged Legault to stop denying there is a problem.
"Just do it," he said. "You will be stronger."
Vollant said he's optimistic there will be changes even though, he noted, the Viens report on Quebec's treatment of Indigenous peoples made similar recommendations nearly four years ago.
Dr. Samir Shaheen-Hussain, a pediatric emergency physician who also testified at the inquiry, says the Legault government should adopt Joyce's Principle, a series of measures drafted by Echaquan's Atikamekw community after her death.
Its recommendations include improving what is taught in the education system about Indigenous people, to eliminate racist bias and prejudice.
By adopting Joyce's Principle, the government will be able to take concrete steps to make sure what happened to Echaquan never happens again, said Shaheen-Hussain, who is also an assistant professor at McGill University, where he studies colonialism and racism in medicine.
"The government needs to show a bit of maturity and a bit of leadership instead of dividing the population on this question," he said.
The coroner's report adds credibility to the growing number of voices calling on Legault to backtrack on his previous comments said Richard Budgell, an Inuk professor of practice of Inuit and Northern health promotion in the department of family medicine at McGill.
"I think it would be a very good sign if the premier has the humility and the humanity to say that he has been wrong about this issue," he said.
Budgell highlighted several other recommendations in the report — such as training health professionals about Indigenous people and culture — would lead to a "higher degree of cultural safety for Indigenous patients in the system."
"This is a systemic issue. Changing systems is not easy, but it requires consistent work and a consistent engagement and commitment to making the kind of change that is necessary to ensure that Indigenous people and communities in this province are treated as equals," he said.
'Doing everything that's possible'
Speaking with reporters on Friday, Geneviève Guilbault, the deputy premier and minister of public safety, said her government has always recognized that racist people exist in Quebec, but fell short of acknowledging the existence of systemic racism.
"What we want to do, and what we are actually doing, is to fight as concretely as possible against racism by actions, by communication," she said.
"We are doing everything that's possible to make sure that what happened to Mrs. Echaquan, to take this very dramatic example, will not happen again."
Health Minister Christian Dubé said the province had been taking actions to remedy the situation, but he declined to comment further until he had time to read them.
Legault has declined to comment until Tuesday, when Kamel will hold a news conference to present her report.
Echaquan's family and community, and the Lanaudière health authority also declined to comment until then.