A group of doctors and academics from across Canada say an Indigenous man who died while waiting for care in a Winnipeg emergency room in 2008 was killed by racism, and say the subsequent inquest into his death didn't address the real problem.
"Medicine and health always sees itself as benevolent and caring for people. It's not true for many Indigenous people, it's a violent encounter," said Dr. Barry Lavallee, a professor at the University of Manitoba and the director of education for the Indigenous Institute of Health and Healing/Ongomiizwin.
Lavallee is one of five members of the Brian Sinclair Working Group, which released an interim report and recommendations on Monday — nearly nine years to the day after the death of its namesake, Brian Sinclair.
Sinclair was 45 when staff at a community health care centre sent him to the Health Sciences Centre to have a catheter changed on Sept. 19, 2008.
Thirty-four hours later, Sinclair was found dead in his wheelchair, after waiting in the hospital's emergency room for more than a day without being seen.
In an inquest into his death, health-care workers from the hospital said they'd assumed Sinclair was drunk and "sleeping it off," had been discharged previously and had nowhere to go, or was homeless and had come to avoid the cold.
The final report, completed in 2014, concluded Sinclair's death was preventable and put forward 63 recommendations to overhaul the front end of Winnipeg's health-care services, including how patients in ERs are triaged and registered.
But the final report from the inquest stopped short of calling Sinclair's death a homicide, and did not echo the family's call for a public inquiry into how Indigenous people are treated in the health-care system.
Lavallee and his team say the inquest failed to address issues that are central to understanding Sinclair's story, criticizing its recommendations as largely leaving aside the unique health needs of Indigenous patients and voicing skepticism about inquests in general as being too narrowly focused on a single death rather than larger social patterns.
"The recommendations from the inquest itself did not and will not interrogate racism," Lavallee said on Monday at a panel discussion on the working group's interim report, Out of Sight, which concludes Sinclair's death was a result of racism in the health-care system.
"…The recommendations wholly have not done anything to protect Indigenous people, 10 years later."
'A wake-up call'
Réal Cloutier, the interim president of the Winnipeg Regional Health Authority, called the group's presentation a "wake-up call," and said the authority has worked to implement many of the recommendations from the initial inquest report in 2014.
"We all know Mr. Sinclair's death was preventable, and we failed Mr. Sinclair as a health-care system," he said. "…We need to understand that the perceptions we have, the assumptions we make about people all impact about how we deliver care to individuals, and we really have to come to terms that systemic racism has [an impact] on the way we deliver health-care services."
In its own report, the working group listed four interim recommendations, including calls on the federal and provincial governments to implement explicit anti-racism policies in health care, and the development of professional accountability strategies for repeated acts of racism.
Cloutier said he hadn't seen the new recommendations prior to Monday, but said he plans to go to the authority's board of directors to discuss the report and how to adopt its recommendations.
A provincial spokesperson wrote in an email the province is reviewing research into anecdotal reports of racism and discrimination in health-care services, and said the recently announced Shared Health Services will be developing "consistent health delivery standards."
The spokesperson said the province is committed to working with the Indigenous community to create long-term changes in health care.
"These kind of programs and services take time, sensitivity and sustained support for meaningful and transformative system change," she wrote.
"While progressing on challenging health system constructs has been slow, we are starting to see positive steps as we move forward."
Lavallee said so far, the group has had "minimal contact" from the WRHA, province and federal government. He said the overall goal of the group's recommendations is to eliminate anti-Indigenous racism throughout the health-care system.
"I think the hope is that there'll at least be some incremental steps, perhaps at a more rapid rate than not," he said.
"I'm going to remain a bit hopeful that maybe we could push it a little bit more at this point in time, but we need our allies in the system to actually come together with us."