Hymie Rubenstein is a retired professor of anthropology at the University of ManitobaThe Winnipeg Free Press, Manitoba’s largest newspaper, recently published an article titled “Manitoba’s MDs mandate steps to end anti-Indigenous racism.” If the headline is accurate, it’s a serious and troubling allegation — especially in a province with a large indigenous population.According to the 2021 census, Winnipeg has the largest indigenous population of any Canadian city, with 102,000 residents. Province-wide, 18.1 per cent of Manitoba’s population — or 237,190 people — identified as indigenous, the highest proportion in the country. There are also 63 registered First Nations bands in Manitoba, including six of the 20 largest.Yet despite these demographics, there is no compelling evidence of widespread or deeply entrenched racism against indigenous people by Canadian physicians..Yet, that hasn’t stopped Manitoba’s College of Physicians and Surgeons from mandating anti-racism training for all medical doctors by November 2027. The aim: eliminate anti-indigenous racism in health care. Two other measures also took effect on June 2 — a rule requiring doctors to report racist behaviour, and a “restorative practices program” for physicians found to have harmed First Nations, Métis or Inuit patients, intentionally or not.Dr. Ainslie Mihalchuk, the college’s registrar, defended the initiatives: “It is very difficult to practise medicine in Manitoba… without interacting with, supporting, [and] caring for people who have Indigenous ancestry… who have suffered the health effects of colonialism.”.That’s why, she argued, all doctors practising in Manitoba need “a baseline understanding of how colonialism impacts health.”What Mihalchuk failed to acknowledge is that colonialism — as it relates to internal indigenous affairs — effectively ended in 1867 with confederation, when Canada became a self-governing dominion and assumed full responsibility for indigenous peoples. The final constitutional ties to Britain ended in 1982.As for evidence of systemic racism today, the main support cited is a report by Manitoba’s provincial health authority and the University of Manitoba’s Ongomiizwin Indigenous Institute. It asserts that indigenous patients in emergency departments were disproportionately likely to leave before seeing a doctor — including those with potentially serious conditions..This is not, by itself, proof of racist treatment. It may reflect patient frustration, long wait times or cultural misunderstandings. Nonetheless, Mihalchuk spun the finding into bureaucratic jargon: “The data supports that we have opportunity to do better… [it] points to the fact that our systems are not serving these people in the best way.”The college’s justification rests largely on three high-profile cases. One is the 2008 death of Brian Sinclair, who died after waiting 34 hours without being seen by a doctor. But triage decisions are made by specially trained nurses, not physicians.A second example is the 2020 death of Joyce Echaquan in a Quebec hospital, where she recorded racist comments by staff shortly before dying. No physicians were involved. A nurse and an orderly were fired.The third is a vague reference to “experiments performed on [Indigenous] residential school students,” describing 1940s nutritional studies. These efforts — questionable by today’s standards — were not malicious and were conducted with the scientific and ethical frameworks of the time..Even if one grants that these cases are tragic, they do not justify sweeping charges against Canada’s entire medical profession.Manitoba doctors already have access to four college-approved anti-racism courses — three for practising physicians and one included in undergraduate or postgraduate training. Why the new, mandatory programs?Because, Mihalchuk said, the college’s indigenous advisory circle recommended new training and a move away from a “blame, shame, punish” approach and toward “restorative justice” instead.“It’s more about healing the harm and going through a process that keeps both parties… intact and whole,” she said. The shift implies a preference for indigenous modes of conflict resolution and spiritual reconciliation over traditional professional discipline.But how much of the perceived problem is racism — and how much is cultural difference?A 2024 Statistics Canada survey found that about one in five indigenous respondents said they experienced racism or discrimination from a health-care provider in the past year. But it didn’t define the nature of the discrimination. It’s likely that many of these claims stemmed from cultural misunderstanding, not racist intent..From an indigenous perspective, good medical care requires incorporating the patient’s values, traditions and social norms. The 2015 Truth and Reconciliation Commission’s final report urged Canada’s health-care system to recognize traditional knowledge and healing.This is not unreasonable — but it’s different than saying doctors are racist. Alleged racism may, in many cases, be a result of miscommunication or mismatched expectations, not malice or systemic bias.If that’s the case, both sides — indigenous patients and non-indigenous care providers — must adjust. True reconciliation, after all, is a two-way street.Hymie Rubenstein is editor of REAL Indigenous Report, a retired professor of anthropology at the University of Manitoba, and a senior fellow at the Frontier Centre for Public Policy.
