Forced sterilizations: educational work among doctors to be done, says the CMQ

A year and a half after the release of the Basile-Bouchard report on the imposed sterilizations of First Nations and Inuit women in Quebec, a think tank from the College of Physicians of Quebec (CMQ) composed of three Aboriginal people and three non-Aboriginal people published its own report (New window) and proposed an action plan so that “these practices cease once and for all”.

In its approach, the think tank – which includes researcher Suzy Basile, president of the CMQ, Mauril Gaudreault, two of the doctors who are members of the College’s board of directors, the general director of the FNQLHSSC, Marjolaine Sioui, and the surgeon Stanley Vollant – observed that significant education and awareness work is necessary, both among doctors and the general public.

In the introduction to their report, the members of the think tank recalled that the moving testimony of the 35 indigenous women in the Basile-Bouchard report reporting forced sterilizations and obstetric violence suffered between 1980 and 2019 could very well be only the tip of the iceberg.

In an interview, Dr. Gaudreault indicated that it was imperative to restore lost trust between Indigenous patients and doctors.

Basile, there are no indigenous women who have suffered these acts who have made reports to the College. And why? Because they don’t have confidence in us, in our system, and have the impression that it won’t achieve anything”,”text”:”Before the publication of Ms. Basile’s report, there were no women indigenous people who have suffered these acts who have made reports to the College. And why? Because they don’t trust us, in our system, and have the impression that it won’t work”}}”>Before the publication of Ms. Basile’s report, there were no indigenous women who had suffered these acts who made reports to the College. And why? Because they don’t trust us, in our system, and have the impression that it won’t work.explained Mauril Gaudreault.

Among the seven recommendations made in the report, we first count the implementation of a rigorous action plan to tackle the issue of sterilizations and terminations of pregnancies imposed on First Nations and Inuit women.

For the president of CMQit is only one step among others that we will have to take, to regain the confidence that we have lost.

The report also plans to establish training on the cultural security of health care in the fall. This will be mandatory for medical inspectors and investigators who work at the College of Physicians, but optional for its other members.

This is what we decided this year, but we could make it compulsory for everyone in the future, if we see that it is necessaryindicated Dr. Gaudreault.

He explains that he himself learned a lot during the process of creating the training, in which he participated with 23 other people, indigenous and non-indigenous.

years in Chicoutimi, I know that I have already had reasoning that came from my biases. For example, it happened to see a native in the emergency room who was confused and we were convinced that they were intoxicated when often this was not the case”,”text”:”We all biases. During my practice for 40 years in Chicoutimi, I know that I have already had reasoning that came from my biases. For example, we happened to see a native in the emergency room who was confused and we were convinced that they were intoxicated when often this was not the case”}}”>We all have biases. During my practice for 40 years in Chicoutimi, I know that I have already had reasoning that came from my biases. For example, it happened to see a native in the emergency room who was confused and we were convinced that they were intoxicated when often this was not the case.he says.

For him, the sterilization imposed on indigenous women was caused by ignorance and prejudice.

The doctors who made the decision to sterilize indigenous women without their knowledge, I think they had thoughts like: “She has enough children and in any case, some of her children will be taken care of by the DPJwhy don’t we stop this?”

A preamble to the Code of Ethics for Physicians will also be added, which is presented as follows in the report. The cultural, Western and patriarchal origins of medicine in Quebec may be responsible for biases in the construction of the health and social services network, care structures and the practice of medicine..

There was talk of changing the definition of free and informed consent, but that would have taken time. We opted instead for the preamble and, in my opinion, it will have more impact because it will color all the articles that followhe explains.

A revealing survey

To better understand where doctors stand on the issues of free and informed consent, the CMQ sent a survey to all doctors in Quebec on June 16, 2023.

Of the lot, 361 of them responded to the survey, a sample that the College considers to be representative of the medical community.

The doctors’ responses showed that only a third of them (35%) knew of the existence of the Basile-Bouchard report on sterilizations imposed on indigenous women. Eight in ten (83%) respondents agreed with the adoption of a rigorous plan related to this issue and 55% believed that offending doctors should be subject to disciplinary complaints.

The report explains that the survey resulted in a abundance of commentswhich were then analyzed, revealing the existence of biases, both implicit and explicit among the respondents.

Several of them recognized the problem of imposed sterilizations and terminations of pregnancies [bien que] some justified it using arguments of a medical nature or by evoking the social context.

Comments to the survey also revealed that many others denied the existence of the problem, believing that this was an extreme generalization or that these events belonged to the past.

Another fact caught the attention of the reflection committee and would benefit from being in depthi.e. the fact that 26% of responding doctors stated CMQ”,”text”:”that they would hesitate to report a problematic situation [où le consentement de femmes autochtone n’était pas respecté] at CMQ”}}”>that they would hesitate to report a problematic situation [où le consentement de femmes autochtone n’était pas respecté] At CMQ.

With information from Carla Oliveira