EPISODE 032001–2020 · Canada · Indigenous and Black patients

Saskatoon · Winnipeg · Joliette · Regina · Moose JawThe Canadian medical profession processes Indigenous and Black patients

The substantive treatment of three of the deaths referenced here is in Case 09. The treatment here is at the level of the profession and its regulators, not the individual deaths.

Between 2005 and 2010, the Saskatoon Health Region operated a postpartum tubal-ligation policy under which Indigenous women have, on the public record, said they were coerced into signing consent forms during or immediately after labour. A 2017 external review by Senator Yvonne Boyer and Dr. Judith Bartlett documented the pattern in the Saskatoon Health Region; the Saskatoon Health Region apologized.9 A class-action lawsuit was filed in 2017 on behalf of two Saskatchewan women and has since grown to approximately one hundred plaintiffs alleging coerced sterilizations between 1970 and 2018.10 One plaintiff, Sylvia Tuckanow, has testified before a Senate committee that she was sterilized against her will after giving birth in July 2001 at the Royal University Hospital in Saskatoon.11 A subsequent case from December 2018 at a Moose Jaw hospital — known on the public record as DDS — was investigated by the Saskatchewan Health Authority after the woman's lawyer testified to the Senate committee on human rights.12 Senator Boyer has estimated, on the basis of available data, that at least 12,000 women have been affected since the 1970s.13

The three deaths examined in Case 09 — Brian Sinclair (Anishinaabe, Winnipeg, 2008), Joyce Echaquan (Atikamekw, Joliette, 2020), and Samwel Uko (Black, born in what is now South Sudan, refugee to Canada in 2005, Regina, 2020) — each involved a Canadian hospital and the operational conduct of physicians, nurses, and security staff working under the credentials and authority of their respective provincial colleges. The first two were Indigenous; the third was Black. In none of the three cases did the relevant provincial College of Physicians and Surgeons strip the licence of any physician on grounds of racism as a contributing factor. In each case, the operating health authority retained its institutional standing. The substantive question of whether systemic racism in Canadian healthcare contributed to the deaths is, on the formal state record, answered as follows: by Manitoba — no formal finding; by Quebec — yes, with the finding refused by the provincial government; by Saskatchewan — no formal finding, question distributed forward across training. The 2020 British Columbia In Plain Sight report, led by Mary Ellen Turpel-Lafond, documented Indigenous-specific racism in BC healthcare as a structural feature, not an aberration.14

What the credential supplied: the operational continuation. Each of the deaths and each of the documented coerced sterilizations occurred under credentials administered by self-regulating provincial colleges. The colleges, the health authorities, and the medical schools each survived. The licences continued. The instrument that enabled the original treatment — the credential, applied by the institution that holds it — was, on the available record, not the instrument that examined the treatment afterward.

EPISODE 042023–2026 · Canada · COVID in healthcare settings

Provincial CMOH · health authorities · colleges · CMAMasking is dropped in healthcare while transmission continues

In April 2023, British Columbia and Saskatchewan became the latest Canadian provinces to lift universal masking mandates in healthcare settings; by that date, the majority of Canadian healthcare facilities had already dropped their mandates.15 The policy shift was led at the provincial level by Chief Medical Officers of Health and provincial health authorities, ratified — in the sense of not being contested — by the provincial Colleges of Physicians and Surgeons, and absorbed by the Canadian Medical Association without sustained institutional opposition. Independent surveillance, including wastewater monitoring and the work of Health Canada's own data systems, continued to record substantial COVID transmission through the 2023–24 and 2024–25 winters, with the winter 2023–24 surge documented as the second-highest peak of U.S. transmission by external researchers.16

Healthcare-acquired COVID infection in patients admitted for unrelated reasons has continued to be documented in the Canadian peer-reviewed literature. Immunocompromised and disabled patients have continued to report, in public testimony and patient-advocacy submissions, being unable to access necessary care safely. Physicians and nurses who advocated publicly for the restoration of universal masking in healthcare — Dr. Nili Kaplan-Myrth in Ottawa being the most prominent Canadian example — have faced sustained professional and public pushback, including harassment and complaints processes.17 Provincial colleges that issued disciplinary warnings to physicians spreading "misinformation" during the pandemic applied that authority asymmetrically: physicians who advocated against vaccination or in favour of unproven treatments received college attention; physicians who advocated for continued protection of immunocompromised patients in clinical settings, where the airborne-transmission science has been settled since at least 2021, did not receive comparable college attention for that advocacy.

What the credential supplied: the cover for a policy choice made on operational and economic grounds. Continued masking in healthcare would have imposed continuing costs — staff time, supply, the politics of being the institution that "still" required masks. Dropping it imposed costs on a different population — immunocompromised patients, who could be told that the decision was a medical one, not an operational one, because medical authorities had endorsed it. The credentialed voice was supplied to a policy whose primary determinants were not medical.