Smith, Preston

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Canadian	Medical	Education	Journal	2018,	9(3)		Correspondence:	Preston	Smith	email:	preston.smith@usask.ca	e107	Canadian	Medical	Education	Journal	Commentary	Commentary:	A	settler	physician	perspective	on	Indigenous	health,	truth,	and	reconciliation	Preston	Smith1		1Faculty	of	Medicine,	University	of	Saskatchewan,	Saskatchewan,	Canada	Published:	July	27,	2018	CMEJ	2018,	9(3):e107-e108		Available	at	http://www.cmej.ca	©	2018	Smith;	licensee	Synergies	Partners	This	is	an	Open	Journal	Systems	article	distributed	under	the	terms	of	the	Creative	Commons	Attribution	License	(http://creativecommons.org/licenses/by/2.0)	which	permits	unrestricted	use,	distribution,	and	reproduction	in	any	medium,	provided	the	original	work	is	properly	cited.	Jaworsky’s	 brief	 commentary,	 A	 settler	 physician	perspective	 on	 Indigenous	 health,	 truth	 and	reconciliation1	is	a	superb,	 thoughtful,	and	powerful	appeal	 for	progress	on	 the	Truth	and	Reconciliation	Commission’s	Calls	to	Action,	most	specifically	18	-24.	The	title	and	the	introduction	start	in	the	right	place	with	an	immediate	focus	on	the	author’s	identity	as	a	settler	physician.	How	we	see	ourselves	determines	how	we	see	others	and	 is	an	essential	step	towards	recognizing	 that	 “First	 Nations,	 Inuit,	 and	 Metis	peoples,	as	the	original	peoples	of	this	country	and	as	self-determining	 people	 peoples,	 have	 Treaty,	constitutional	 and	 human	 rights	 that	 must	 be	recognized	and	respected.”	2	My	own	Canadian	identity	was	comfortably	rooted	in	an	 Irish	heritage	with	 immigration	 to	Canada	 in	 the	context	 of	 The	 Great	 Famine	 and	 English	 tyranny.	Those	 oppressed	 ancestors	 became	 oppressors	 as	participants	in	colonization	and	I	and	the	institutions	I	 represent	 continue	 to	have	a	 “role	 in	 the	ongoing	oppression	 of	 Indigenous	 peoples.”1	 Beginning	with	that	 recognition	 I,	 medical	 schools,	 and	 all	 of	Canadian	 healthcare	 can	 move	 on	 to	 the	 author’s	next	three	action-oriented	recommendations.		The	 author’s	 first	 recommendation	 is	 for	 education	and	 amplifies	 the	 statement	 by	 the	 Honorable	Senator	 Murray	 Sinclair,	 Chief	 Commissioner	 of	Canada’s	 Truth	 and	 Reconciliation	 Commission	“Education	 has	 gotten	 us	 into	 this	 mess,	 and	education	will	get	us	out.”		Jaworsky	takes	this	even	further	by	emphasizing	that	only	by	confronting	and	embracing	truth	will	we	move	to	reconciliation.		Jaworsky	calls	for	medical	educators	to	include	in	our	teaching	of	the	social	determinants	of	health	“a	frank	description	 of	 the	 historical	 realities	 of	 settler	colonialism	 in	 Canada”.1	 This	must	 go	 far	 beyond	 a	brief	 history	 of	 residential	 schools,	 start	 with	education	about	the	history	and	health	of	Indigenous	peoples	prior	 to	 the	 fifteenth	century	and	chronicle	the	 subsequent	decline.	 	A	 superb	 required	 reading	might	 be	 “Clearing	 The	 Plains	 –	 Disease,	 Politics	 of	Starvation,	and	the	Loss	of	Aboriginal	Life”	by	James	Daschuk.	The	CanMEDS	Health	Advocate	role	states	“advocacy	requires	action”3	and	Jaworsky	clearly	calls	on	us	to	practice	what	we	teach	in	service	provision,	cultural	safety,	 and	 engagement	 of	 Indigenous	 peoples	 in	their	healthcare.	Jaworsky	calls	on	all	physicians	but	the	TRC	is	even	more	explicit	 in	calling	on	all	“those	Canadian	Medical	Education	Journal	2018,	9(3)		 e108	who	 can	 effect	 change	 in	 the	 Canadian	 healthcare	system”2	 and	medical	 schools,	 in	 particular,	 to	 lead	and	 drive	 the	 change	 so	 that	 “we	 may	 finally	 find	ourselves	 on	 a	 path	 towards	 reconciliation	 in	healthcare.”2		Jaworsky	 exhorts	 us	 that	 own	 individual	 and	collective	actions	can	positively	change	the	future	of	healthcare	for	Indigenous	people.	We	need	to	do	this	for	our	Indigenous	patients,	communities,	colleagues,	residents	 and	 students.	 We	 need	 to	 create	 safe,	respectful	 spaces	 to	 dialogue	 about	 racism	 and	inequity	in	healthcare.	And	we	must	respect,	support	and	 listen	 to	 Indigenous	 people	 as	 they	make	 their	voices	heard.	Change	is	a	team	sport!	References	1. Jaworsky	 D.	 A	 settler	 physician	 perspective	 on	Indigenous	 health,	 truth,	 and	 reconciliation.	CMEJ.	2018;9(3):101-6.		2. Truth	and	Reconciliation	Commission	of	Canada.	Truth	and	Reconciliation	Commission	of	Canada:	Calls	to	Action	3. Frank	 JR,	 Snell	 L,	 Sherbino	 J,	 editors.	 Can	Meds	2015	Physician	Competency	Framework.	Ottawa:	Royal	 College	 of	 Physicians	 and	 Surgeons	 of	Canada;	2015.													

Commentary: A settler physician perspective on Indigenous health, truth, and reconciliation

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Commentary: A settler physician perspective on Indigenous health, truth, and reconciliation

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