British Columbia is investigating allegations health-care staff in emergency rooms were playing a “game” to guess the blood-alcohol level of Indigenous patients, behaviour officials describe as an overt example of widespread, deep-rooted racism across the field of health.
Provincial Health Minister Adrian Dix made the accusations public during a news conference on Friday, after hearing about the allegations late Thursday.
“If true, it is intolerable, unacceptable and racist,” Dix said.
Métis Nation British Columbia (MNBC), the governing body for Métis in B.C., later said health-care staff called the game “The Price Is Right.” Physicians and nurses try to guess the blood-alcohol level of incoming patients they presumed to be Indigenous as closely as they could, without going over.
Dix declined to identify the hospitals or health authorities being investigated. He would not clarify whether staff involved are suspended or still at work.
If the allegations are true, such behaviour would have “affected profoundly patient care,” Dix said.
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Mary-Ellen Turpel-Lafond, a former judge and longtime children’s advocate in B.C., has been appointed to investigate “the facts of the issue” and make recommendations to the province.
Dix did not give a timeline for Turpel-Lafond’s investigation, but said she is starting her work “immediately.”
Turpel-Lafond said she is aware of one incident involving “a range of people,” however, at least one health authority in B.C. will be investigated to see how pervasive the “game” is and to possibly review other, similar incidents of racism in the health-care system. She said other health authorities could also be investigated depending on the results of the initial investigation.
“Clearly, if there’s any workplace in British Columbia where people are playing games at the health or expense of Indigenous people, one can only expect someone in those roles to face severe consequences,” she said.
Turpel-Lafond said she is looking to release a statement about her plan for investigation to the public next week, but did not offer a timeline to complete her work.
Documented history of racism in health care
The allegations Friday come as little surprise to health-care professionals and members of the public.
MNBC CEO Daniel Fontaine said he heard about the game after a health-care worker told leaders about it during the Provincial Health Services Authority’s (PHSA) San’yas Indigenous Cultural Safety Training. Fontaine informed the provincial government this week, triggering Friday’s news conference.
Fontaine said the game is widespread and “very pervasive,” but only a fraction of the problem.
He cited a 2019 report which catalogued 15 pages of “shocking and disturbing” incidents of racism and discrimination against Indigenous people across various sectors of the health-care system in B.C.
He said examples within that study “are equally as egregious” as the game described on Friday.
“There is something seriously wrong here besides The Price is Right. The Price is Right is just one game,” Fontaine said.
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The College of Physicians and Surgeons of B.C. reacted to the news conference in a statement, writing “the allegations suggest conduct that is absolutely inexcusable for any health-care provider, especially in emergency rooms where people are most vulnerable and rely on medical professionals to care for them in their time of need.”
“The College extends its full support to the investigation. If it results in findings of racist conduct involving a physician or surgeon (registrants of this College), the College would take swift action to open its own investigative file into the matter.”
The Hospital Employees’ Union also issued a statement on Friday afternoon, expressing their support for the investigation.
“Racism is deeply ingrained in many of our institutions including our health care system,” the statement read in part.
“Health authorities and all who are charged with delivering care must double down on efforts to confront and combat the poison of anti-Indigenous racism.”
Harmful behaviours by staff
Another 2015 study, which was national in scope, found racism against Indigenous people in the health-care system was a major factor in poorer health among Indigenous people across Canada.
The study, called First Peoples, Second Class Treatment, said the inequality between Indigenous and non-Indigenous health is rooted in colonialism, particularly government policies around segregation and residential schools.
The research suggested Indigenous people experience so much racism from health-care workers, they often strategize ahead of time how to deal with the behaviour before visiting emergency departments or avoid hospitals altogether.
In 2017, a joint presentation from the First Nations Health Authority and the BC Patient Safety & Quality Council said experts found more than 3,800 examples of stereotyping against Indigenous people in 2014, with “alcoholic” being the most common.
Harmful behaviours by staff included misdiagnosis, delay or denial in service, “improper procedure” and withholding of pain medication for Indigenous patients. People have died after receiving inadequate care.
The Canadian Public Health Association said in 2018 those who experience racism “exhibit poorer health outcomes, including negative mental health outcomes, negative physical health outcomes and negative health-related behaviours.”
Health Minister Dix said he will be reaching out to Indigenous leaders in B.C., especially in health care, as well as FNHA about the recent allegations.
Doctors of B.C., an organization representing physicians in the province, and the B.C. Nurses Union both said they support the investigation.