The Canadian Medical Association (CMA) has announced significant updates to its Code of Ethics and Professionalism, aimed at combating anti-Indigenous racism and discrimination within the healthcare system. This campaign is just one step in the CMA’s larger Reconciliation Action Plan to restore this connection. Its purpose is to address the cumulative impacts of historical and ongoing inequities experienced by First Nations, Inuit, and Métis Peoples.
In September 2024, the CMA issued a formal apology for its role in perpetuating these harms in the health system. Dr. Alika Lafontaine, an anesthesiologist based in Grande Prairie, Alberta. He is the CMA’s Indigenous advisor in residence, and he is helping to craft essential reforms to the profession. He is currently participating in a public working group that is reviewing the Code.
The updated Code will emphasize trauma-informed care and cultural awareness training to better equip healthcare providers in addressing the unique challenges faced by Indigenous patients. Dr. Lafontaine was clear about the significance of this initiative. He explained, “Racism and discrimination have been in the corners, but now we’re realizing it’s under the whole system. We are combining this with a new effort to better empower patients to speak up when they feel they had a problem.
Additionally, the amended Code will acknowledge and help redress discrimination that Indigenous healthcare providers have experienced themselves. The CMA has been working to elevate the voices of communities of color, who experience racism and discrimination. Notable examples are the Black Physicians of Canada and Canadian Association of Physicians with Disabilities. This participatory process aims to mitigate those risks by creating a strong, adaptive framework. Its aim is to address structural racism across multiple U.S. communities in the public healthcare sector.
The CMA intends to publish a second version of the Code in early 2026. They’ve opened up a review process for stakeholders to give them feedback before they finalize those changes later this year. Dr. Lafontaine emphasized the need for an evolving ethical framework, noting, “Things that might have been viewed as ethical even 20 years ago may be seen as clearly unethical based on today’s practice and clinical standards. The Code must be a living document, reflecting core principles but the changing context for health care.”
These amendments have serious ramifications. Combined, they are poised to change the way in which the medical profession addresses Indigenous health for generations to come. Dr. Lafontaine shared concerns about existing disparities, stating, “What I’ve heard consistently from Indigenous patients is that their chance of having a negative health care encounter is much higher than it is for the general population.” He illustrated the systemic failures perfectly, talking about how patients with worrisome symptoms like chest pain can have dangerous long waits.
“I want people to come out of the process feeling like we have moved towards a better health care system of dignity and respect — one that addresses racist behaviour, acknowledges experiences of racism and is free from hostility.”
Through these initiatives, the CMA plans to continue to create a more equitable healthcare space for all Canadians.
