The coroner’s report on the death of Joyce Echaquan has been released and it calls for the government of Quebec to recognize and eliminate systemic racism.
The 37-year-old Atikamekw mother of seven sent shock waves around the world by live-streaming the racist taunts of hospital caregivers in Joliette, QC shortly before her death.
Since her death, her home community of Manawan First Nation has been calling for the adoption of Joyce’s Principle which demands that Quebec acknowledge systemic racism among other things.
Quebec’s ruling Coalition Avenir Québec (CAQ) has agreed to adopt several aspects of the principle but has repeatedly declined to acknowledge systemic racism exists.
Quebec provincial police have concluded that Echaquan’s death was not the result of a criminal act.
The coroner report concludes that Echaquan’s “clinical situation could have been reversible” if the following had taken place:
- there had been increased supervision by an experienced nurse or failing that, a faster transfer to the intensive care unit had been made.
- an assessment by the doctor responsible for medical hospitalizations had been made taking a different approach before allowing a new tranquilizer;
- monitoring of the restraint used on Echaquan had been put in place as prescribed;
- early recognition of her precarious state had been detected;
- a protocol had been in place for the early launch of a code blue [medical emergency alert to staff];
- cardiac monitoring and had been installed.
The corner report states that Echaquan died of a lack of oxygen in her bloodstream likely due to cardiomyopathy (chronic heart disease).
Aside from the acknowledgment and elimination of systemic racism, the Quebec coroner’s report lays out several other recommendations to other public bodies.
They recommend that the Lanaudière Integrated Health and Social Services Center (who oversee the hospital where Echaquan died):
- Ensure the integration of a liaison officer from Manawan First Nation (Echaquan’s home community) into the hospital.
- Ensure a collaboration between the Manawan clinic and the emergency department of the Joliette Hospital so that medical information concerning the patient is transmitted in real-time.
- Ensure that the notes in the medical file reflect the reality of the care of a patient.
- Review its nurse and patient ratios based on standards recognized at the provincial level in order to offer safe services to the population.
- Apply an emergency management model based on the guiding principles of the Emergency Management Guide.
- Maintain periodic training in the hospital’s code of ethics, restraint measures, patient surveillance and record keeping.
- Quickly set up training and activities for the inclusion of Indigenous culture in concert with the community of Manawan.
- Perfect the nurse /nursing assistant collaboration model and ensure that each understands their role.
That the Collège des médecins du Québec review the quality of the medical acts of the doctor responsible for hospitalizations in family medicine and the resident in gastrology who provided care to Ms. Echaquan during her hospitalization in September 2020.
The report also recommends that the Order of Nurses of Quebec:
- Examine the quality of the services of the nurses who provided care to Ms. Echaquan during her hospitalization from September 26 to 28, 2020;
- Reviews the integration practices of college-level nursing candidates in hospital emergencies across the province.
The report also recommends that the Ministry of Higher Education ensure that colleges and universities who train doctors, nurses, and nursing assistants:
- Include in the curriculum training on the care of Indigenous patients that takes into account the realities of Indigenous communities.
- Establish with Indigenous communities more opportunities for internships for both nurses and medical residents.
The full coroner report can be read here: Quebec Coroner Report
Anniversary week marked by political sparring
While moments of silence were held across the province in respect for the late Joyce Echaquan on Wednesday – the quiet didn’t hold long in Quebec’s national assembly.
Premier Francois Legault was chided by the speaker of the house in the National Assembly after he accused opposition leaders of trying to “win points” by implying the province’s recently-tabled language legislation feeds “systemic racism.”
“I am a nationalist,” Legault told reporters at a press conference held on Sept. 29. “I will never accept, never – either from Justin Trudeau or from Greg Kelley that we put together the Bill 21, the Bill 96, and racism, and something – I don’t know the word [for] what happened to Joyce Echaquan, which is unacceptable.”
The National Assembly remarks, and Legault’s subsequent press conference prompted AFNQL Regional Chief Ghislain Picard to comment on Facebook “our schoolyards have more civicism than that.”
“It just goes to show that they have no idea of the depth of First Nation issues,” Picard wrote on September 30th. “It is an insult that they have become the reason for small and partisan politics.”
In their own, separate press release, the Conseil de la Nation Atikamekw (CNA) decried the “complete lack of respect” shown by Quebec politicians and other organizations during the week of commemorations.
In the release, the CNA called Quebec’s announcement that a wildlife reserve would be re-named in honour of Joyce “nothing but a smokescreen to divert attention.”
“The family, who have been consulted now for some time, clearly expressed their need to take time to reflect on this subject,” according to the statement.
“The fact of making [this announcement] without any concern on the impact of the family on the day making the anniversary of Joyce’s death demonstrates a flagrant lack of respect or collaboration.”
In an emailed statement to APTN News, Quebec’s Indigenous Affairs Ministry said it was “surprised” by the declaration made by the Conseil de la Nation Atikamekw.
“A formal announcement was planned and postponed at the request of the family,” explained a press attaché for Minister Ian Lafreniere.
“We simply confirmed our intention to move forward, responding positively to the [Echaquan] family’s request.
The CNA’s release also took aim at a disciplinary decision made on the anniversary of Joyce’s death.
According to the statement – as well as numerous media reports – Quebec’s nursing board ruled on a one-year license suspension for the nurse seen at Joyce’s bedside in her last live-streamed video.
An email sent by APTN to the Ordre des infirmières et infirmiers du Québec (OIIQ) went unanswered by deadline.
But Carol Dube, Joyce’s widower, was quick to respond in a Facebook post.
“The OIIQ announcement and the protected [wildlife] area on the same day as the commemoration – you have no respect. You could’ve at least waited,” Dube wrote on September 29.
“I feel enraged,” he added.
Neither Legault, Lafreniere, or the province’s Health Minister issued public statements responding to Friday’s drop of the coroner’s report.