In Canada, one in three Indigenous adults say they’ve faced unfair treatment in health care. This is much higher than the rest of the population. Joyce’s Principle calls for a change in how care is given, and it needs to happen fast.
The Atikamekw Nation created Joyce’s Principle after Joyce Echaquan died at Joliette Hospital Centre on September 28, 2020. It focuses on dignity and safety. It wants health and social services to be fair and free from discrimination, so everyone can be as healthy as possible.
It’s based on UNDRIP Article 24, which supports the right to traditional medicines and fair access to care. In November 2020, the Council of the Atikamekw of Manawan and the Atikamekw Nation Council asked Canada and Quebec to adopt Joyce’s Principle quickly.
Leaders like Paul‑Émile Ottawa and Constant Awashish say we can’t keep things as they are. Carol Dubé has called for action, saying her spouse’s death should lead to real change. Joyce’s Principle is more than words; it’s a way forward for Indigenous health rights in Canada, based on accountability and respect.
What Joyce’s Principle Means for Health Rights in Canada
Joyce’s Principle is a clear guide for health equity in Canada. It focuses on dignity, trust, and safety in all healthcare settings. The legacy of joyce echaquan pushes for action that people can feel in healthcare.
Core aim: equitable, discrimination-free access to health and social services
The main goal is clear and strong: every Indigenous person should get care without fear. They should receive discrimination-free care. This means culturally safe services everywhere, from cities to remote areas.
Systems must track results and make care better and more respectful. When care meets people where they are, trust grows. This leads to better health.
UNDRIP Article 24 as the foundation
Joyce’s Principle is built on UNDRIP health rights, mainly Article 24. This article ensures equal access to health and social services. It also supports the right to choose healing practices.
It tells governments to aim for the best health possible over time. Policies and funding should reflect this duty across Canada.
Recognizing physical, mental, emotional and spiritual health
Health is more than just physical; it includes mind, emotion, and spirit. Care teams need to listen and adapt to support healing. They should respect a person’s life and choices.
Screening, crisis support, and long-term care work best when they respect family, language, and local realities. This makes care safer and more consistent.
Respect for traditional and living Indigenous knowledge
Respect means supporting traditional medicine and living Indigenous knowledge. This includes land-based healing and Elders’ guidance. It also means protecting medicinal plants and animals.
When traditional practices are valued alongside modern care, results get better. This vision honours joyce echaquan and moves towards health equity Canada. It does this through discrimination-free care based on UNDRIP health rights.
Origins: From tragedy to a national call for change
A painful truth sparked the push for change. In September 2020, a young Atikamekw mother died. The Joliette Hospital incident exposed cruelty on camera, shocking Quebec and Canada.
This event brought systemic racism in health care into the spotlight. It showed the urgent need for change.
In memory of Joyce Echaquan and the 2020 Joliette Hospital incident
Joyce Echaquan recorded her final moments at the Joliette Hospital Centre in Lanaudière on September 28, 2020. Her video captured racist slurs as she sought care. The footage prompted vigils, statements from officials, and demands for structural change from coast to coast.
Communities near Manawan named the injustice clearly. They linked the loss to long-standing failures in policy and practice. The call was not for blame alone, but for repair, accountability, and safer care for every patient.
Atikamekw leadership: Council of the Atikamekw of Manawan and Atikamekw Nation Council
Atikamekw leadership moved quickly. The Council of the Atikamekw of Manawan and the Atikamekw Nation Council shaped a clear roadmap known as Joyce’s Principle. They presented it to both Quebec and Ottawa in November 2020, urging a coordinated response with Indigenous authorities.
Their brief safeguarded Aboriginal title and rights and set out practical steps for change. It asked governments to work in good faith with communities to prevent further harm and to rebuild trust where it was broken.
Public consultations and community-driven development
A two-week public consultation Quebec process ran from October 14 to 28, 2020. Survivors, families, and front-line staff shared lived experience. Their voices influenced the language, scope, and timelines inside the proposed actions.
Stakeholder memoirs added guidance for hospitals, professional orders, educators, and unions. This community-driven approach kept the focus on safety, dignity, and results that can be measured and reported.
Commission Viens context and findings on systemic discrimination
The initiative built on the record of Commission Viens, whose 2019 final report said it was impossible to deny systemic discrimination affecting First Nations and Inuit in public services. Its analysis included hospitals in Quebec and the region around Joliette.
By drawing on Commission Viens and lived testimony, the roadmap linked promises to practice. It placed the Joliette Hospital incident within a documented pattern, and it showed how targeted reforms could curb systemic racism in health care while respecting Atikamekw leadership and law.
Joyce Echaquan
Joyce Echaquan (1983–2020) was an Atikamekw woman from Manawan. Her last hours showed the harm in Canadian care. A video from Joliette Hospital Quebec revealed racist insults and neglect.
It made everyone look at anti-Indigenous racism in health systems across Canada. The Joyce Echaquan biography is now a key for safer care. It helps families, clinicians, and policymakers.
The memory of Joyce is kept alive through vigils, murals, and the phrase “Justice for Joyce.” Eruoma Awashish (Atikamekw Nehirowisiw) created artwork for the Joyce’s Principle brief. It honours her life and courage.
Her spouse, Carol Dubé, believes adopting the Principle will carry her voice forward.
On September 28, 2021, federal ministers made a promise. They said what happened at Joliette Hospital Quebec must not be forgotten. They vowed for Indigenous Peoples to have top-notch health care without bias, as UNDRIP states.
This promise made the Joyce Echaquan biography a public record and a moral guide.
Families, Elders, and care workers keep Joyce’s memory alive. They fight against anti-Indigenous racism in health systems. They work to create safe spaces.
Her story leads the way in education, patient advocacy, and reforms. It focuses on dignity, language, and respect.
Key commitments sought from the Government of Canada
They want clear steps to honour Joyce’s Principle across Canada. The goal is to move from promises to action, respecting Indigenous rights and experiences. Any progress must be steady, even in disagreements between Quebec and Canada, and ensure safe access to healthcare.
Legislative measures to implement Joyce’s Principle
Ottawa is asked to take real steps through enforceable laws. This means using tools that respect Indigenous rights in health laws. Laws should protect the right to choose trusted facilities and ensure care continues, even across borders.
Action plan co-developed with Indigenous authorities
A plan made with First Nations, Inuit, and Métis is key. It should have clear timelines, shared goals, and ways to fix problems when they happen. It must involve health leaders and, for oversight, the Toronto Coroner’s Office to ensure transparency.
Funding practices aligned to real community needs
Funding must match the health needs of Indigenous communities, not just short-term projects. It should allow for the movement of healthcare teams. This way, nurses, midwives, and others can help in and out of communities. Reports should focus on outcomes that matter to people.
Harmonizing coverage and reimbursement across jurisdictions
There should be one standard for prescriptions, equipment, travel, and rehab. Harmonizing coverage with provinces and territories would reduce delays and denials. Shared criteria and billing would make treatment and medication easier to get.
These promises match previous federal commitments to UNDRIP health rights and collaborative change. Now, communities want these promises kept, in a fair and measurable way, across Canada.
Expectations for the Government of Quebec
Quebec’s health policy needs to move from promises to action. Communities want clear steps that respect self-determination and ensure safe care everywhere. Leaders like Dr Audette and Commission Viens show us how to take practical steps.
Recognition of systemic racism and Indigenous self-determination
Recognizing systemic racism is just the beginning. By recognizing Indigenous jurisdiction in health and social services, Quebec can support care that respects all aspects of wellbeing. Standards should be developed together and apply everywhere.
Establishing an Indigenous Health Ombudsman
An Indigenous Health Ombudsman Quebec office is needed. It should have the power to investigate complaints, require fixes, and share findings to drive change. The process should be easy to access in many languages.
Indigenous representation on decision-making bodies
It’s important to have Indigenous people on hospital boards and other groups. They should have guaranteed seats and fair pay. This builds trust and makes sure policies reflect real needs.
Human resource mobility to support communities
Health workers need to be able to move easily to help communities. Portable skills, shared teams, and support for travel and housing are key. This helps teams respond quickly to urgent needs.
| Priority | Concrete Action | Community Benefit | Policy Anchor |
|---|---|---|---|
| Systemic Racism Recognition | Issue a formal directive acknowledging systemic barriers and set timelines for reforms | Clear accountability and faster removal of harmful practices | Commission Viens recommendations; Quebec health policy |
| Indigenous Health Ombudsman Quebec | Legislate an independent office with investigatory and order‑making powers | Timely redress for patients and families; transparent outcomes | Patient safety and oversight standards |
| Indigenous Representation | Reserve voting seats for First Nations and Inuit leaders on health boards | Decisions reflect community priorities and cultural safety | Good‑governance norms; equity mandates |
| Mobility of Health Workers | Enable portable licences, shared rosters, and funded travel and lodging | Stable coverage in understaffed clinics and hospitals | Workforce agreements; inter‑regional compacts |
| Co‑Development | Formal protocols with Indigenous authorities for program design and evaluation | Services matched to local needs and traditions | Self‑determination commitments; accountability frameworks |
Building culturally safe systems: education, professions, and organisations
In Canada, people are making health spaces safer and more respectful. Cultural safety education is key, starting early and lasting a lifetime. It’s guided by Indigenous voices and experiences. This approach is practical, accountable, and builds trust.
Teaching institutions: mandatory content on Joyce’s Principle
Colleges and universities now include Joyce’s Principle in health and social service programs. They work with Indigenous health partners to create this content. It’s taught by respected knowledge holders and faculty.
Students learn through classroom lessons and hands-on experience in community settings. There are clear standards to ensure they apply what they learn in real-life situations.
Recruitment, support, and success of Indigenous students
Schools offer more support to Indigenous students, including advisors, bursaries, and housing. They also have special programs and Elders-in-residence to help students feel at home.
Flexible schedules, trauma-informed services, and peer mentoring help students stay and graduate. This way, they can confidently serve their communities with recognized skills.
Decolonizing curricula and recognising Indigenous knowledge
Schools are changing their curricula to reflect Indigenous perspectives. They use Indigenous languages, ceremonies, and protocols in teaching and practice.
Teachers get cultural safety training and work alongside Indigenous Knowledge Keepers. Libraries also focus on Indigenous scholarship to ensure learning reflects community values.
Professional orders: mandatory continuing education and board representation
Professional orders in health are now integrating Joyce’s Principle into their work. They require ongoing education designed with Indigenous authorities. This education is regularly checked for quality and impact.
Each order also has an Indigenous member on its board. This strengthens oversight and response to racism. They publish annual reports on their progress in handling complaints and improving practice standards.
Hospitals, clinics, and social services have clear policies based on Joyce’s Principle. They offer staff ongoing cultural safety education and visible accountability measures. They also have an Indigenous-specific Ombudsman for support.
Leaders are leading by example. Clinicians like Jennifer Cowan MD show how learning, teamwork, and community partnerships lead to better care. They respect rights and dignity in their work.
By focusing on mandatory training, decolonizing curricula, and supporting Indigenous students, we’re getting closer to safe, consistent care for all.
Federal actions and investments in healthcare
The Government of Canada has taken steps to improve healthcare. Ministers Carolyn Bennett, Patty Hajdu, Marc Miller, and Daniel Vandal are leading the charge. They aim to make clinics, hospitals, and community services safer and more respectful.
National Dialogues on anti-Indigenous racism in health (2020–2021)
Leaders and practitioners came together for three rounds. They discussed how to tackle anti-Indigenous racism in health. This included working with National Indigenous Organizations, provinces, territories, and health partners.
These sessions focused on ending harmful practices and rebuilding trust. They looked at real-life experiences and set priorities for change. Indigenous expertise, including nurses, midwives, physicians, and Elders, was at the forefront.
Commitment to distinctions-based health legislation
Ottawa is working on new health legislation. This legislation will respect First Nations, Inuit, and Métis jurisdiction. It’s all about improving service quality and local control.
The goal is to protect culture and language in care. It also aims to remove barriers to access. This approach recognizes regional diversity and lets communities shape their own solutions.
$126.7M over three years to foster safe, respectful systems
Budget 2021 allocated $126.7M for safer, more respectful care. This includes funding for service access, patient safety, Indigenous representation, and program evaluation.
For more details on how the funds will be used, see the federal overview at actions to address anti-Indigenous racism in health.
| Priority Area | Amount (CAD) | Purpose | Reach and Partnerships |
|---|---|---|---|
| Total Investment | $126.7 million | Three-year federal commitment to safer, respectful health systems | 157 projects with 102 partners nationwide |
| Culturally Safe Services | $33.3 million | Improve access and embed trauma‑informed, patient‑centred care | Community health providers and regional networks |
| System Adaptation and Representation | $46.9 million | Advance cultural and patient safety; increase Indigenous presence in health roles | Hospitals, regulators, and training institutions |
| Supports and Accountability | $37.8 million | Enhance complaint mechanisms, data, and evaluation for continuous improvement | Indigenous Services Canada with community partners |
| Federal Leadership | $8.7 million | Coordinate national action and regional roundtables | Federal, provincial, and territorial collaboration |
| Targeted Community Funding | $2 million | Support to the Conseil de la Nation Atikamekw and Conseil des Atikamekw de Manawan | Capacity building and local implementation |
Alignment with MMIWG Calls for Justice and 2SLGBTQQIA+ inclusion
The investment supports MMIWG Calls for Justice. It focuses on the safety of women, girls, and 2SLGBTQQIA+ people. This includes better complaint pathways and trauma‑informed supports.
Champions like Indigenous clinicians and researchers are pushing for change. Their work supports distinctions-based legislation and the National Dialogues. They aim to ensure dignity and human rights in care.
Community voices, remembrance, and accountability
They honour Joyce Echaquan by putting lived experience first in policy. In October 2020, families, Elders, and workers shared their views on safe care and trust. Their words helped create steps for organisations to follow, making sure everyone feels valued.
Annual reports, made with Indigenous leaders, help keep health care accountable. These reports have clear goals and updates in simple language. They let communities see how things are going and ask for improvements. Places that show they respect Joyce’s Principle prove respect is more than a promise.
Marking the first year after Joyce Echaquan’s death, federal statements called for action. They supported UNDRIP health rights and Canada’s anti-racism promises in health care. This includes training, safe ways to complain, and funding for Indigenous-led projects. Building strong relationships with care facilities is also key.
Friendship Centres are important in this effort. They help with training, cultural safety, and speaking out. You can learn more about their work on the national network’s health policy page. It shows how local leaders and tools can drive change.
Social leaders and governments are asked to fight racism against Indigenous people. Education campaigns led by Indigenous people help reduce stigma and start healing. Many also want to understand the meaning of sipi in care, so language and rituals are respected.
Conclusion
Joyce’s Principle is a clear guide for fair health services in Canada. It’s based on UNDRIP Article 24, which supports Indigenous rights to top-notch care. This principle was born from Joyce Echaquan’s tragic death in Joliette.
It urges governments to act quickly and with respect for Indigenous knowledge. This is key in making policy choices.
The Atikamekw Nation has outlined steps to follow Joyce’s Principle. They want laws to adopt it, work with Indigenous leaders, and make health services consistent across the country. Quebec is also asked to tackle racism in health, create an Indigenous Health Ombudsman, and ensure Indigenous voices are heard.
Education and standards must also evolve. Schools should teach about Indigenous history and culture. This includes training for professionals and leaders.
Canada has made progress, like holding dialogues and investing in Indigenous health. But, there’s more to do.
To honour Joyce Echaquan, we must work together. This means fighting racism in health and building trust in services. With ongoing efforts to respect Indigenous rights and knowledge, we can move towards a better future. dr joyce sun