Brief presented by the Council of the Atikamekw of Manawan and the Council de la Nation Atikamekw in honor and memory of Joyce Echaquan.

About Joyce’s Principle

This principle is a call to action and a commitment from governments to end an intolerable and unacceptable situation. In itself, Joyce’s Principle is inspired by the United Nations Declaration on the Rights of Indigenous Peoples (2007), Article 24, which reads as follows:

• Indigenous peoples have the right to their traditional medicines and to maintain their health practices, including the conservation of their vital medicinal plants, animals and minerals. Indigenous individuals also have the right to access, without any discrimination, to all social and health services.
• Indigenous individuals have an equal right to the enjoyment of the highest attainable standard of physical and mental health. States shall take the necessary steps with a view to achieving progressively the full realization of this right.

Joyce’s Principle

Joyce’s Principle aims to guarantee to all Indigenous people the right of equitable access, without any discrimination, to all social and health services, as well as the right to enjoy the best possible physical,mental, emotional and spiritual health.

Joyce’s Principle requires the recognition and respect of Indigenous people’s traditional and living knowledge in all aspects of health.

1. Relationship between Indigenous people and the Government of Canada relating to health and social services.

The Government of Canada must recognize the right to autonomy and self-determination of Indigenous peoples in matters of health and social services. The Government of Canada must recognize the systemic racism faced by Indigenous people when attempting to access social and health services, particularly in relation to rights of equitable access without discrimination. Indigenous people must have the right to the enjoyment of the highest attainable standard of physical, mental, emotional and spiritual health. To achieve this, recognition and respect for Indigenous people’s traditional and living knowledge in matters of health are sine qua non.

The Government of Canada, in collaboration with the Indigenous authorities concerned, must put in place an action plan regarding Joyce’s Principle.

Without limitation, the following measures should be adopted:

1. The Government of Canada must take all legislative measures necessary to implement Joyce’s Principle;
2. The Government of Canada must review its program funding practices related to the provision of services in collaboration with the Indigenous authorities concerned;
3. The Government of Canada must harmonize its reimbursement and coverage program with the provinces. This will help ensure optimal and equitable access to care, treatment and medication for all Indigenous people;
4. The Government of Canada must facilitate access to safe care for members of Indigenous communities in an equitable manner, accounting for the bond of trust that must exist with the chosen health facility;
5. The Government of Canada must link the resources allocated to real needs of Indigenous people;
6. The Government of Canada must do everything to facilitate the mobility of health and social services resources between and outside of communities;
7. The Government of Canada must implement Joyce’s Principle regardless of jurisdictional conflicts between Quebec and Canada.

2. Relationship between Indigenous people and the Government of Quebec relating to health and social services.

The Government of Quebec must recognize the right to autonomy and self-determination of Indigenous peoples in matters of health and social services. The Government of Quebec must recognize the systemic racism faced by Indigenous people when attempting to access social and health services, particularly in relation to rights of equitable access without discrimination and the right to the enjoyment of the highest attainable standard of physical, mental, emotional and spiritual health. To achieve this, recognition and respect for Indigenous people’s traditional and living knowledge in matters of health are sine qua non.

The Government of Quebec, in collaboration with the Indigenous authorities concerned, must put in place an action plan regarding Joyce’s Principle.

Without limitation, the following measures should be adopted:

• The government of Quebec must take all legislative measures necessary to implement Joyce’s Principle;
• The government of Quebec must establish an Ombudsman office for Indigenous health. The powers and means of action of this Ombudsman must be decided in collaboration the Indigenous authorities concerned;
• The Government of Quebec must work with Indigenous authorities to deploy Joyce’s Principle;
• The Government of Quebec must appoint an Indigenous member on all decision-making bodies affected by Joyce’s Principle;
• The Quebec government must put measures in place that facilitate the mobility of human resources providing health and social services to Indigenous communities;
• The government of Quebec must implement Joyce’s Principle regardless of jurisdictional conflicts between Quebec and Canada.

3. Relationship between Indigenous people and the public relating to health and social services.

To reduce stigma and prejudices against Indigenous people regarding health, social leaders and members of government at all levels must actively fight against racism aimed at Indigenous people. The importance of educating non-natives about the realities of Indigenous people must be recognized.

The Indigenous authorities concerned must be given the necessary means to fight systemic racism and ignorance of Indigenous realities.

Without limitation, the following measures should be adopted:

1. The government of Quebec must financially support the Indigenous authorities that set up awareness raising and education campaigns about the realities of Indigenous life;
2. The Government of Canada must provide financial support to the Indigenous authorities concerned in order to set up awareness-raising and education campaigns about the realities of Indigenous life;
3. Social leaders must prevent, denounce and condemn any manifestation of racism against Indigenous people.

4. Relationship between Indigenous people and teaching institutions in the fields of health and social services

Any program offered by a teaching institution that trains workers in the health and social services field must include a component relating Joyce’s Principle.

Any program aimed at training workers in the health and social services field must include measures to integrate Indigenous students and ensure their success.

Without limitation, the following measures should be adopted:

1. Teaching institutions related to the fields of health and social services must provide compulsory training relating to Joyce’s Principle to all its students. These training courses must be developed by, or in collaboration with, the Indigenous players in health and social services;
2. Teaching institutions linked to the fields of health and social services must make it as easy as possible for Indigenous people to access training programs, including by establishing new specific programs as well as putting in place financial and social measures;
3. Teaching institutions linked to the fields of health and social services must decolonize course content and teach methods across its entire curriculum, including continuous education;
4. Teaching institutions linked to the fields of health and social services must facilitate the recognition of knowledge and the sharing of knowledge by Indigenous people.

5. Relationship between Indigenous people and professional orders in the health and social services field

All professional orders with members health and social services fields must integrate a commitment to respect Joyce’s Principle into all their public protection mechanisms and must include a component relating to Joyce’s Principle in their continuing education requirements.

Without limitation, the following measures should be adopted:

• The government of Quebec must amend the Professional Code in order to implement recurrent and mandatory training courses relating to Joyce’s Principle within all professional orders relating to health and social services in Quebec. These training courses must be fully developed by, or at the very least, developed in collaboration with Indigenous stakeholders in health and social services.
• Professional orders related to the fields of health and social services must, in collaboration with the appropriate Indigenous authorities concerned, designate an Indigenous person to sit on their board of directors.

6. Relationship between Indigenous people and health and social services organizations

All health and social services organizations must have a policy in place that recognizes and applies Joyce’s Principle.

All health and social services organizations that regularly serve an Indigenous clientele must enter into an agreement with the appropriate Indigenous authorities regarding the implementation of any policy related to Joyce’s Principle.

Organizations must visibly display their commitment to Joyce’s Principle. Each year, governmental authorities must publicly present the progress of the implementation of this action plan and, with the appropriate Indigenous authorities, determine if adjustments should be made.

Without limitation, the following measures should be adopted:

• Health and social services organizations should be committed to continuous education related to Joyce’s Principle. These training courses must be developed by, or at least in collaboration with, the Indigenous stakeholders in health and social services;
• Health and social services organizations must put in place all the measures necessary to ensure the cultural safety of Indigenous people;
• Health and social services organizations must facilitate access to an Ombudsman specific to Indigenous people;
• Health and social service organizations must prevent, denounce and condemn any manifestation of racism against Indigenous people.