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The video of her treatment went viral and drew outrage and condemnation across the country.

The Quebec minister responsible for relations with First Nations and Inuit acknowledges there is more to do to restore confidence in the health system for Indigenous people, while also highlighting the government's efforts.

"It's hard when we're commemorating the death of a woman in horrific circumstances to say (that) I'm happy with the results," Lafrenière told The ºÃÉ«tv Press. "I'm very cautious in what I'm telling you. It's true that great strides have been made. The biggest danger we face is to say it's done, it's settled, let's move on to other things."  

A coroner concluded that Echaquan's death was accidental and the result of pulmonary edema. However, her 2021 report also said Echaquan would likely still be alive if she were a white woman and that systemic racism "undeniably'' contributed to her death.

The report also recommended that the Quebec government acknowledge the existence of systemic racism and root it out of institutions.

Members of Echaquan's community have lobbied governments to adopt Joyce's Principle, which "aims to guarantee all Indigenous people equal access, without discrimination, to all social and health services." It has not yet been adopted in Quebec.

Jennifer Petiquay-Dufresne, an Atikamekw from Manawan, is the executive director of the Joyce's Principle Office. According to her, another tragedy could still occur. "I am certain that it can happen again," she said.

She said some doctors and organizations would like to adopt and implement the principle, but are limited due to "political orientations."  

"Canada had committed to implementing it. All the other western provinces are doing much more than the Quebec government is currently doing," she said. "I think the government has the means to do more, to do things differently."

Lafrenière says his government has taken concrete action, notably by providing mandatory training on Indigenous cultural awareness for health-care personnel. 

Petiquay-Dufresne, who has also served as an Indigenous liaison officer in the provincial health system, said the training was originally designed for Justice Department staff. She said the content is mainly used to raise awareness or educate people about Indigenous realities, and does not address cultural safety. 

In December 2024, the province adopted Bill 32, an act to establish the cultural safety approach within the health and social services network

This law requires the province's health department to conduct an annual review of culturally safe practices that have been put in place. The first report is expected in 2026. 

Lafrenière notes the government has also created a committee on cultural safety, which includes members of Indigenous communities and which will be able to make recommendations to the health minister on the application of the law. 

Petiquay-Dufresne is reserving any applause for the future, once she's convinced the committee is not merely "decorative." 

"It could be good news if this committee has the rights and responsibilities that will allow it to have a real impact on how care is provided, how Indigenous people are welcomed, and the development of service programs that are designed to minimize barriers to accessibility," she said. 

The Coalition Avenir Québec government still refuses to recognize systemic racism, despite multiple calls in the wake of Echaquan's death. Lafrenière said the term "divides and polarizes."

"I understand their arguments very well...but on the other hand, what doesn't help is that some people don't interpret it the same way," he said. "For them, systemic means systematic. That would mean that we are always racist."

Lafrenière acknowledges that racism exists, that discrimination and profiling persist in Quebec, and that these issues must be addressed. However, he does not subscribe to the term "systemic racism."

"I'm very open, I'm willing to discuss it, but I don't think it's honest to think that recognizing the term will solve everything," he said. "That's not true."

Petiquay-Dufresne disagrees. She still regularly hears about cases of discrimination and racism occurring in the health system, while acknowledging the workers who are trying to bring about change.

"I don't want to take anything away from these people, the allies who are putting their shoulders to the wheel and helping, but there is still work to be done," she said. "So systemic racism, if we are able to recognize it, is already a step forward. Because once we recognize as a society that systemic racism exists, we give ourselves the means to act."

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