Evidence of meeting #153 for Health in the 42nd Parliament, 1st Session. (The original version is on Parliament’s site, as are the minutes.) The winning word was medical.
A recording is available from Parliament.
Conservative
Ben Lobb Conservative Huron—Bruce, ON
Mr. Davies mentioned he was in the room when his wife gave birth. I'll admit I was there as well—
Lawyer, Semaganis Worme Lombard, As an Individual
You were at his wife's birth?
Conservative
Ben Lobb Conservative Huron—Bruce, ON
Actually, I won't admit that. I was not there for that one, but I was at the birth of my own children.
I'm not trying to make light of this, but as I recall—and I'm certain for the births of your children as well—there's no discussion about whether you'd like to have a tubal ligation at that time, right?
Conservative
Ben Lobb Conservative Huron—Bruce, ON
No. If, in fact, this is what occurred, it just seems so egregious that that would be happening simultaneously.
Again, does the Government of Saskatchewan or the health authority dispute this, or are they requesting more information? Where is this?
Lawyer, Semaganis Worme Lombard, As an Individual
Thank you for that question.
They tearfully apologized in the summer of 2017 for the experiences of the women—to their faces, who were present during that apology—and said that they would change their policy.
Conservative
Ben Lobb Conservative Huron—Bruce, ON
I notice the word “allegation” is used in a lot of the news stories. Is that an apology to an allegation or was it an apology to an admission of something that actually happened?
Lawyer, Semaganis Worme Lombard, As an Individual
It was an apology resulting from an independent investigation and an external report authored by Dr. Judith Bartlett and now Senator Yvonne Boyer, which found that there was pervasive systemic racism in the health care system.
I think the apology is still available online. The Saskatoon Health Region at that time, now the Saskatchewan Health Authority, apologized to the women for their treatment, and said that they did not deserve to be treated that way, that what they experienced no woman should ever experience. Yet here we are.
Conservative
Ben Lobb Conservative Huron—Bruce, ON
Was that a blanket apology? Was it specific to, say, the 100 people who you talked to? Was it a blanket apology to any and all?
Lawyer, Semaganis Worme Lombard, As an Individual
It was to women who had been sterilized without their consent.
Liberal
Ron McKinnon Liberal Coquitlam—Port Coquitlam, BC
Thank you, Chair.
Thank you, all, for being here.
Ms. Lombard, you mentioned there was a breakdown between the women involved and police. It seems to me there was actually a lot of breakdown in this whole system.
Ms. Omeniho remarked that the victims are often disadvantaged women. They don't know their rights. They don't know that they can make a complaint. They don't know necessarily that they should make a complaint. It seems to me that's one of the fundamental breakdowns here, that many of these processes, such as activating the police and so forth, need a complaint to kick them off.
I'm also struck by Ms. Omeniho's comment that coercion happens by social workers in the hospital. Do the medical professionals who are doing the procedures believe that they actually have informed consent? Is that a reasonable thing, or is this something that's happening up the line? Where is this breaking down in that respect, around the obtaining of consent in relation to medical ethics?
Could somebody speak to that?
President, Women of the Métis Nation / Les Femmes Michif Otipemisiwak
In some of the incidents that we are aware of, it was social workers in a place in the hospitals where they were assessing that the person had too many children that they couldn't properly care for, or there were poverty issues or other social issues, and they're the ones who encouraged the signing of the documents at the hospital.
Do I know whether the doctors were given the details of how those forms are coerced? No, but also, for non-indigenous Caucasian women in most hospitals, they discourage, if some woman goes in there and says, “Okay, I've had enough kids. I don't want any more. I want a tubal ligation at the end of pregnancy.” They'll say, “No, this isn't the time to make that decision.” However, in our instances, they have actually had conversations, but lots of times it's issues with social workers that we've been made aware of who have intervened with those women to try to convince them to sign these documents.
Liberal
Ron McKinnon Liberal Coquitlam—Port Coquitlam, BC
In that case, the doctors themselves might have been in full and reasonable belief that they had proper consent.
Chaneesa Ryan Director of Health, Native Women's Association of Canada
It's a really important question and it also connects with an earlier question about research.
I don't know how to answer your question. We've certainly heard stories anecdotally and from talking to service providers. I think, or I'd like to believe anyway, that many of these service providers aren't doing this out of hate or as an act of violence. I think it comes down to beliefs, and again, that systemic racism, but because we don't know, it's really hard to address the problem and provide informed policy and program recommendations.
Going back to research, as much as we need to hear from the indigenous women who have been impacted, we need to shift the research gaze to the service providers as well and find out why they are forcing or coercing indigenous women into sterilization. We need to put the onus back on the service providers. I don't think any training is going to be effective if we don't understand why service providers are doing this.
Liberal
Ron McKinnon Liberal Coquitlam—Port Coquitlam, BC
Do you believe there's still an added responsibility on the physicians in these cases to make absolutely sure that consent is given?
Lawyer, Semaganis Worme Lombard, As an Individual
I do. It's a legal obligation.
Liberal
Ron McKinnon Liberal Coquitlam—Port Coquitlam, BC
If they're getting a form that says this is signed off on and they haven't necessarily any reason to question it, do they still have a legal obligation to do so?
Lawyer, Semaganis Worme Lombard, As an Individual
Yes, absolutely. The signature on a consent form does not indicate, in any way, shape or form, proper and informed consent.
Proper and informed consent involves four pillars: capacity; full disclosure of the risk, consequences and options; the appropriate environment in which to consider that information and time to do so; and the absence of coercion.
I'll quickly recall D.D.S.'s story where, immediately before the administration of an epidural, the surgeon interrupted the discussion with the anesthesiologist in an abrupt and aggressive manner, directing her to sign a consent form for the Caesarean section. D.D.S. noticed that a tubal ligation was also listed on the consent form but did not believe she had a choice but to sign. These are the types of circumstances in which this is arising. When you're bent over in a hospital robe awaiting a needle in your spine and a clipboard is thrown into your face, it's really difficult to call that proper and informed consent.
Liberal
Lawyer, Semaganis Worme Lombard, As an Individual
I do, without question.
Liberal
NDP
Don Davies NDP Vancouver Kingsway, BC
I have only three minutes, so I'm going to make these questions short snappers.
Ms. Lombard, we've heard a lot of talk about Saskatchewan. Can you give this committee some sense of the geographic scope of this issue? Is it only happening in Saskatchewan, or where else is it happening?
