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Is cultural safety enough to prevent systemic racism and reduce health inequities? A critical look at Quebec’s Bill 32

Par : Contributeur(s) : Type de matériel : TexteTexteLangue : français Détails de publication : 2025. Ressources en ligne : Abrégé : Introduction: Faced with the glaring inequities between Indigenous and non-Indigenous populations, the Quebec government has proposed a bill to increase cultural safety in its health and social services for Indigenous populations. Objective: This article aims to critically examine this bill. Results: We show that it is marked by a colonial rationale. This rationale is as evident in the content of the bill as it is in its form. Regarding the content, Indigenous stakeholders were not consulted to jointly develop the bill, which fails to include any Indigenous demands. It denies the existence of systemic racism within healthcare institutions and neglects the inherent power dynamics integral to the concept of cultural safety. Regarding its form, the drafting of the bill is marked by paternalism, and the use of the “us/them” dichotomy reinforces a racialized and binary discourse between the dominant culture and Indigenous cultures. This dichotomy perpetuates ideologies of superiority and inferiority among population groups. Conclusion: By focusing on Indigenous cultural realities, the government sidesteps addressing the root causes of health inequities. Instead, the government should collaborate closely with Indigenous stakeholders and support policies addressing the structural determinants of health. It must also support the self-determination of Indigenous peoples.
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Introduction: Faced with the glaring inequities between Indigenous and non-Indigenous populations, the Quebec government has proposed a bill to increase cultural safety in its health and social services for Indigenous populations. Objective: This article aims to critically examine this bill. Results: We show that it is marked by a colonial rationale. This rationale is as evident in the content of the bill as it is in its form. Regarding the content, Indigenous stakeholders were not consulted to jointly develop the bill, which fails to include any Indigenous demands. It denies the existence of systemic racism within healthcare institutions and neglects the inherent power dynamics integral to the concept of cultural safety. Regarding its form, the drafting of the bill is marked by paternalism, and the use of the “us/them” dichotomy reinforces a racialized and binary discourse between the dominant culture and Indigenous cultures. This dichotomy perpetuates ideologies of superiority and inferiority among population groups. Conclusion: By focusing on Indigenous cultural realities, the government sidesteps addressing the root causes of health inequities. Instead, the government should collaborate closely with Indigenous stakeholders and support policies addressing the structural determinants of health. It must also support the self-determination of Indigenous peoples.

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