Submission ID 130715
| Issue/Objective | In September 2024, the Canadian Medical Association (CMA) publicly apologized for its role, and the role of physicians, in past and ongoing harms experienced by First Nations, Inuit, and Métis Peoples within the Canadian health system. This apology included a commitment to revising the CMA's Code of Ethics and Professionalism to explicitly address anti-Indigenous racism. This initiative positions ethics reform as a lever for structural change, seeking to clarify and reshape the values, obligations, and accountabilities that govern the medical profession. While grounded in the Canadian context, this work is relevant to other jurisdictions where colonial legacies continue to shape health systems and offers a material example of how professional ethics can advance Indigenous rights, antiracism, and meaningful change that ultimately influences clinical care. |
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| Methodology/Approach | Qualitative analysis of purposively sampled normative frameworks informed the revision of the Code. Analysis included a targeted literature review, environmental scan, and comparative analysis of ethics codes, professional standards, and regulatory frameworks from international medical associations, governments, and oversight bodies. This approach ensured that proposed revisions were evidence-informed, addressed gaps in existing governance instruments, and aligned with professional standards. |
| Results | The analysis revealed persistent gaps in professional ethics frameworks regarding racism and historic and ongoing harms, particularly the absence of explicit recognition of Indigenous rights and the medical profession's role in perpetuating structural inequities. While some domestic and international codes reference non-discrimination and cultural safety, these commitments are often framed generically, limiting their capacity to promote accountability or systemic change. These findings directly shaped revisions to the CMA Code, which now explicitly names anti-Indigenous racism and articulates physicians' duties to practise cultural humility, respect Indigenous self-determination in health decision making, and actively challenge racism within health systems. The revisions enhance guidance in areas such as advocacy, accountability, and collective responsibility, positioning codes of ethics as a governance tool capable of influencing education, regulation, organizational policy, and clinical norms. |
| Discussion/Conclusion | Revising the CMA Code of Ethics and Professionalism demonstrates how professional ethics can function as an instrument for reconciliation and structural change, rather than a neutral or aspirational statement of values. By embedding provisions to address anti-Indigenous racism within binding ethical obligations, this work positions ethics as a tool to shape professional norms that influence subsequent care. More broadly, it offers a model for other health systems seeking to align professional governance with anti-Indigenous racism, supporting reconciliation through ethical practice and accountability. |
| Presenters and Affiliations | Krista Halliday Canadian Medical Association Krista Halliday Canadian Medical Association Alex Dearham Canadian Medical Association Cortney Clark Canadian Medical Association |
