Death of Joyce Echaquan

Joyce Echaquan was a thirty-seven-year-old Indigenous Canadian woman who checked herself into a hospital in Saint-Charles-Borromee, Quebec, because of severe stomach pain. Echaquan was verbally abused by racist hospital staff members who called her stupid and said she was better off dead. Echaquan livestreamed her mistreatment on Facebook. Echaquan died shortly after posting the video on September 28, 2020. Echaquan’s family believes she was given morphine, a drug to which she was allergic.

The death of the mother of seven sparked outrage throughout Canada, drawing attention to the systemic racism faced by Canada’s Indigenous citizens. In September 2021, autopsy results placed her official cause of death as pulmonary edema but also stated the treatment she received at the hospital, where employees wrongfully assumed she was suffering from drug withdrawal, contributed to her death. The death of Joyce Echaquan provided insight into the plight of First Nations peoples living in Canada in the twenty-first century.

Background

Canada’s 1.6 million Indigenous citizens, also known as First Nations people, have been victims of systemic racism and violence since European colonization in the sixteenth century. The Indian Act, first implemented in 1876, made it illegal for the Indigenous people to practice their own culture or religion. They were forced onto reservations, and their children were taken from them and sent to residential schools. The act was amended many times over the years, but segregation continued.

Racism against First Nations people still exists in the twenty-first century and has pervaded Canada’s healthcare system. A report released in 2015 by the Wellesley Institute indicated that racism contributes to poorer health outcomes for Indigenous Canadians. They have a lower life expectancy and higher rates of chronic diseases than non-Indigenous Canadians. According to a report released in 2020, many Canadian healthcare workers harbor the following stereotypes about Indigenous people: they are poor parents, they take advantage of the healthcare system, and they are prone to addiction. Because of the racism in the healthcare system, many Indigenous Canadians go without the treatment they need.

Healthcare is also not accessible for many of these, despite the existence of a universal healthcare system in Canada. Many First Nations communities have only nursing stations nearby, which provide minimal care. To go to a hospital, Indigenous Canadians must travel long distances. The distance from Manawan, where Echaquan lived, to the hospital where she was admitted, is 114 miles (183 kilometers).

Echaquan was not the only Indigenous Canadian to be denied care or abused in one of Canada’s hospitals. In 2008, Brian Sinclair, a forty-five-year-old Indigenous man, died of a treatable bladder infection after being ignored for thirty-four hours in a hospital emergency department. Sinclair was a double amputee who used a wheelchair. By the time the staff checked on him, rigor mortis had already set in.

Other incidents have also come to light. Many Indigenous women claim to be coerced into having tubal ligation, a form of sterilization, after childbirth. This coercion has taken place from the 1800s and into the twenty-first century. A Cree mother of four gave birth to her son in an Ontario hospital in 2007. She said her physician pressured her to have a tubal ligation during her prenatal visits, and when she had an emergency C-section, he performed the procedure without her consent. A lawsuit has been filed by a Saskatchewan-based attorney who is representing more than one hundred Indigenous women who claim to have been forced or coerced into having tubal ligation. In the mid 2020s, the class-action lawsuit was still in its early stages.

Overview

Joyce Echaquan had been treated at the Centre Hospitalier Regional de Lanaudiere in Saint-Charles-Borromee since 2014. She had a heart condition that required her to wear a pacemaker. However, Echaquan could not understand the hospital staff. While they spoke in French, Echaquan spoke only in her Indigenous Atikamekw language. Because she distrusted the hospital staff and could not comprehend their words, she recorded Facebook live videos during her hospital stays, and a cousin later translated them for her.

On September 26, 2020, a Saturday, Echaquan traveled to the hospital complaining of severe stomach pain and was admitted. When her pain worsened on Monday, hospital staff restrained her to a stretcher and gave her morphine. While she was writhing and screaming in pain, a nurse and an orderly verbally abused her in French. Echaquan recorded it all, at one point pleading for someone online to come to the hospital and help her. The nurse and the orderly were heard on the video telling Echaquan that she was “stupid as hell” and would be “better off dead.” “You made some bad choices, dear,” one of them said. “What are your children going to think, seeing you like this?” Echaquan was also asked if she was “done acting stupid” and told that she was “only good for sex.” Echaquan died soon after she posted the video. The nurse was fired the next day. The orderly was fired on October 1.

This was not the first time Echaquan was mistreated at the hospital. In 2020, a woman visiting her father in the Alzheimer’s center overheard Echaquan screaming in pain. She said the staff was ignoring Echaquan and overheard a nurse ask, “Will she ever shut up?” When the woman approached Echaquan to help, she was told by the staff to mind her own business.

As the 2020s progressed and outrage continued to grow, still no formal charges were filed against the nurse or the orderly who berated Echaquan moments before her death, and they were allowed to keep their medical licenses. Although they were initially fired, the orderly had her job reinstated following arbitration. The hospital also did not face any charges regarding Echaquan’s death.

A hearing for the coroner’s public inquiry was scheduled for May 10 to May 27, 2021. The objective of this hearing had nothing to do with criminal charges; however, it was to determine the official cause and circumstances of death. Throughout the inquiry, groups and marches supported the quest to bring justice to Echaquan. In September 2021, the coroner ruled the official cause of death as pulmonary edema, while also stating an affirmation of the role racism played in her death. In September 2022, the family of Echaquan filed a $2.7 million lawsuit against the Quebec public health agency.

After the video of Echaquan’s mistreatment went viral, a large march was held through Montreal, during which people carried signs saying, “Justice for Joyce” and “Native Lives Matter.” The Atikamekw Nation submitted “Joyce’s Principle” to federal and provincial governments. It recommends steps to be taken to ensure that Indigenous Canadians have equitable access to healthcare without discrimination. “Joyce’s Principle” has been adopted by the federal government, many unions, and universities. However, it has not been adopted by the government of Quebec. The death of Joyce Echaquan exposed the systemic racism inherent in Canadian institutions, which affects the lives of Indigenous Canadians on a daily basis. It has brought into the discourse important conversations on healthcare inequality, Indigenous rights, and the need for cultural and social reforms.

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