Criminal investigation needed into death of Joyce Echaquan, say 2 legal experts

The Quebec medical staff captured in an online video uttering racist insults while treating Atikamekw woman Joyce Echaquan shortly before her death should be investigated by police to determine whether their actions were criminally negligent and motivated by hate, say two legal experts.

Echaquan, 37, a mother of seven, died Monday in a hospital in Joliette, Que., about 74 kilometres north of Montreal after filming some of the last moments of her life on a Facebook video. The video captured Echaquan screaming in distress, along with the voices of staff members insulting her.

"They acted callously; they acted in a way they knew was unsafe; they acted with hatred; they acted with negligence," said Amir Attaran, a professor in the Faculty of Law and School of Epidemiology and Public Health at the University of Ottawa.

Attaran said that based on Echaquan's anguished complaints that she was being overmedicated, along with statements by family members that she was allergic to morphine and had heart problems, the medical staff should be investigated for criminal negligence causing death for negligently administering her drugs. 

In addition, he said, their insults — calling her "stupid," saying that she was "only good for sex" and lamenting that their tax dollars were "paying for" her health care — show racism played a role in how medical staff treated Echaquan, which opens up the possibility this was also a hate crime. 

"This was motivated by prejudice against Indigenous people, and that is clear from their comments," said Attaran, who is also a practising lawyer.

"You have those two aggravating factors: an abuse of the position of trust and the motivation driven by prejudice or racism." 

One nurse has been fired

On Tuesday, Quebec Premier François Legault said one of the nurses who treated Echaquan has been fired. The province said Echaquan's death is being investigated by the coroner and the health unit.

Quebec's provincial police, the Sûreté du Québec, said it hasn't yet opened a criminal investigation into the death but that it is collaborating with the coroner's office. The Quebec police said that a criminal investigation may hinge on the results of the autopsy. 

The province's nursing body, L'Ordre des infirmières et infirmiers du Québec, said in a statement it was also looking into the case and denounced "the racism suffered" by Echaquan. The organization said it couldn't provide details of its actions for confidentiality reasons.

Alisa Lombard, a partner with the law firm Semaganis Worme Lombard, which is representing two Indigenous women in an ongoing lawsuit against Ottawa and Saskatchewan over coerced sterilization, said police should have immediately opened a criminal investigation.  

"There needs to be a thorough police investigation, and that investigation has to be full and professional and must include a full investigation of any criminal misconduct, whether partly or fully motivated by a hate crime," said Lombard. 

"Not undertaking this kind of investigation would be further demonstrative of the contempt held by the health-care providers for Indigenous people. Joyce, when she was dying, was met with contempt. Their remarks show … hate and really clear racism."

Not bad apples but a 'putrid orchard'

Lombard said studies, reports and inquests — such as the one into the 2008 death of Brian Sinclair, the double-amputee who died in a Winnipeg hospital from sepsis after spending 34 hours in an emergency waiting room — have repeatedly shown that Indigenous people suffer from racism within the health-care system. 

"It's discrimination, it's hate and it's causing death," said Lombard. "Something has to be done, and it has to be done now."

Legault denied Tuesday that Echaquan's death was a result of systemic racism. He has steadfastly denied that the problem exists in Quebec.  

However, a Quebec commission led by Justice Jacques Viens concluded in a September 2019 report that Indigenous people in Quebec were the victims of systemic discrimination when it comes to receiving public services.

Lombard said Echaquan's death is not a case of simply some bad apples in the system, as Legault suggested. 

"What we are looking at is a putrid orchard, and that orchard needs some serious attention," said Lombard. She also asked, "How many times has [Legault] attended a hospital with an Indigenous person in his life?"

Hospital could face civil liability

David Schulze, a Montreal-based lawyer who is representing 22 former day school students from Echaquan's home community of Manawan, Que. — who are suing Ottawa over sexual abuse — said the Joliette hospital is also facing significant civil liability from Echaquan's family. 

"If they caused her death, they are liable for damages that are pretty significant," said Schulze. "There is a separate issue that her estate inherits [Echaquan's] right to sue for the abuse that she suffered before her death.

"I think that the hospital is on the hook. It's hard to imagine how they wouldn't be."

Joliette is about 184 km south of Manawan and is the largest nearby centre, where most of the population does its shopping and accesses public services, such as health care.

Schulze said Manawan is a community that has suffered trauma throughout its history, including losing its land base to forestry and hydro development. Manawan also doesn't have cellphone service and has unreliable electricity and internet access. 

"Their way of life was on the territory, and that territory is decimated, and now, they were shoved into this under-serviced, under-funded reserve, pushed into this institutional abuse, day schools, residential schools and hospitals," said Schulze. 

"This is something non-Indigenous people do not understand very well."