Joyce Echaquan's husband brings courtroom to tears as he pleads for change

After hearing from expert witnesses, health-care workers and Indigenous leaders, through four weeks of gruelling testimony, Joyce Echaquan's family issued its own recommendations to the coroner Monday, based on one guiding principle — that her death not be in vain.

The coroner's inquiry is examining the death of Echaquan, a 37-year-old Atikamekw mother of seven, who filmed herself on Facebook Live as a nurse and an orderly were heard making derogatory comments toward her shortly before her death Sept. 28, 2020, at the Joliette hospital, 75 kilometres northeast of Montreal.

Carol Dubé, his daughter Wasiana Dubé and mother-in-law Diane Echaquan Dubé all stood in front of the courtroom on the penultimate day of the inquiry.

"Listening to the testimonies, trying to make out what is true and what is not has been very difficult," Carol Dubé said.

He told coroner Géhane Kamel several points that have been brought up during the inquiry should be considered, including the adoption of a measure called Joyce's Principle to ensure equitable access to health care, and having that principle enshrined by provincial law.

Dubé and his family also want Premier François Legault to recognize that systemic racism against Indigenous people is a reality in Quebec's public institutions.

After giving his recommendations, Dubé said he had been left with an impossible story to explain to his seven children, on how their mother was taken away from them.

"It's a story based on a nightmare, on lies. If you are listening, would you accept to tell this story to your children?" Carol Dubé concluded.

The final words from the family brought the packed courtroom to tears, particularly when the coroner asked everyone present to stand up in honour of the family's courage.

"You opened your heart to witnesses who came here, and it's the least we could do for you," said Kamel.

Hope for change

Before the family spoke, the new CEO of the Lanaudière health board, Maryse Poupart, gave some indication that changes were in motion at the public health agency that oversees services at the Joliette hospital.

Poupart has only been in the job since April, replacing the former CEO Daniel Castonguay. She said a change in the "management culture" is needed. "I'm a person of action," she said.

She offered her condolences to the family and said Echaquan's death is always at the back of her mind when she is making decisions.

"Because I never want something like that to happen again within our walls," she told the family.

Among the changes, Poupart said relations with Indigenous patients will be one of her priorities. She said she still has a lot to learn about the Aitkamekw culture, but said she wants to work toward building a culture of respect.

More Atikamekw employees are also being hired to create a safer space for patients who visit the Joliette hospital.

"We'll have to be patient, because cultural safety is a long journey," she said.

Calling on Quebec to recognize systemic racism

Atikamekw leaders also testified at the inquiry, calling on the Quebec government to recognize systemic racism in the health-care system and to adopt the community's solutions to reduce inequities faced by Indigenous patients.

Paul-Émile Ottawa, chief of the Conseil des Atikamekw de Manawan, said Echaquan's death has left an open wound in the community, which is located about 250 kilometres north of Montreal.

Ottawa told the coroner it heightened the fears of a community already reluctant to seek care at Quebec hospitals.

"On some level, we all feel guilty for being unable to act so that Joyce could be saved,'' Ottawa said. "It was a huge trauma for everyone."

People fear it will happen again, he said, after the community of 3,000 was both panicked and stunned by the Facebook video. 

"Never again do I want to see images like those that still haunt me today — no more videos like Joyce broadcast in a bid to save herself, no more videos of a daughter filming her mother dead and powerless,'' Ottawa said.

His recommendations include having doctors and other health-care staff trained in school on the realities of the country's Indigenous peoples, simplifying the hospital complaints process, recognizing systemic racism and adopting Joyce's Principle.

Numerous recommendations made in Joyce's principle

Joyce's Principle is a series of measures drafted by the Atikamekw community to ensure equitable access to health care for Indigenous patients. The document describes Quebec's health system as being imbued with systemic racism.

The numerous recommendations in Joyce's Principle include that the federal government revise its financing model for health and social services regarding Indigenous groups and that Quebec set up an ombudsperson for Indigenous health.

Legault and his government have refused to accept the full document because of its mention of systemic racism, which they deny exists in Quebec.

Constant Awashish, grand chief of the Conseil de la Nation Atikamekw, told the inquiry Tuesday that the government's refusal to adopt Joyce's Principle is a "perfect example of systemic racism.'' Awashish invited Legault to reflect carefully on the issue.

"Joyce's Principle are solutions that we brought, we are the ones who live with discrimination, with systemic racism, we are the ones bringing simple solutions. We want it to be done by us, not by others for us,'' Awashish testified.

"If we're able to apply it, things will get better, for us and for society because everyone will feel safer.''