Content warning: This article discusses forced sterilization, racism
Radio-Canada recently aired an interview with a 44-year-old Haitian woman, Maria*, who claimed she was sterilized without consent at a Montreal hospital in 2018. She was asked if she wanted to undergo tubal ligation to prevent further pregnancies during her emergency C-section. Maria said that she refused the procedure, and there is no trace of written consent in her medical file. Non-consensual sterilizations are not bioethical dilemmas; they are the result of longstanding colonial practices that inflict disproportionate, irreparable harm on Black and Indigenous women. In a province whose leadership denies systemic racism, the onus is on the Quebec healthcare system to eliminate racial, gender, or other biases—as well as to guarantee that medical consent is given affirmatively and unequivocally.
Some patients might want their tubes tied, and some may opt to undergo the procedure after a C-section. But professionals must ensure that consent is unambiguous, especially when it is solicited from those whose first language is not French or English. Such a decision should never be allowed without the patient’s full and informed consent.
Despite no written consent, the Quebec College of Physicians is taking the doctor’s word for obtaining “verbal consent.” Although this type of consent may be acceptable in extreme circumstances, even then, it only holds if the doctor makes certain that the patient comprehends the full extent of the procedure. The government should require translators fluent not only in French and English but also in Indigenous languages to be on-site at all times. Even if this is infeasible in the short-term, there are potential translation technologies that could be harnessed if they can be medically verified.
It goes without saying that patients should not be asked to make such a life-altering decision under the already stressful, and at times traumatic, circumstances of childbirth. Nicole Awashish, an Atikamekw woman who is one of many Indigenous women who have experienced non-consensual sterilization, felt that the pain and stress of her contractions made it impossible for her to fully grasp the details of the procedure. To mitigate the risk of medical practitioners taking advantage of such stressors, patients must be given the time to think about whether the procedure is right for them far in advance and without any external pressure.
Human rights groups have every reason to be skeptical of physicians, and of medical racism more broadly. Canada has a long history of forcibly sterilizing racialized “Others,” including Indigenous women, Black women, immigrants, and other minorities––and these atrocities are not a thing of the past. In this context—a callous cacophony amplified by a premier who denounces “wokes” for protesting structural prejudices—the government would be abdicating justice if it did not investigate Maria’s case, along with all others like it.
Premier Legault’s opposition to “woke” activists is a form of rhetorical terrorism against people who criticize his politics, positioning them as enemies of the Quebec nation. Moreover, by fomenting bigotry, his words and labels compound the racism already embedded in the health care system, reinforcing well-founded distrust between racialized women and medical professionals, and discouraging vulnerable populations from seeking care. The government must take accountability for the women whose lives their health care system has irreparably damaged and must also address their underlying causes, lest Quebec hospitals remain structures of indifference and factories of injustice.
Quebec’s health care system has robbed victims of their agency, and their trauma must not be forgotten. Women’s health continues to be taken for granted, their pain minimized and their concerns about racial inequities labeled as “woke” paranoia. In this way, healthcare has become a crossroads of intersecting daggers of discrimination. A radical shift in Quebec’s approach to health care is the only way to bridge the cavernous legacies of oppression that serve to dehumanize and ignore racialized women.
*Maria’s name has been changed to preserve her anonymity.