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Moving beyond Ignorance and Epistemic Violence: Indigenous Health Nurses' Response to Systems Transformation. 超越无知和认识暴力：原住民保健护士对系统转型的回应。
Healthcare Papers Pub Date : 2023-04-01 DOI: 10.12927/hcpap.2023.27107
Meste'si Llucmetkwe, Colleen Seymour, Mona Lisa Bourque Bearskin, Liquaa Wazni, Rose Melnyk, Nikki Rose Hunter Porter, Michelle Padley
{"title":"Moving beyond Ignorance and Epistemic Violence: Indigenous Health Nurses' Response to Systems Transformation.","authors":"Meste'si Llucmetkwe, Colleen Seymour, Mona Lisa Bourque Bearskin, Liquaa Wazni, Rose Melnyk, Nikki Rose Hunter Porter, Michelle Padley","doi":"10.12927/hcpap.2023.27107","DOIUrl":"10.12927/hcpap.2023.27107","url":null,"abstract":"<p><p>Health inequity among Indigenous populations continues to widen despite advances in Indigenous health research. Under Canada's esteemed universal healthcare system, Indigenous populations continue to experience much poorer health outcomes due to the intersectional legacies of colonialism and racism. In this commentary, we reflect on structural, systemic and service delivery racism at all levels of care, which are deeply embedded in historical, political, institutional and socioeconomic policies and practices that continue to perpetuate harm and genocide of Indigenous Peoples. We call for immediate action to re-establishing epistemic justice and reframing Indigenous knowledge systems in nursing practices, policies, research and education as the starting point in counteracting systemic racism.</p>","PeriodicalId":35522,"journal":{"name":"Healthcare Papers","volume":"21 2","pages":"35-41"},"PeriodicalIF":0.0,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9803556","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Response to "Canadians Need Improved Access to Drugs for Rare Diseases, Not More Denial". 回应 "加拿大人需要改善罕见病药物的获取，而不是更多的拒绝"。
Healthcare Papers Pub Date : 2023-04-01 DOI: 10.12927/hcpap.2023.27111
Sandra Sirrs, Bashir Jiwani, Eric Lun, Bob Nakagawa, Anne McFarlane
{"title":"Response to \"Canadians Need Improved Access to Drugs for Rare Diseases, Not More Denial\".","authors":"Sandra Sirrs, Bashir Jiwani, Eric Lun, Bob Nakagawa, Anne McFarlane","doi":"10.12927/hcpap.2023.27111","DOIUrl":"10.12927/hcpap.2023.27111","url":null,"abstract":"<p><p>The comments provided by Rawson and Adams (2023) miss the mark of our articles (Sirrs et al. 2023a, 2023b). We agree that the patient perspective is critical and that patients with \"rare diseases have a right to healthcare and have huge unmet needs …\" (p. 7). However, we challenge Rawson and Adams' (2023) thesis that keeping drug prices higher in Canada than in most other countries would solve the problem of access to therapies for rare diseases that have no available treatment.</p>","PeriodicalId":35522,"journal":{"name":"Healthcare Papers","volume":"21 2","pages":"11-12"},"PeriodicalIF":0.0,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9810362","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Less Talk, More Action: Strategies to Mitigate Inequities Experienced by Indigenous Peoples in the Healthcare System. 少说多做：减少土著居民在医疗保健系统中遭遇的不平等的策略》。
Healthcare Papers Pub Date : 2023-04-01 DOI: 10.12927/hcpap.2023.27110
Annette J Browne
{"title":"Less Talk, More Action: Strategies to Mitigate Inequities Experienced by Indigenous Peoples in the Healthcare System.","authors":"Annette J Browne","doi":"10.12927/hcpap.2023.27110","DOIUrl":"10.12927/hcpap.2023.27110","url":null,"abstract":"<p><p>Healthcare policy and decision makers in Canada have the power to address the persistent inequities experienced by Indigenous Peoples. Bold, immediate actions are necessary to address the varying manifestations of systemic racism, the ongoing denial of racism and the negative impacts on access to care and health outcomes. The perspectives presented in this issue of HealthcarePapers highlight a clear imperative: much more must be done at multiple levels to make healthcare systems safer for Indigenous Peoples. The actions discussed in this introductory paper reflect key, evidence-informed strategies to guide healthcare policy and decision makers in Canada and, potentially, other jurisdictions.</p>","PeriodicalId":35522,"journal":{"name":"Healthcare Papers","volume":"21 2","pages":"13-19"},"PeriodicalIF":0.0,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9810353","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Call Individuals to Action. 号召个人采取行动。
Healthcare Papers Pub Date : 2023-04-01 DOI: 10.12927/hcpap.2023.27105
Kimberly D Fairman
{"title":"Call Individuals to Action.","authors":"Kimberly D Fairman","doi":"10.12927/hcpap.2023.27105","DOIUrl":"10.12927/hcpap.2023.27105","url":null,"abstract":"<p><p>This commentary calls on individuals, researchers and leaders to reconsider the sustained and ongoing impact of colonialism with respect to our individual commitment to relationships in a context where policy alone will not address the issues we face. The author intends to recognize people's individual power and accountability in their relationship with Indigenous Peoples and describes how relationships, in the end, will drive the change that is needed. The author raises the need for distinctions-based legislation to carry and convey the intention for change. Individuals empowered by the legislation are urged to use their personal leadership to address racist policies and services. This paper is a call to make the commitment to being in relationship with Indigenous People and using levers within their scope of practice to address discrimination and racism against Indigenous Peoples in healthcare.</p>","PeriodicalId":35522,"journal":{"name":"Healthcare Papers","volume":"21 2","pages":"48-50"},"PeriodicalIF":0.0,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9803554","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Does Health Care? Accountability Matters for Indigenous Patients. 医疗保健？土著患者的责任问题。
Healthcare Papers Pub Date : 2023-04-01 DOI: 10.12927/hcpap.2023.27106
Amy Shawanda
{"title":"Does Health Care? Accountability Matters for Indigenous Patients.","authors":"Amy Shawanda","doi":"10.12927/hcpap.2023.27106","DOIUrl":"10.12927/hcpap.2023.27106","url":null,"abstract":"<p><p>In Canada, there is evidence that Indigenous Peoples have experienced systemic and medical racism directly or indirectly. This commentary discusses the prejudice and racism evident in healthcare throughout history. The narrative then shifts to address medical professionals who do not provide quality treatment, and a guideline is provided for Indigenous patients and clients to enable them to file complaints with licensing boards. The intention is for healthcare professionals to incorporate cultural competency, cultural safety and cultural humility into their practices and, if possible, create a structure that will allow Indigenous patients to voice their concerns.</p>","PeriodicalId":35522,"journal":{"name":"Healthcare Papers","volume":"21 2","pages":"42-47"},"PeriodicalIF":0.0,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9803558","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Canadians Need Improved Access to Drugs for Rare Diseases, Not More Denial. 加拿大人需要改善罕见病药物的获取，而不是更多的拒绝。
Healthcare Papers Pub Date : 2023-04-01 DOI: 10.12927/hcpap.2023.27112
Nigel S B Rawson, John Adams
{"title":"Canadians Need Improved Access to Drugs for Rare Diseases, Not More Denial.","authors":"Nigel S B Rawson, John Adams","doi":"10.12927/hcpap.2023.27112","DOIUrl":"10.12927/hcpap.2023.27112","url":null,"abstract":"<p><p>Sirrs et al. (2023a) discuss what they consider \"explosive growth\" (p. 11) in the research and development (R&D) and commercialization of expensive drugs for rare diseases (DRDs). They contend that the \"status quo is no longer an option\" (Sirrs et al. 2023b: 75), so it is critical to drastically reduce the prices of DRDs and/or ration access.</p>","PeriodicalId":35522,"journal":{"name":"Healthcare Papers","volume":"21 2","pages":"4-10"},"PeriodicalIF":0.0,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9810360","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
An Inuit Perspective on Health and Healthcare in Canada. 因纽特人对加拿大健康和医疗保健的看法。
Healthcare Papers Pub Date : 2023-04-01 DOI: 10.12927/hcpap.2023.27109
Richard Budgell
{"title":"An Inuit Perspective on Health and Healthcare in Canada.","authors":"Richard Budgell","doi":"10.12927/hcpap.2023.27109","DOIUrl":"10.12927/hcpap.2023.27109","url":null,"abstract":"<p><p>This article presents a portrait of some of the challenges that Inuit encounter in contemporary healthcare systems. It explores the distinctive constitutional and legal framework that encompasses Inuit in Canada and the important work being done by Inuit entities to describe Inuit social determinants of health.</p>","PeriodicalId":35522,"journal":{"name":"Healthcare Papers","volume":"21 2","pages":"21-27"},"PeriodicalIF":0.0,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9810361","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Action, Accountability and Transparency for Indigenous Health Systems Safety. 土著医疗系统安全的行动、问责和透明度。
Healthcare Papers Pub Date : 2023-04-01 DOI: 10.12927/hcpap.2023.27108
Richard T Oster, Pamela Roach, Fiona Clement, Esther Tailfeathers, Bonnie Healy, Lori Meckelborg, Joanna Gladue, Patrick McLane
{"title":"Action, Accountability and Transparency for Indigenous Health Systems Safety.","authors":"Richard T Oster, Pamela Roach, Fiona Clement, Esther Tailfeathers, Bonnie Healy, Lori Meckelborg, Joanna Gladue, Patrick McLane","doi":"10.12927/hcpap.2023.27108","DOIUrl":"10.12927/hcpap.2023.27108","url":null,"abstract":"<p><p>Anti-Indigenous racism is prevalent in Canada, especially within healthcare systems. Consequences are catastrophic, including deaths of Indigenous patients. Systems change and critical education guided by the Indigenous Peoples and research into how racism operates within healthcare settings are needed. In Alberta, promising initiatives are under way, including a First Nations-led initiative identifying racism and colonialism as key health determinants, novel experiential education, transformative education for senior health leaders and reframing health system measures to reflect Indigenous Peoples' perspectives. The time is now for comprehensive action toward eliminating racism within healthcare systems and fostering Indigenous health systems safety. Indigenous lives depend on it.</p>","PeriodicalId":35522,"journal":{"name":"Healthcare Papers","volume":"21 2","pages":"28-34"},"PeriodicalIF":0.0,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9803555","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Expensive Drug Prices for Rare Cancers: Are Patients Truly Benefitting? 罕见癌症昂贵的药物价格:患者真的受益吗?
Healthcare Papers Pub Date : 2023-01-01 DOI: 10.12927/hcpap.2023.26996
Kristina Jenei, Bishal Gyawali
{"title":"Expensive Drug Prices for Rare Cancers: Are Patients Truly Benefitting?","authors":"Kristina Jenei,&nbsp;Bishal Gyawali","doi":"10.12927/hcpap.2023.26996","DOIUrl":"https://doi.org/10.12927/hcpap.2023.26996","url":null,"abstract":"<p><p>Cancer medicines comprise the largest proportion of expensive drugs for rare diseases (EDRDs). The US Orphan Drug Act (ODA) (Office of Inspector General, Department of Health and Human Services 2001) encourages pharmaceutical manufacturers to develop medicines for rare diseases through a range of financial incentives, which has shifted the development of cancer medicines to rare cancer subtypes. Although certain medicines approved through the ODA have revolutionized cancer treatment, only half demonstrate added therapeutic benefit compared to existing alternatives. Canadian regulators should ensure that cancer medicines that receive fast-track approval through the Health Canada Notice of Compliance with conditions offer benefit to Canadian patients. Furthermore, payers might engage in methods for reassessment and renegotiations over the medicines' lifespan.</p>","PeriodicalId":35522,"journal":{"name":"Healthcare Papers","volume":"21 1","pages":"44-51"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9550341","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
High Prices for High Profits? 高价换高利润?
Healthcare Papers Pub Date : 2023-01-01 DOI: 10.12927/hcpap.2023.26998
Aidan Hollis
{"title":"High Prices for High Profits?","authors":"Aidan Hollis","doi":"10.12927/hcpap.2023.26998","DOIUrl":"https://doi.org/10.12927/hcpap.2023.26998","url":null,"abstract":"<p><p>Canadian and foreign governments are struggling with determining whether to reimburse expensive drugs for rare diseases. The problem is that although insurers want to offer fair access to medicines for patients with rare diseases, the drugs are often priced far above normal cost-effectiveness thresholds. This leaves insurers with no tools to determine how much to pay. This article notes one reasonable standard: prices should not, in these circumstances, allow for profiteering by innovative companies.</p>","PeriodicalId":35522,"journal":{"name":"Healthcare Papers","volume":"21 1","pages":"34-37"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9550344","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
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