PoPulationand Public HealtH etHics

Case discussion in response to
First nations Drinking water Policies
Ted Schrecker
Clinical Scientist, Institut de recherche Bruyère Research Institute
Adjunct Professor of Epidemiology and Community Medicine, University of Ottawa
Principal Scientist, Institute of Population Health, University of Ottawa
Ottawa ON
tsCHReCkeR@syMPatICo.Ca
Introduction
As the authors note, the problem of drinking water safety in First Nations
communities is one of long standing. The Auditor-General of Canada concluded
in 2011 that “[f]ederal action on drinking water quality [had] not led
to significant improvements” since a previous audit in 2005, and indeed
pointed out the recognition by the Royal Commission on Aboriginal Peoples
in 1996 of the multiple hazards to health associated with living conditions
on First Nations reserves. 1 The Government of Canada (GoC), the actor with
primary responsibility for public health in such communities, cannot claim
ignorance of the issue. Indeed it can be argued that continued inaction on
the drinking water issue should not be viewed in isolation, but rather as part
of a larger pattern of privation (including, for example, inadequate housing)
that generates health disparities between Aboriginal people as a whole and
the rest of the Canadian population 2 and is clearly inequitable based on a
definition of health equity as “the absence of disparities in health (and in its
key social determinants) that are systematically associated with social advantage/disadvantage.”
3 The primary ethical issue in this case is the GoC’s
apparent neglect of its constitutional responsibilities related to a basic prerequisite
for health. The survey that is the focus of the case study served an
important purpose in documenting the extent of the problem, but it was far
from the first description.
First Nations Drinking Water Policies
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