Out of Sight: Interim Report of the Sinclair Working Group

Out of Sight: Interim report of the Sinclair Working Group

Brian Sinclair was killed by racism.  He was ignored for 34 hours, despite his need for urgent medical care, because medical professionals made negative assumptions about him based solely on his appearance.  Anti-Indigenous bias is an endemic problem in Canadian health care, but one that state authorities in Canada seem to disregard, as if ignoring the issue will make things better.  The hospital authority denied that stereotyping had anything to do with Mr. Sinclair’s death.  The government of Manitoba refused to hold a public inquiry.  The inquest into Mr. Sinclair’s death sidelined issues of race and social marginalization.  Regulatory bodies have been slow to implement any changes, if at all, and no one has been held accountable for professional misconduct or criminal neglect.

Into this void, a group of concerned Canadian experts has stepped in to address the difficult systemic issues that state authorities have largely chosen to marginalize.  The Sinclair Working Group, following painstaking research and careful contemplation, has now released its interim report, Out of Sight.  The report features four broad interim recommendations aimed at ameliorating the problem of anti-Indigenous bias in health care.

The Sinclair family sincerely thanks the members of the Working Group for the generous devotion of time, energy, and thoughtfulness that they have contributed to this critically important issue.  With their efforts, the family is optimistic that it can truly achieve its most profound objective: ensuring that Brian Sinclair’s death is not in vain. However, the family will still need all of those involved in the health care system and the justice system to step up and follow through on the recommendations.

 

EVENT: Sept 18, 2018, Winnipeg MB – Systemic Racism: Brian Sinclair’s story

The Sinclair family acknowledges and supports the ongoing work being done by the members of the Sinclair Working group and others to address the root causes of Brian Sinclair’s death and ensure his death was not in vain.  The following event is an important contribution to this ongoing work:

SYSTEMIC RACISM: BRIAN SINCLAIR’S STORY

Monday September 18, 2017, 11:00 – 1:00
Theatre C, Basic Medical Sciences Building, Bannatyne Campus, University of Manitoba

“The Brian Sinclair Working Group: Making Anti-Indigenous Racism in Health Visible” – Dr. Mary Jane McCallum, Professor, Dept. of History, University of Winnipeg

“Proving Racism in Inquests and Inquiries into the Deaths of Indigenous People in Custody” – Dr. Sherene Razack, Distinguished Professor and Penny Manner Endowed Chair, Dept. of Gender Studies, University of California at Los Angeles

Panel discussion led by Dr. Barry Lavallee, Director of Education, Ongomiizwin-Education, University of Manitoba and Caitlyn Kasper, staff lawyer at Aboriginal Legal Services, Toronto

Info: Tara.Smoat@umanitoba.ca or 204-789-3511

Link to event poster

Final Report on Sinclair Inquest, and why the Death was Homicide

The final report of the Inquest into the Death of Brian Sinclair can be found here: Sinclair inquest final report (links to external site)

The family of Brian Sinclair and counsel for the Sinclair family responded to the report as follows:

Press release issued Dec. 12, 2014

Statement of Robert Sinclair

Op-ed: Death by stereotyping

Death by stereotyping: Why a marginalized man’s death after a 34-hour ER wait was homicide 

What do you call it when the medical professionals in a Canadian hospital emergency department wrongly assume you are just there because you are drunk and homeless, ignore you for 34 hours while you vomit and go into sock, and leave you to die there?

That is not a “natural death.”

That is homicide.

The inquest into the death of Brian Sinclair wrapped up last week in Winnipeg.  Mr. Sinclair was a vulnerable Aboriginal double-amputee who went to the Health Sciences Centre complaining of abdominal pain and a catheter problem.  He was told to go wait in the waiting room.  He was never called back. Ever.  He was ignored to death.

He had a bladder infection.  He just needed antibiotics and a catheter change.  According to the Chief Medical Examiner, “if the treatment had been given… he would not have died on that day.”

Security video footage showed nurses and other staff walking right past Mr. Sinclair many times, but never interacting with him.  Fellow patients or their companions noticed that he was in distress and approached staff to try to get help for him, only to be brushed off.  Mr. Sinclair threw up twice as he went into shock, and staff kicked into action by giving him a large throw-up basin, but never interacted with the man.

At the inquest, the medical professionals agreed that the presumption that must be made is that every person who presents at an emergency department is in need of urgent medical care.  However, nobody made that presumption about Mr. Sinclair.

Some nurses and security guards assumed he was intoxicated. He wasn’t.  Some assumed he was homeless and was just there for shelter.  Wrong again.  Some who observed him sitting in the same spot one day to the next thought maybe he had been discharged but had come back – anything to explain away why Mr. Sinclair was there, except that he was waiting for urgent medical care.

The sole basis for their assumptions was their visual observations of Mr. Sinclair. They could see he was Aboriginal.  They could see he was disabled, legless, in a wheelchair.  They could see he wasn’t well-dressed or clean-cut.  Based solely on those visual observations, they concluded that he was drunk, or homeless, or otherwise not in need of medical care.  Then they just left him there until he died – and then for a few more hours more until rigor mortis set in.

When you make assumptions about someone based solely on what they look like, that is called stereotyping.  When those stereotypes are based in part on the race of a person, that is called racism.

Racism is not always manifested overtly.  People can, and often do, make assumptions based on a person’s race or other physical characteristics without even knowing or intending to.  The problem is that in a hospital those kinds of stereotypes can lead to critical mistakes.  In Mr.  Sinclair’s case, they were fatal.

No one is suggesting that anyone intended to discriminate against Mr. Sinclair as he sat there in distress for 34 hours.  Yet, he was discriminated against. The result matters, not the intention.

Mr. Sinclair’s death can only be understood as a colossal human failure.  He should not have died.  He only died on that day because the conduct of the people charged with his care substantially contributed to that outcome.  In law, when the conduct of a person substantially contributes to the death of another, it is called homicide.

It is necessary to understand Mr. Sinclair’s death as a homicide in order to appreciate that it wasn’t just flawed systems that led to his neglect – it was people who fatally neglected him.  Unless those behavioural and attitudinal issues are appreciated and addressed, marginalized people will consider to suffer bad treatment and outcomes in the health care system.   Mr. Sinclair was the proverbial canary in a coal mine.  His death exposed the toxicity of the stereotyping and assumption-making that happens in the health care system.  It is incumbent on us to fix that.

Denying that there is prejudice in the system is not going to make anything better.  Denial is effectively the approach taken by the inquest, by focusing Phase II on issues that had nothing to do with Sinclair’s death such as “patient flow” and “access block” while marginalizing issues related to discrimination and social determinants of health.  That is why the Sinclair family and all of the Aboriginal parties with standing lost confidence in the inquest and withdrew from  Phase II. That is why the Government needs to call a public inquiry to deal with the treatment of marginalized and Aboriginal people in our health care system.

Call it false-assumption-making rather than racism if that makes you more comfortable, but just address the problem.

  • Vilko Zbogar, co-counsel for the Family of Brian Sinclair

Transcripts – Inquest into the death of Brian Sinclair

Complete transcripts from the Inquest into the Death of Brian Sinclair can be found here: Consolidated Sinclair Inquest transcripts

Transcripts from each individual inquest hearing date can be found here: Sinclair inquest transcripts

For reference, the list of the witnesses who were called to give evidence at the inquest, their affiliation, and the date(s) of their testimony can be found here: List of Sinclair inquest witnesses

Breach of the Charter right to life and other claims against WRHA

This page is intended as public resource containing links to the main court documents in the Sinclair family’s lawsuit against the Winnipeg Regional Health Authority and its staff for Brian Sinclair’s wrongful death and breach of his Charter rights and privacy rights.

Statement of Claim (as amended)

Statement of Defence of Winnipeg Regional Health Authority

Statement of Defence of Brock Wright and Heidi Graham

Particulars in support of Plaintiffs’ claim

Manitoba Court of Appeal decision, 2015 MBCA 44 – confirming Sinclair family’s right to sue for Charter violations and breach of privacy, overturning lower court’s decisions
Factum of Plaintiffs, submitted to Court of Appeal
Factum of Defendants, submitted to Court of Appeal
Judgment of Master Berthaudin 2012 MBQB 88 (overturned on appeal)
Judgment of Justice Hanssen, 2013 MBQB 194 (overturned on appeal)

Criminal responsibility for Brian Sinclair’s death

Brian Sinclair’s death, which resulted from being ignored while waiting for urgent medical care in a hospital emergency department for 34 hours, should have triggered a police investigation and criminal charges.

“The HSC and its medical staff had a legal duty to care for and provide medical treatment to Mr. Sinclair.  It appears that they knew Mr. Sinclair was in urgent need of care, but endangered his life and safety by failing to act even after several non-medical staff and patients alerted nurses to his serious distress.  On the basis of the publicly available information (including press reports and the documents released to the Sinclair family by the office of the Chief Medical Examiner) it would appear that the HSC and its medical personnel departed in a marked and substantial manner from the standard of care required of a hospital emergency room and its staff, and that this failure resulted in Mr. Sinclair’s death.  Accordingly, there appear to be grounds to lay a charge of causing death by criminal negligence under s.220 of the Criminal Code.  This is a serious criminal offence punishable by up to life imprisonment.

Moreover, the HSC and its staff had a specific legal duty to provide the necessaries of life, including medical attention for a bladder infection and blocked catheter, food, and water or hydration, to Brian Sinclair, who was a person under their charge. They appear to have entirely failed to do so for 34 hours, and this foreseeably endangered Brian Sinclair’s life.  Accordingly, there appear to be grounds to lay a charge of failing to provide the necessaries of life under s.215 of the Criminal Code, an offence punishable by up to five years in prison.”  – Clayton Ruby

Legal opinion by Clayton Ruby

Endorsements of Ruby opinion by 29 senior Canadian law professors and international experts

After significant public pressure, the Winnipeg Police Service finally did undertake an investigation.  The Winnipeg Free Press reported in September 2011 that the police would be recommending that criminal charges be laid, according to a Manitoba Justice source, but the police denied that report.  Ultimately, in July 2012, the Crown Attorney made a decision not to proceed with any charges.  The Sinclair family requested that the reasons for that decision be disclosed, but that request was refused.

Human Rights violations take the lives of Indigenous people in Canada like Brian Sinclair

Brian Sinclair’s death was a manifestation of the systematic failure of the governments of Canada and Manitoba to abide by Universal Declaration of Human Rights, the International Covenant on Civil and Political Rights; the International Covenant on Social and Economic Rights; and the Declaration on the Rights of Indigenous Peoples.

“This particularly egregious instance of loss of life — an Indigenous man simply being ignored to death in a hospital waiting room in a large city in a wealthy G8 state — is the “tip of the iceberg” consisting of deaths by suicide, illness, violence, homelessness and other problems that take the lives Indigenous people in Canada disproportionately.

Regarding of the slow, painful death of Brian Sinclair in September 2008, it is apparent that governments of Canada and Manitoba are, inter alia, in violation of:

    1. The right to life. 
    1. The inherent dignity of the human person. 
    1. The right to health and the timely provision of emergency health care. 
    1. The right to freedom from racism and discriminatory treatment.

Submission to the Special Rapporteur on the rights of Indigenous Peoples (June 11, 2009)

First update to the Special Rapporteur (March 31, 2010)

Second update to the Special Rapporteur (Jan. 21, 2011)