Cultural Safety and Providing Care to Aboriginal patients in the Emergency Department.

In July 2014, the United Nations Special Rapporteur on the rights of Indigenous peoples concluded that Canadian Aboriginal peoples face human rights problems of crisis proportions. The consequences of this are evident every day in many of Canada’s emergency departments (EDs), yet the implications for ED patient care are not obvious. In a recent report, the Royal College of Physicians and Surgeons of Canada (RCPSC) stated, “[I]f the mainstream healthcare system in Canada is to be effective in helping to improve the health of First Nations, Inuit, and Métis clients, it must provide culturally safe care.” EDs across the country treat the most acute manifestations of Aboriginal health inequities, manifested through disproportionate burdens of addiction, mental illness, physical trauma, chronic diseases, and infectious diseases. However, concepts related to cultural safety remain nebulous to most emergency physicians. The purpose of this paper is to present background and principles relevant to the practice of cultural safety in the ED.