MONTREAL -- Atikamekw leaders testifying at a coroner's inquiry Tuesday called on the Quebec government to recognize systemic racism in the health-care system and adopt the community's solutions to reduce inequities faced by Indigenous patients.

The inquiry is examining the death of Joyce Echaquan, a 37-year-old Atikamekw mother of seven, who filmed herself on Facebook Live as a nurse and an orderly were heard making derogatory comments toward her shortly before her death last September at a hospital northeast of Montreal.

Paul-Emile Ottawa, chief of the Conseil des Atikamekw de Manawan, said her passing has left an open wound in the community, located about 250 kilometres north of Montreal. Ottawa told coroner Gehane Kamel that Echaquan's death exacerbated the fears of a community already reluctant to seek care at Quebec hospitals.

"On some level, we all feel guilty for being unable to act so that Joyce could be saved," Ottawa said. "It was a huge trauma for everyone, even today … the fear that it'll happen again."

He said people in the community of 3,000 were panicked and stunned by the video, which depicted a dying woman being mistreated by health-care workers at the hospital in Joliette, Que., located about 75 kilometres northeast of Montreal. Echaquan's daughter had also filmed her mother at the hospital shortly before she died.

"Never again do I want to see images like those that still haunt me today -- no more videos like Joyce broadcast in a bid to save herself, no more videos of a daughter filming her mother dead and powerless," Ottawa said.

His recommendations include having doctors and other health-care staff trained in school on the realities of the country's Indigenous Peoples, simplifying the hospital complaints process, recognizing systemic racism and adopting Joyce's Principle.

Joyce's principle is a series of measures drafted by the Atikamekw community to ensure equitable access to health care for Indigenous patients. The document describes Quebec's health system as being imbued with systemic racism.

The numerous recommendations in Joyce's Principle include that the federal government revise its financing model for health and social services regarding Indigenous groups and that Quebec set up an ombudsperson for Indigenous health.

Premier Francois Legault and his government have refused to accept the full document because of its mention of systemic racism, which they deny exists in Quebec.

Constant Awashish, grand chief of the Conseil de la Nation Atikamekw, told the inquiry Tuesday that the government's refusal to adopt Joyce's Principle is a "perfect example of systemic racism." Awashish invited Legault to reflect carefully on the issue.

"Joyce's Principle are solutions that we brought, we are the ones who live with discrimination, with systemic racism, we are the ones bringing simple solutions, we want it to be done by us, not by others for us," Awashish testified. "If we're able to apply it, things will get better, for us and for society … because everyone will feel safer."

Echaquan's husband or daughter are expected to take the stand one last time on Tuesday, before lawyers for the various parties deliver their final representations Wednesday.

- This report by The Canadian Press was first published June 1, 2021.