Individuals who are mentally ill, distressed, or struggling with addiction are among the most vulnerable in any Aboriginal community. However, in addressing their needs, Western medical models of diagnosis and treatment marginalize the historical and social context of their suffering, the social inequities that exacerbate their distress, and the inner strengths and resilience of Aboriginal peoples and their cultures to survive despite ongoing adversity. This paper is grounded in research that has documented the lived experiences of Aboriginal peoples. Learning from this experience, I argue for the creation and application of an ethical framework in mental health and addictions programming that is led by Aboriginal health care leaders and based upon a blending of Aboriginal and Western understandings of moral governance. With the systematic application of ethical guidelines, success rates for prevention, promotion, and treatment programming will increase because of the added commitment to Aboriginal patients, clients, communities, and organizations; potential harm to vulnerable populations will decrease; and higher levels of trust between government health ministries and different levels of primary health care in Aboriginal communities, specifically community front-line health organizations and workers, will be achieved.
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