Medical Colonialism and the Power to Care: Unsettling Participatory Inclusion in the Settler-State Care Paradigm

This article looks at the implications of medical colonialism in Canada for the feminist concept of care. Because medical colonialism is an ongoing material relation where good settler care cannot be separated from Indigenous dispossession, I defend the view that care and violence can be coextensive and suggest that a decolonial care ethic needs to disrupt the directionality of care as flowing from agential carers toward colonized care-receivers. I argue that contemporary medical colonialism should indeed be understood as a form of care if structural harm is to be addressed in practice, and trouble the notion of inclusion at work in some contemporary theories of care. By finding demands for assimilationist participatory inclusion in examples of government-run, Indigenous-serving care services, I caution against the implicit settler-colonial assumptions in notions of caring democracies and caring societies on the welfare-state model. If care is political and can participate in the normative pressures of civic assimilation, then to decolonize it through refraction, disruption, infiltration, disconnection, re-appropriation, and resistance also means to decolonize citizenship and civic life in the interests of Indigenous self-determination, rather than presumed inclusion in settler-state processes.