title: Resituating the ethical gaze: government morality and the local worlds of impoverished Indigenous women.
abstract: BACKGROUND
  Over generations, government policies have impacted upon the lives of Indigenous peoples of Canada in unique and often devastating ways. In this context, Indigenous women who struggle with poverty, mental illness, trauma and substance abuse are among the most vulnerable, as are Indigenous children involved in child welfare systems.
  
  
  OBJECTIVE
  By examining the life history of Wanda, a First Nations woman, this article examines the intergenerational role that government policies play in the lives of impoverished Indigenous women and their families. Questions of moral governance and responsibility and the need for ethical policies are raised.
  
  
  METHODS
  The life narrative presented in this article is part of a larger qualitative research programme that has collected over 100 life histories of Indigenous women with addictions and who have involvement with the child welfare system, as children or adults. Wanda's life story exemplifies the impact of government policies that is characteristic of vulnerable Indigenous women and draws attention to the lack of ethical standards in government policymaking in child welfare, public health and mental health/addictions.
  
  
  RESULTS
  The path to recovery for Canadian Indigenous women in need of treatment for co-occurring mental disorders and substance addiction is too frequently characterized by an inadequate and ever shifting continuum of care. For those who feel intimidated, suspicious or have simply given up on seeking supports, a profound invisibility or forgetting of their struggle exists in areas of government policy and programming provision. Living outside the scope of mental health and addiction priorities, they become visible to the human service sector only if they become pregnant, their parenting draws the attention of child and family services (CFS), they need emergency health care, or are in trouble with the law. The intergenerational cycle of substance abuse, mental illness and poverty is commonly associated with child welfare involvement, specifically practices that place the health and well-being of Indigenous children at risk. In order to break this cycle, close attention to implementation of ethically based policies and best practice interventions is required.
  
  
  CONCLUSIONS
  From an ethical policy perspective, the focus of government policies and the practices they generate must be first and foremost to ensure that individuals, families and groups are not left worse off than prior to a government policy impacting upon their life. Furthermore, the impact of living a life determined by multiple government policies should not be a story of individual and family devastation, and government policies should not be the most significant determinant of health for any group of people.
authors.affiliation: Department of Psychiatry, University of Saskatchewan, Saskatoon, Canada. caroline.tait@usask.ca
authors.forename: Caroline L
authors.initials: CL
authors.lastname: Tait
mesh_terms: D000328:Adult; D002170:Canada; D002648:Child; D002669:Child Welfare / Q000941:ethics; D005260:Female; D006078:Government Programs / Q000941:ethics*; D006291:Health Policy; D006801:Humans; D007198:Indians, North American; D009014:Morals; D011203:Poverty / Q000208:ethnology*; D012941:Social Responsibility
keywords: First Nations; addictions; child welfare; ethical policy; government policy; mental illness