The Indian philosopher Amartya Sen, who developed the "capabilities approach" according to which an individual's freedom to achieve well-being is best interpreted by the capabilities granted to him to achieve the goals and life they desire has been quoted as saying that “…human beings live and interact in societies and are social creatures. It is not surprising that they cannot fully prosper without participating in political and social affairs and without being effectively involved in joint decision-making.” (Public Health, Ethics and Equity, 2004). Say no to plagiarism. Get a tailor-made essay on "Why Violent Video Games Shouldn't Be Banned"? Get an Original EssayThis statement validates the importance of self-determination as it is an invaluable process for marginalized individuals to set their own goals and implement policies that benefit the target population and nullifies the effects of colonial and destructive policies of assimilation. Positive change occurs in the realm of self-determination and self-governance, as a result of restoring autonomy to the affected indigenous population and encouraging them to be innovators of problem-solving strategies within their communities. Speaking strictly in terms of health, the Marmot-Whitehall study is a great example of the benefits of self-determination in improving health outcomes. As part of this study, researchers studied the hierarchy of the British civil service and attempted to ascertain how certain social classes impact mortality and morbidity. Researchers have found a correlation between higher status and better health outcomes. Michael Marmot attributed this relationship to autonomy and the level to which people feel in control of their lives, stating that “social injustice is disempowering. It deprives people of control over their lives. In low-income countries, where people struggle to feed their children and lack access to clean water and sanitation, their powerlessness is material, as is the feeling of being at the mercy of forces outside the own control." (The Health Gap, 2015). Therefore, when individuals do not feel in control of their destiny and livelihood, a positive correlation can be drawn with worsening health outcomes. This relationship manifests itself with the Indigenous population sharing the least amount of autonomy in Canada as a community, exhibiting the worst overall health outcomes within the country. In the presence of positive self-determination and self-government policies, communities feel in control of their own future and destiny. As a result, health outcomes improve based on the degree of autonomy gained, and areas that need to be specifically targeted and prioritized are given prominence, which serves to improve health and socioeconomic outcomes more easily than an outsider attempting to rationalize changes. that the community must contribute to the benefit of the target population. One of the biggest obstacles to Indigenous self-determination in health matters can be attributed to general dishonesty on the part of the federal government. This history dates back to the implementation of Treaty 6 and the Pharmaceutical Clause, in which the government exercised plausible deniability against indigenous peoples, insisting that the spirit of the clause was not to provide free uninsured health care benefits, ranging from dental care , to medicine supplies and access to traditional healers to the indigenous people, but claiming that they only had to provide a medicine chest or afirst aid kit. This example of dishonesty also plays out in today's society with the federal government cutting transfer funding to First Nations health facilities on reserves and Inuit health care in northern Canada. These policies have been justified by the federal government as the result of running deficits, and ensuring that the budget remains balanced, however, this apathetic attitude comes at the expense of the benefits of Indigenous self-governance within their own structures and health outcomes overall. This paradigm was eloquently explained in a book on Aboriginal social determinants as “…the current shared federal/provincial responsibility for the provision of health and social services for First Nations peoples includes health services, education, social support and assistance to childhood. Shared responsibility has not been a collaborative effort based on meeting client needs but, rather, has led to jurisdictional ambiguity that leads to inequitable access to required services – and, often, gaps or barriers to service.” (Aboriginal Child Health and the Social Determinants, 2010). These policies are to the detriment of Indigenous self-governance because they accentuate the gap between obtaining health care at a city facility versus an Indigenous individual receiving care at a rural health facility. reserves, as the disparity in funding leaves health facilities on reserves at a huge disadvantage in providing adequate health care. Underfunding affects self-determination because it creates a scenario where only routine healthcare is met, resources provided cannot meet demand, and healthcare staff must compromise to save costs, which is antithetical to achieving optimal healthcare. the federal government has put itself in the driver's seat in determining who gets certain benefits is with the management of the First Nations and Inuit health branch, the problem with this program is "...the FNIHB limits its services to First Nations and Inuit populations who are registered with the Department of Indian and Northern Affairs of Canada and many of their programs are limited to people living on reserve. As previously mentioned, Metis and non-status First Nations are excluded from health services, benefits and FNIHB programs.” (Social Determinants of Health: Canadian Perspectives, p. 454) The irony with First Nations and Inuit Health Department eligibility is that this process is based on specific accommodation. of the needs of indigenous peoples, ultimately takes the option of applying for these benefits out of the hands of indigenous peoples and is decided by an arbitrary third party of the government and some groups of indigenous peoples are excluded from reaping the benefits. Michael Murphy in the University of Toronto Law Journal attributed the ancient indigenous colonial policies that had served to define who qualified as an indigenous individual from the white perspective to the government's "divide and conquer" mentality and attributed it to a legacy of isolation that has always been consolidated, stating that in those times "alienation was more important, from the government's point of view, because their ultimate goal was to legally define Indians disappear, thus relieving themselves of any further political or financial responsibility for these populations” (Representing Indigenous Self-Determination, 2008). The types of policies we see with selective policing of First Nations and Inuit Health Departments are anti-self-determination and strangely not too far from.