Indigenous Health Policy and the politics of 'Democratic Exclusion' or Self-determination

The tensions, contradictions and inconsistencies that pervade contemporary Indigenous health policy are grounded in the philosophical positions that policy actors take on the nature and conditions of Indigenous belonging to the liberal democratic state. The theoretical contradictions that distingush and confuse the policy environment are contrasted to show that participatory parity, recognition and relational justice combine to create a theoretically defensible and substantive framework for thinking about self-determination as an alternative to democratic exclusion, which remains the predominant influence over the public construction of Indigenous health policy. The argument presumes that just relationships require a politics of recognition that admits Indigenous peoples as distinct political communities whose extant rights are affirmed at international law and include the rights to deliberate in public affairs, to have their cultures respected in dealings with the state, and to function independently of the state in areas such as health.