The Little Salmon Carmacks First Nation is asking Yukon Supreme Court to order a coroner's inquest into the death of Cynthia Blackjack, who died while being medevaced to Whitehorse from Carmacks on Nov. 7, 2013.

Together with Blackjack's family, the First Nation is arguing that the coroner's original investigation was inadequate, and did not address "systemic racism" as a potential factor in Blackjack's death.

The day before she died, 29-year-old Blackjack had gone to the Carmacks nursing station complaining of toothache, abdominal pain and vomiting.

The cause of Blackjack's death was reported as multi-organ failure secondary to liver failure. A coroner's report the following year cited issues with medical equipment and made recommendations for the government to review policies and procedures.

But the lawyer representing Blackjack's family and the First Nation says the coroner's investigation was inadequate, as it failed to consider systemic racism in Yukon health care. They want a formal inquest, a quasi-judicial proceeding before the coroner and a six-member jury.

The First Nation also asked in 2015 for an inquest, but coroner Kirsten MacDonald refused. The First Nation then applied to the court, and the coroner argued the First Nation has no standing. (Cheryl Kawaja/CBC)

According to the Yukon Coroners Act, the coroner can order a formal inquest if there's reason to believe someone died "as a result of violence, misadventure, or unfair means or as a result of negligence, misconduct or malpractice on the part of others."

The First Nation also asked in 2015 for an inquest, but the coroner refused. The First Nation then applied to the court, and the coroner argued the First Nation has no standing.

The court disagreed and the petition is now before a judicial review.

'Lay bare those problems that do exist'

Blackjack was an alcoholic and was known at the Carmacks nursing station. After her visit on Nov. 6, she was given a tentative diagnosis and treatment, then sent home and told to find her way to the Whitehorse hospital, a two hour drive away or come back at the end of the day.

Carmacks is about a two-hour drive from Whitehorse. Blackjack had initially been advised at the Carmacks nursing station to make her way to Whitehorse on her own.

Blackjack did not go to Whitehorse or return to the nursing station that day. The next morning her health had deteriorated.

Her family called for an ambulance but according to the lawyer for Blackjack's family, Susan Roothman, it took about an hour and a half before a Carmacks ambulance was eventually sent to bring Blackjack to the local nursing station.

She was eventually medevaced to Whitehorse but court documents say her vital signs were lost before the plane reached Whitehorse.

Roothman argued in court on Thursday that systemic racism in the health care system means First Nations people are not always getting the care they need, especially in remote northern communities.

"If you are First Nations, the ambulance is not dispatched if you have a problem," she said, as an example. "This case provides a unique chance to address those problems in Yukon ... Lay bare those problems that do exist."

"As long as these issues are not publicly aired, nothing will be done about it."

Roothman argued that an inquest is not just about determining who died and the reason for the death, but it should also examine broader issues.

"Many people do not want to seek medical attention now because of what happened to Cynthia," Roothman told the court. "We can't wipe racism under the carpet and say it doesn't exist."

Reading from an affidavit from Blackjack's family, she said, "I am so mad at how the nurses treat First Nations," and "Why was she turned away when it was an emergency... this is so painful, this treatment must stop."

No evidence of racism as factor in Blackjack's death, lawyer says

Rick Buchan, a lawyer representing Kirsten Macdonald, chief coroner for the Yukon, said there is no evidence to suggest a delay with the ambulance, or racism, were factors in Blackjack's death.

"There may well be some degree of racism, discrimination in our health care system, and it may exist in Carmacks, but [the coroner] takes no position on that," he told the court.

"The cause of death was wholly associated with Cynthia Blackjack's terrible state of health, her alcoholism, her obesity."

Buchan further argued that the court doesn't have the jurisdiction to order an inquest in this case since the coroner has already rejected the idea, but he said the court can look for legal errors in the coroner's ruling on the death.

Justice Ron Veale has reserved judgement.