Volume 17, Number 2, Fall 2011
Représentations, pratiques et expérience dans le champ de santé : tendre des ponts entre des disciplines
Guest-edited by Marguerite Soulière, Geneviève Saulnier and Marie-Luce Garceau
Every society has its explanations for the problem of suffering and disease. Although those explanatory models and the therapeutic responses that correspond to them vary greatly, there are healers in every society. In the Western world, most of the healing is done by medical doctors. Is that to say that doctors are healers? This begs the question: what are healers? This article presents the results of a research project that has been conducted at Sainte-Justine Mother and Child University Hospital Center, in Montreal, a high level hospital serving a multicultural population. It is based on in-depth interviews with medical doctors of different specialties. The interviews explore the concept of healing through recurrent themes in the anthropological literature on the subject, such as the themes of gift, transformation and power. The analysis shows that most doctors don’t see themselves as healers, partly because they reject what they see as the magical components of healers’ practices that are, in their view, opposed to their scientific approach. For them, the doctor’s most important task is to identify the source of the ailment, to suggest a treatment and to accompany the patient on the road to recovery, assuming a part of his anguish. Paradoxically, this is quite close to the healer’s role as it appears in various cultural contexts described in the anthropological literature.
In obstetrics, several options are offered to improve health outcomes. These possibilities can be considered as many decisions that parents will need to face. To proceed to the choice of care, the model of shared decision making is currently the main paradigm. Taking as an example the decision process regarding the mode of delivery after cesarean section, we explore some aspects of the process of decision making in obstetrics. In general, decision making regarding the mode of delivery after cesarean is more the principle of autonomy then shared decision. Individual or group counseling, or decision analysis tools are promising tools to help with the various problems encountered.
This article is the result of a field research conducted among Haitian immigrants in Montreal, whose objective was to understand the low rate of immigrant families who visit the Gastroenterology Department of CHU Ste-Justine. We were interested in Haitian immigrants because they have an important medical culture and are one of the largest minorities in Montreal. We followed a qualitative methodology based on anthropological and hermeneutical approaches through thirteen semi-structured interviews conducted with five Haitian families. The analysis was based on the model « signs, meanings and actions » (Corin et Bibeau 1995). In this article we document the explanations and means of relieving the stomachaches of their children. Similarly, we identify the factors that led these families to do — or not — efforts to seek help from clinical services, and disclaim some useful ideas to clinicians who work with these populations. In general, these families assign tentative explanations for aches. However, they are in constant reformulation. Regarding the resources to deal with stomachaches, these families use different and simultaneous methods. The family space, church activities and links to community organizations are privileged therapeutic spaces. In general these families have ambivalent opinions about medical services and consider them as their last resource.
This paper present a recent experiment of intercultural training offered to practitioners at Le Pavillon du Parc, a readaptation center for people with an intellectual disability or autism spectrum disorder. This experiment consists in an exploratory stage of a doctoral research project and is based on intercultural approach and principles of experiential learning. This paper will describe and highlight the original model of training by presenting its theoretical basis and terms in the specific context of Le Pavillon du Parc. Finally, the perceptions of clinicians who were involved in this training activity will be presented in terms of their assessment of the strengths and limitations of this model.