The state demands that its doctors be even more productive. If we trust the text of Marie-Eve Cousineau published in The duty November 10, it is not surprising that some of them plan to abandon their patients for the sake of preserving their well-being. It seems that the state no longer understands medicine.
Since the 1980s, with the rise of neoliberalism, the value of care has been radically changed. The State, in its accounting logic, does not understand that the act of care goes far beyond the technical gesture, which, after all, is relatively easy. To treat is also to consider the existential dimension of the patient, it is to warm his heart, it is above all to listen to what seeks to express itself in the patient when the disease turns his life upside down.
It is not acceptable to think of medicine on the model of industrial production. The act of care is not engineering. Imposing an infernal rhythm on our doctors and all health professionals can only distort the act of care. Even if the State implanted an efficient system in home care as well as in all other spheres, doctors would practice medicine with death in the soul if we do not understand that they participate in the reconfiguration of human life. in its existential dimension. There is incompetence in the understanding of what personal care is, there is a mutilated vision of its essence: to offer thoughtful support adapted to people’s vulnerability.
When the Quebec government wants to make physicians more productive, that implicitly means reducing medicine to a technical act. The technique has become the symbol of success, especially since it is easily observable, measurable and quantifiable. We do not understand that the life of the patient with his disease does not end with an examination; it is an experience which challenges the doctor. It’s no wonder Frankenstein regains his humanity when he accesses feelings. If our health care system has become terrifying, it is because we have discarded the lived experience and the meaning of a human life that inhabits the patient, in the same way that we have discarded the ideal of the care of the patient. side of caregivers.
For 40 years, we have not stopped destroying the act of care. In this context of high technical performance where care is no longer in the direction of the patient, but of production, it is not surprising that caregivers feel betrayed in their ideal, defeated by an administrative power obsessed with profitability. . We forget that the caregiver allows continuity in a life story. We do not understand that in the act of care, it is the existential that jumps in the face of any caregiver.
The state’s attempts to make every doctor part of the cogs of the big machine demonstrate the political nature of medicine. However, there is no political answer without ethical questioning about the meaning of care. It is not a better system that we need, but a change of thinking. Ethics is the courage to defend humanity lurking at the bottom of the act of care carried out by each human being, including the caregiver. More than ever, it becomes necessary to make a dent in these morbid ideas promoted by the State. At a time of politicization of medicine, critical thinking is essential to give the field a human soul. Because in the determination of medicine, the human being puts his destiny into play: the question is to know what we honor.
The instrumentalization of medicine on the basis of quantitative objectives, as in industry, takes us away from its spirit: an attention to vulnerability, to the power of life, to the passage of time, to promises and to meaning. of life which are developed in the clinical encounter, and which require listening time.
Is it then possible for a doctor to continue in his deep desire to treat when he sees an institution that cracks everywhere, letting its humanity slip away? We can say that the escape of medicine from the act of care, carried by the Hippocratic soul, can only promote its own ruin. In this case, should we be surprised if we are witnessing a disengagement?