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French

ID: <

10.7202/055408ar

>

·

DOI: <

10.7202/055408ar

>

Where these data come from
For a sociology of medical practice in Quebec

Abstract

there is a lot of discussion in Quebec about medical practice. The new social security measures have called into question its traditional practice. But this is perhaps not the most important one: the status of the doctor has long been linked to a more general context of privileged occupations which are radically changing. In addition, there are profound changes in attitudes which have not yet been carried out very openly, but the expectations of the patient vis-à-vis the doctor are also shifted. There seems to be a poorly cultivated field of research in us where there are problems that are decisive for a sociology of occupations; but it is also a sociology of knowledge that is concerned not only with the ideological origins of science, but also with regard to its integration into social practices. In order to continue research on this issue, it should be possible to establish the history of medical practice in our country. For the time being, the documentation has proved to be thin. It seemed to us that a broad position on the problem was first necessary. Is it not appropriate to formulate a coherent set of questions at the outset? It is this analytical framework that I shall set out here: our assumptions may, in subsequent studies, be subject to more detailed historical and sociological investigations. Let us first present our most general perspectives. Talcott Parsons proposes five fundamental elements which, in his view, summarise the characteristic features of the professional role of doctors in modern society. These are: 1. Technical competence: knowledge of the doctor in so far as it consists of applied scientific knowledge. 2. The universalism of the role: the doctor treats all his patients equally, solely because of what they suffer and not because they are or do in society. 3. The specific functional role: all aspects of the doctor’s role, competence, authority, privileges and obligations are limited only to health and maladie.4. Emotional neutrality: prohibiting doctors from experiencing personal feelings towards their patients. 5. Disinterested and altruistic attitude: the doctor places the well-being of the patient above his or her personal interests and excludes movers from profit. We believe that these five lines can logically be linked to the following three aspects of medical practice: 1. The internal definition of medicine: the definition of medicine by the dimension of knowledge, since it represents the core of its internal organisation. Together with the doctor’s technical competence. 2. The institutional framework for medical practice: all the social, economic and political factors which actually determine the practice of medicine (the state, prevailing ideologies, the College of Doctors, etc.). Together with the universalism of the role, emotional neutrality and the specific functional role. 3. Medical values: mainly disinterest and altruism. They remain constant at all times at all times and provide justification for the medical practice from Hippocrate. Together with the disinterested and altruistic attitude, emotional neutrality. Let’s mark a second step and let us say what is now called the extreme dimensions of any social structure: culture, socio-economic organisation. In the cultural centre, we link the internal definition of medicine, the medical values and the features of Parsons attached to them. In the socio-economic cluster, we link the institutional framework for medical practice and the features of Parsons attached to it. We are thus faced with a sort of systematic.The systematisation it entails is essential for a clear understanding of the link and the implications of the social factors in question. But societies, as we know, never function as coherent mechanisms: our systematic approach must therefore enable us to assess the discrepancies and even the contradictions which mark the structure of medical practice. To give us a historical perspective, we will apply our model in turn to the traditional practice of medicine and current practice.

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