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Overcoming social differences in care provision: Clinical practices, ethical dilemmas, and sociological reflexivity

Par : Contributeur(s) : Type de matériel : TexteTexteLangue : français Détails de publication : 2023. Sujet(s) : Ressources en ligne : Abrégé : This article offers a reflection on the possible clinical and ethical uses of the flourishing body of social science work on social inequalities in health in France—studies that increasingly emphasize the impact of healthcare on these disparities. A review of recent surveys reveals that ways of providing care and interacting with patients can be marked by a lack of social understanding as well as being fraught with stereotypes. Our own work has helped shed light on a tendency toward social profiling in preventive care, specifically in general practice. We review sociological survey data on the ethical-political positions of professionals in French healthcare, and reflect on the contradictory injunctions inherent in care. The demonstration of the endogenous production of social inequalities in healthcare complicates, through a kind of social imperative, the classic ethical tension between universalism and personalization of care. Would a sensible adaptation of healthcare practices therefore take unequal social relationships into account and try to limit their impact? What does—and what could—work in the sociology of health contribute to this endeavor? By mobilizing the social sciences and drawing on the reflexivity of clinicians, we offer some markers to blaze the path toward a socially informed ethic to attempt to reduce the damage linked to the paradox of egalitarian care in an inegalitarian society.
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This article offers a reflection on the possible clinical and ethical uses of the flourishing body of social science work on social inequalities in health in France—studies that increasingly emphasize the impact of healthcare on these disparities. A review of recent surveys reveals that ways of providing care and interacting with patients can be marked by a lack of social understanding as well as being fraught with stereotypes. Our own work has helped shed light on a tendency toward social profiling in preventive care, specifically in general practice. We review sociological survey data on the ethical-political positions of professionals in French healthcare, and reflect on the contradictory injunctions inherent in care. The demonstration of the endogenous production of social inequalities in healthcare complicates, through a kind of social imperative, the classic ethical tension between universalism and personalization of care. Would a sensible adaptation of healthcare practices therefore take unequal social relationships into account and try to limit their impact? What does—and what could—work in the sociology of health contribute to this endeavor? By mobilizing the social sciences and drawing on the reflexivity of clinicians, we offer some markers to blaze the path toward a socially informed ethic to attempt to reduce the damage linked to the paradox of egalitarian care in an inegalitarian society.

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