Making secular 'French" medical ethics: transcendent morality and patient subjectivities in southern French hospitals
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Accepted manuscript
Date
2020-12-01
Authors
Arkin, Kimberly
Version
Accepted manuscript
OA Version
Citation
Kimberly Arkin. 2020. "Making Secular 'French" Medical Ethics: Transcendent Morality and Patient Subjectivities in southern French Hospitals." Journal of the Royal Anthropological Institute, Volume 26, Issue 4, pp. 824 - 841. https://doi.org/10.1111/1467-9655.13418
https://doi.org/10.1111/1467-9655.13418
Abstract
Drawing on eight months of fieldwork with southern French physicians and nurses working in two state-funded hospitals, this paper explores why and how medical care providers worked to produce a distinctively ‘French’ medical ethics. As the laws and expectations governing French medicine are increasingly saturated with discourses of patient autonomy, responsibility, and choice, some southern French doctors have pushed back, countering what they call ‘Anglo-Saxon transactionalism’ with a quasi-nationalist defence of patient ‘dignity’ that serves as a counterweight to ‘liberty.’ I argue that this national ethics of ‘dignity’ is shot through with anti-liberal, anti-consumerist, and corporatist assumptions about personhood and society, assumptions that bear striking affinities to some contemporary French Catholic moral concerns. But in the public space of hospital ethics deliberations, these moral concerns are experienced and presented as secular. Doctors and nurses offer pseudo-psychoanalytic accounts of patient subjectivities that paint individuals as incapable of knowing, let alone ‘owning’ or fully mastering themselves. Instead of scaffolding autonomous patient ‘choice,’ such depictions suggest that hierarchical authority and transcendent morality are requirements for appropriately ethical outcomes. By paying close attention to these arguments about patient subjectivities, I ultimately suggest that some aspects of French secularity may be far less Protestant and liberal than contemporary anthropological work tends to assume.