Conflict and Recognition in the Social Space of the Clinic
Diversity – whether social, cultural, ethnic or religious – challenges the provision of health care services on a daily basis. This variable characteristic of patients and health care providers shapes the encounter between migrants and non-migrants, minority and majority members of different identities and belongings to national or ethnic origins, social status and religious affiliations. Clinical encounters are traversed by this diversity and become a social space for the negotiation of knowledge, norms and values (care-receiver/care-giver/family). Beyond the specifics of the health care context and the care-giver/care-receiver relationship, the quality of social relationships within the clinic is not exempt from local societal dynamics. The hospital is also a site where recent migrants happen to intersect with local institutions, surpassing its symbolic role as a site of care. The hospital is a political and apolitical actor in the city. From a comparative study of Canadian pediatric hospital settings, we will discuss the relational dynamics (care-receiver/care-giver/family) within therapeutic areas (complex, acute and chronic care) paying attention to situations marked by conflict. We will explore how the negotiation of norms and values in these contexts may facilitate the emergence of a plural medical practice, in synchronization with the locality. This negotiation is largely dependent on the recognition or lack of recognition of the Other in the clinical space. Consequently, health care settings are becoming a context which enables us to understand the changing relationship dynamics in cosmopolitan milieus.