[by Renée Fregosi]
On May 7, 2021, Le Quotidien du médecin published an article entitled "Medical universalism in the face of identity surges". It is significant that the medical profession now dares to speak out loud about practices that have been going on quietly for several years now. The supporters of a universalist humanism seem to feel more heard and supported since organizations such as LICRA, on the occasion of the renewal of their leadership, returned to their original positioning after having given in for a time to the vulgate of communitarian political correctness. Without doubt, movements such as the Observatoire du décolonialisme have also contributed to the lifting of the omerta in many professional circles (academic, but not only).
The issue of communitarian lists of doctors began to make noise in the media in August 2020 when Myriam Aïssatou's Twitter account entitled "Globule Noir" proposed a directory of caregivers of color. This list was described as "Folie identitaire" by LICRA and the CNOM (National Council of the Order of Physicians) spoke of "sirens of communitarianism and division". Of course, the "anti-racist" activist justified her "individual" initiative by what she considers to be racism, if not yet "systemic", then at least frequent: "what is unacceptable are the words and gestures of certain caregivers towards black patients" she says. An assessment supported by the CRAN (Representative Council of Black Associations) whose vice-president and spokesperson Thiaba Bruni affirms: "The denial and impunity of racist remarks and acts in the medical field is mind-boggling".
Certainly, as Dr. Juliette Tchuenbou, president of the Association of African Doctors of France (AMAFF), says: "that patients have the impression that they will be better cared for by caregivers of the same origin, closer to them, is perfectly legitimate and it is a societal evolution that goes beyond medicine." And of course, except in the case of an emergency at the hospital, the patient's free choice of doctor must be respected. Moreover, we see here the opening of a breach of communitarianism concerning the medical environment, it is true, in the same way (but no less) than the whole of society.
Each person privileging, to the detriment of all other possibilities, a real or imaginary belonging to an ethnic-cultural group or one marked by another specificity but considered as "discriminated", communities are formed and close in on themselves. All social relations, including the therapeutic bond such as the neighborhood in the home, camaraderie in the school establishment and with work colleagues, are established and remain within the exclusive belonging group. And this works regardless of the community chosen as a referent.
Thus, in the medical community, several alerts have been launched about directories of religious doctors to denounce "religious fundamentalisms that threaten our health system", as the weekly Marianne headlined on November 14, 2019. On Twitter, unionists such as Jérôme Marty, president of the UFML, or a nurse member of the Printemps républicain, Vincent Lautard, have warned about the creation of the directory of the Muslim Organization of Health Actors (OMAS), close to the Muslim Brotherhood. According to Vincent Lautard, the organization supports care "according to the rules of the Koran" and promotes medical obscurantism: "We will go see a doctor who shares his beliefs, by mixing religious practice and medical practice, which is problematic." The separation of the sexes in particular will be affirmed in the refusal that women be treated by men and vice versa.
Certainly some Catholic doctors have not remained: the association "Choisir la Vie", which organizes marches against abortion and the Leonetti-Claeys law, offers training intended for health professionals and students from a denominational perspective obviously. And evangelicals like the Universal Church of the Kingdom of God organize sessions of "restoration of health by faith" and advocates the taking into account of sexual orientations, with risks of sectarian deviations denounced by the MIVILUDES (Interministerial Mission of Vigilance and Fight against Sectarian Deviations).
In addition, other directories have emerged on the Web at the initiative of associations that claim to be feminist. Created in 2018, the collective Pour une MEUF (For committed, united and feminist medicine) brings together around a hundred caregivers, many general practitioners, midwives, nurses and speech therapists. Another medical island was created at the initiative of overweight people, the "fat people" as the Gras Politique collective more simply calls them. It collects patient testimonies (graspolitiqueliste@gmail.com) to blacklist discriminatory practitioners on the Internet: "Caregivers, you are on this list because your users have reported fatphobic behavior or mistreatment," explains their site.
The beginnings of this movement of community medicine can be traced back to when gay doctors created an association (AMG) in 1982, when AIDS was beginning to decimate homosexual patients. Now dormant, the AMG passed the baton in 2016 to the network of doctors gay friendly, at the time of the debate on marriage for all, reacting to a context of more or less latent homophobia to offer LGBT people a directory of some 400 professionals. Among them, Dr. Véronique Sansigolo, a general practitioner, specifies that her approach is "purely friendly, without judgment or proselytism; the network would only pose a problem if it became sectarian and expanded."
Indeed, this reaction of solidarity and support for homosexuals who were truly ostracized at a time when AIDS was considered "the gay cancer" was completely understandable and very useful in several respects. Thus, the pressure that associations put on public authorities and scientific circles probably contributed to the early discovery of the virus and then to the acceleration of research into treatments. But like any social phenomenon, the structuring of the homosexual milieu also produced perverse effects (i.e. unwanted and sometimes contrary to the initial goal), in particular the risk of a separatist identity withdrawal.
This is the flaw that can undoubtedly be blamed on the proliferation of racialist, religious, sexist and communitarian networks of all types. The risk consists in fact in the departure from a universalist conception of medicine, in other words the abandonment of a personalized approach, that is to say centered on the whole person, on the unique individual, in favor of an approach favoring the collective dimension supposed to define the patient alone. While the very singularity of each person makes him belong to the common humanity of humans beyond their diversity, communitarianism denies the plurality of particularities that constitute us and which in this case must inform the diagnosis and guide the therapy adapted to each person individually.
