From “intact knowledge” to “knowledge in contact”. A feminist review of the meaning of “contact” in contemporary debates about clinical relationships

Abstract

In the last decade, medical professionals have proposed an apparently renewed and hopeful role for patients in their relationship with professionals, namely the “smart patient” model and other proposals coming from humanizing medical trends. In this article, I critically analyze the “smart patient” model as a contemporary historical assemblage that reflects an apparent trend in biomedicine: the revaluation of “contact”, between professionals and patients, and the promotion of patient participation and education to be better informed. However, does this enhancement of contact implies, within the relationship, a transformation of the consideration of biomedical expert knowledge? To answer this question, I analyze the limits of emerging models, and I provide a rereading of the contact perspective. I contrast this perspective with the approach of two classic works of feminist anthropology, published two decades ago, and which critically address the so-called “Evidence-Based Obstetrics”. I will put these works into dialogue with phenomenological readings that transcend a vision of the body based on the gendered binary body / mind. These dialogues will allow me to delve into the proposal to analyze the clinic as a space for the creation of “contact zones” in specific (g)local contexts. This analysis has a critical value for the present. It will also allow me to argue in favor of encounters ‒between transdisciplinary professional teams, patients and organizations- that look for an epistemic rebalancing that embraces the experiential knowledge of those who suffer. These encounters I am proposing do not leave medical knowledge intact.