Cultural Safety, Family Influence and the Problem of Patriarchy

Lessons Learned through Ethnographic Research on Perinatal care for Highly Vulnerable Women in Montreal

Please welcome Dr. Kathleen Rice for a talk, as we start of this series of research seminars on a Wednesday. 

This talk is grounded in ongoing ethnographic research at a healthcare organization in Montreal called the Maison Bleue (“Blue House”), which provides interdisciplinary team-based social perinatal care to highly vulnerable women. Patients at the Maison Bleue share common vulnerabilities (e.g., low socioeconomic status; isolation; precarious immigration status in Canada), but are extremely diverse in terms of ethnocultural background, with many clients having followed complex migratory journeys prior to settling in Montreal. 

Since 2023, I have been working with the Maison Bleue to help them improve the cultural competency and cultural safety of the care that they provide to their increasingly diverse patient body. However, my ethnographic material shows that healthcare providers at the Maison Bleue struggle, practically and morally, with patient care situations where patriarchal and familial factors influence patient decision-making. Drawing on examples from my work at the Maison Bleue, this talk will show how current concepts of “cultural safety” and “cultural competency” that are promoted in Canadian healthcare and medical education fail to meaningful engage with how patriarchal power and extended family relations shape patient decision-making, meaning healthcare cannot determine how best to navigate these kinds of situations. Then, drawing on concepts of relational personhood and anthropological insights into collective decision-making, I will discuss my ongoing work aimed at developing a concept that can be used in medical education that better reflects the lived realities of patients. 

Bio

Kathleen (Kate) Rice is Associate Professor and Research Director in the Department of Family Medicine at McGill University in Montreal, Canada. A PhD anthropologist, she holds the Canada Research Chair in the Medical Anthropology of Primary Care. With two decades of research experience in academic institutions, research institutes, and academic hospitals in Canada and South Africa, in all her work Kate's research focuses on critically investigating everyday practice to understand the discourses, ideologies, and categories that shape healthcare and well-being (broadly defined), and the relations of power that underpin them. Kate's current areas of topical focus include perinatal care, chronic pain, and gender-based violence. Her areas of geographic focus are South Africa (especially the Eastern Cape), and urban and rural Canada (especially Montreal, and Northwestern Ontario). Her publications can be found in a range of social science and biomedical journals.