What is to be done?
While we have a choice how to respond on an individual level to a
situation like the above, an ethic of hospitality also demands
consideration as to why the current design of our health care system may
obstruct fuller expressions of hospitality in the first place. We might
rightly ask why the design of acute care spaces conjures unfamiliarity
in the first place. We might ask to which degree health care systems may
carry negative connotations for those accessing them, thinking
specifically of the long history of colonialism and structural violence
that has impacted Indigenous peoples living in what is now Canada. We
might ask how the affordances of the medical language that clinicians
employ – so useful in effecting biomedical treatment – may be limited
by the impenetrability of that language to many families. We might ask
whether a more robust primary health care system may have meant an
earlier assessment of this infant, preventing him or her from falling
behind on secretion clearance and breastfeeding. These are necessary
questions that the demands of busy clinical duties might prevent us from
addressing, that current curricular content and design might not
adequately position us to even ask, and that a system that demands
exhaustive expressions of altruism from its individual practitioners to
shore up its shortcomings may obstruct.
It is undeniable that the onset of acute illness is a time of
unavoidable precarity. While there may be little we can do to offset
this aspect, infusing clinical care with an ethic of hospitality may
open up needed space to better understand how professional medicine can
provide care that goes beyond only addressing the biomedical aspects of
illness. Specifically, it provides us with an orientation and a language
that may speak to the silences that shroud patient experience of the
unhomelike state of illness and the journey into the kingdom of the
sick, the additional disorientations that may accompany a family’s
navigation through the landscapes of the acute care setting, and the
vulnerabilities and anxieties that accompany patient engagement with
health care systems writ large.