Prejudice penalize caregivers support homeless cancer

The moral judgment of caregivers frequently affects the medical care of people homeless person (SDF), especially when they are diagnosed with cancer, said the anthropologist Yann Benoist, speaking at the conference Ethics and cancer organized by the League against cancer at the Museum of Science and Industry in Paris.

The homeless are afraid to seek treatment

Yann Benoist, ethnologist and anthropologist at the University of Paris V - René Descartes, followed people homeless for several months in 2006. He has been in contact with people from three schools in Nanterre, the Hosting Center and Home Homeless People (CHAPSA), the Residential and long-term reintegration (CHRS) and home retirement welcoming former homeless, all of which "known wandering."

Analyzing their relationship to the system of care, he noted, "and this is not new, it is a big problem of support in the area of extreme poverty, where the use of care is absent or very random ".

For cancer, it is even worse than "homeless cumulative risk behaviors, including alcohol, tobacco and malnutrition. As they have their own representations of caregivers, negative, the majority refuses to go see a doctor. Added to this is a medical treatment unsuitable for this population, "which is probably feed their fears.

Time medicine encroach on the activities of the homeless, "to the sleeve, alcooliser, doing paperwork for undocumented immigrants, etc..". Yann Benoist stated in an interview with the newspaper of the League "Gradually close" the homeless "does not seek treatment for fear that prevents them from drinking. For them the pain of alcohol withdrawal is stronger than the pain of the disease. "

In this interview, he also stated that homeless people "does not necessarily link their cancer such conduct [of alcohol], even though they know the risks. Hobos are solicited for screening, they know what what a cancer, but only consider their disease, is alcoholism. "

Fools, children, wild

At the symposium, Yann Benoist also explained that over time took on their activities and wanting to prevent drinking, "homeless people quickly considering medicine as a coercion. Consequently, caregivers consider them psychiatric cases and the gap is widening. "

"In the medical pregnant, they are taken either fools or for children need mothering, even for Indians. The advantage of these representations for caregivers is to reassure themselves on their own identity. They also justify the idea that the medical scheme is good. Nothing is done to suit specific needs, "he complains.

He illustrated his point with two examples. The first was a man, a former homeless in long-term home, undergoing radiation treatment for cancer. "He never went to these meetings and apologies were deemed inadmissible by the medical profession. Caregivers therefore declared that he was in denial about his illness and his intelligence and understanding were poor. They have prescribed anxiolytic without explanation. "

The ethnologist, after discussion with this man says that "it was not in denial. He chose, given their living conditions, to spend time with his friends before he died rather than its meetings Radiotherapy ".

It then summarizes the case of a woman who complained of pain in one breast. "His complaint did not give rise to an immediate diagnosis.'s Team said it's crazy, she does not have cancer, do not believe what she says' me. A following another consideration for anything else, she again complained of pain in this and caregivers have discovered cancer. This would never have happened to a non-homeless person. "

Profitable and unprofitable patients

"Does a good sick person who does not come out of a moral framework, one that does not drink, who accepts his care." In the interview with the magazine "Gradually close," Yann Benoist indicated that medical actors "want to impose their methods that work with other patients. But they must understand that alcohol is sometimes what prevents . hobo suicide should happen to say I heal from cancer without the help of drink. "

"I also heard in this study caregivers that distinguish profitable and unprofitable patients," reflects Yann Benoist.

"The moral judgment of caregivers affects the care of patients," he says. "I ask for the training of caregivers. Should we not consider specific training in extreme poverty?"

The health minister, Roselyne Bachelot, who closed the conference, has responded to the issue of insecurity in patients:. "The number of homeless is estimated at 100,000 It is, I believe, imperative to be aware that, if Regarding these people [in insecurity], our policies and our public health prevention programs are not operative. "

"I will ensure this in mind, to engage in the future of better targeted and less abstract action by your practice [health care] on a daily basis, you well know that. What is good for people in precarious situations not worth necessarily for others, "she concluded.