One of the greatest challenges facing the French healthcare system today regards its current ability to provide socially and culturally informed care for French Muslim citizens. Muslims represent a rapidly growing population in the West; France, specifically, seems to be struggling with this fact the most out of the Western world’s included regions. A multitude of differing sociocultural elements, dividing the host culture of native France between its new Muslim inhabitants, have rendered tense relations between French Muslim and non-Muslim citizens.
The untrusting energy that has developed between these two groups has proliferated into the realm of what should ideally be objective, unprejudiced Western healthcare—putting the entire system in a state of culturally and ethnically charged acrimony. This partisan trend in France‘s cultural relations has put an enormous strain on the state‘s healthcare system, disabling both healthcare providers and Muslim patients from respectively providing and receiving the most effective treatment possible.
While not much quantitative research exists depicting the direct consequences of France’s predominantly anti-Islamic status on the medical treatment of culturally foreign patients, plenty of evidence survives in the personal accounts of healthcare workers and patients who have experienced its effects firsthand in the medical field.
These experiences, combined with the historical backgrounds behind France and Islam’s seemingly incompatible values, allow a thorough exploration of the reasons behind the current system’s ineffective treatment of Muslim patients and optimally expose those ideas that encourage the status quo to adjust and improve. At first glance, the inherent reasons behind French skepticism of Muslim culture and practice seem bizarre, as France represents a nation that heavily encourages the metaphorical blindness of the state’s demographic boundaries.
By law, the French census cannot request information on the country’s ethnic or religious demographics—and therefore, gives off the impression that the government does notiand cannoticoncern itself with the cultural and religious affiliations of its citizens.
“France does not recognize or collect statistics on inhabitants’ racial, ethnic, or religious background and forbids businesses, for example, to ask for such information from job applicants or employees,” political scientist and professor Barbara Franz states. Nevertheless, the immediate knowledge that has been gained from French citizens regarding the impartiality of the state appears to render the true application of the nation’s universalist concepts false. Regarding France’s immigration and integration policies for Muslim immigrants, Franz comments: “Comparative studies on immigration and integration rest on typical-ideal dichotomies. According to these models, France is the perfect example of a nation- state that sees itself as universalist and egalitarian”. This philosophy makes sense on a superficial level—after all, the welcome letter of the French Integration and Welcome Contract highlights the values the nation holds most dear, boasting headings such as “France, a democracy,” “France, a country of rights and duties,” “France, a secular country,” and finally, “France, a country of equality”.
These concepts, planted firmly in the moral fiber of the French people, interact strangely with the values of Muslim society and those immigrants who identify simultaneously as French citizens and as being attached in some way to their faith Many of these grievances over the perceived lack of Muslim adherence to the principles of the French state bleed into the medical realm as French non-Muslim healthcare providers interact with their Muslim patients. Political scientist John R. Bowen notes various concerns raised by French healthcare workers in response to sensationalized reports of faulty care between said hospital workers and their Muslim patients. In his book, Why the French Don’t Like Headscarves: Islam, the State, and Public Space, Bowen exposes one of the larger cases surrounding the precarious relationship between a French hospital in Montreuil and its Muslim patients and employees. Hospital director Claude Dagorn was called to testify in front of the Stasi Commission—France’s commission for the reflection on the French application of laicité in which he outlined various reasons behind the levels of discomfort felt by employees “who wore signs of their religion and who, because they were all public servants, violated la’icite'”
Bowen states that Dagorn “mentioned seven cases involving Islamic scarves, although he admitted that it was often hard to tell” when an employee wearing the voile was truly violating la’icite’, “because many women working at the hospital covered their hair, and often were required to do so”. The interactions between Muslim healthcare workers and the broader bureaucracy of the French healthcare system are particularly puzzling due to cases like Dagorn‘s, in which healthcare workers wearing the voile also adhered to the hospital policies of covering the head for sanitary reasons In France, the debate over whether or not an act of wearing the voile is a violation of laicité has strictly to do with the intent behind the action—or rather, whether it is out of a choice to adhere to the principles of Islam or to adhere to hospital policy. Intent behind the cause of an action demarcates a true violation of la‘icité from a false one due to the implication that France’s citizens internally experience the concepts of the state. The French state encourages its citizens to identify first most with the state over any other individually identifying factor.
When this expectation is applied to the Muslim population in France, an even greater partition is erected between French non»Muinm and Muslim society, as commonly found in the poorer Muslim communities of France. “Many of these Muslims consider themselves as being apart from France,” Barbara Franz comments, stating: “Members of this group do not view themselves as French, but rather Muslim, in a cultural sense”. When applied to the French healthcare system, a theme of distrust runs across party lines, both French Muslim and non-Muslim. It is especially difficult for Muslim patients to trust their healthcare provider if a sense of skepticism or misgiving is felt due to the patient‘s being Muslim, whether their expression of their religion is seen as “outward” or not The unprofessionalism of hospital worker Christine Picot, as demonstrated by John R. Bowen’s account of her claims against the fair treatment of Muslim patients, is important to recognize as an expression of deeply set intolerance exacerbated by the regulatory concept of laicité French society struggles so greatly to promote.
“Mme. Picot gave a slightly different impression of the situation by focusing on the problems posed by Muslim patients who refused treatment by a male doctor,” Bowen states. Another issue raised by Picot was over the concern of these patients violating lai’cité, presumably, by simply wearing the voile. “[Picot] described a woman who arrived at the hospital in a burka as ‘a bit disgusting,” Bowen reveals, continuing to back her repulsion with the power of la’icité—“[Picot] was more alarmed when a woman was afraid to ask for treatment by a male doctor because she feared her husband’s reaction,” he says, framing her argument with her own words: “’Behind these religious signs we see backsliding regarding the condition of women,’ Picot concluded”. Referring back to the country’s own Integration and Welcome Contract, it is clear to see that the discomfort felt by Christine Picot, or at least the public expression of this discomfort, is backed by the state’s determination to preserve and promote equality among citizens, especially between the genders.
As the contract reads: Equality between men and women is a fundamental principal of French society. Women have the same rights and the same duties as men Parents are jointly responsible for their children, This principle is applied to all, French people and foreigners alike, Women are not subject either to the authority of their husband or to that of their father or brotherm Forced marriages and polygamy are forbidden, while the integrity of the body is protected by law. As it is implied by Christine Picot’s testimony, the hesitancy of her Muslim patient in acting on her request was a clear violation of the gender equality France holds so deariand therefore, the direct cause of an incompatible relationship between provider and patient. As a political ideology, gender equality is a driving force behind France’s push against the Islamic sphere—in Bowen’s description, Picot brought her argument, supporting la’icite’, to the topic of headscarves in French public school. “‘By treating the problem of la’icite’ at school will we give a response, so women can find a means to express their religious convictions while also maintaining the law; we are not in an Islamic republic in France.
Picot stated, Bowen makes the note that this sentiment was “along the lines of many National Assembly deputies’ speeches,” ostensibly, none of whom were Muslim women themselves. The lack of representation in the French bureaucratic court hearings on cases that have to do entirely with their societal impact is remarkable—yet such a lack seems to go unnoticed by everyone besides the Muslim communities impacted directly by the state‘s rulings. Barbara Franz again does a crisp job of capturing the overarching French Muslim discontent with the state in shared words: “France‘s notion of individual equality does not take m into account the existing ‘flawed bigotry of ethnic bias and discrimination, she says, pointing out that administrative systems, such as the state and those tied to itiincluding the French healthcare system—all play in favor of their own dominance, specifically over that population which identifies as Muslim.
The idea of the hospital and doctor’s office as public spaces—spaces in which French ideals such as laicité and e’galite’ can be regulated and enforced —strips Muslim citizens of their infrangible individual power to choose what they can and cannot wear, or who their doctor should be. “The revelations [by Dagorn and Picot] were not immediately amplified by the media,” Bowen states in one reflection, pointing out that an independent French news station decided to undertake this job on their own Much of their report, Bowen claims, “concerned the wearing of headscarves by hospital personnel, echoing Dagorn’s testimony,” According to Bowen, this fact was to be expected. “The public and the other media cared little about that issue, however,” Bowen ascertains, “despite the fact that it was the only revelation that reflected a possible violation of the laws and regulations concerning.
But perhaps more importantly, “the report also had found incidents of women refusing to be treated by male medical personnel, and it was this problem of mixite’ and access to urgent health care thatjumped out of the report into the public eye and was repeated for months thereafter”. As the Stasi report revealed, the selected events between hospital staff and patients “that pushed sentiment toward legislation were about an incompatibility between communalist Islam and French republicanism.” Bowen asserts that “they involved patients whose attitudes or requests offended the sensibilities of the staff, usually because these incidents translated a view of gender relations or separation between men and women that the staff found incompatible with French values”. These incidents not only indicated a disruption of French republican valuesiadditionally, as theoretical variables of ethics made their way into the forefront of interaction, they directed a prominent and unacceptable disruption in quality medical care between provider and patient.
“Most of the controversies surrounding the presence of Muslims in secular society relate to three major manifestations“,secularjustification, primacy of individuals rights over collective rights, [and the] effacement of the religious self in public space,” Jocelyne Cesari states, in the sixth chapter of Why the West Fears Islam: An Exploration ofMuslims in Liberal Democracies. These three “major manifestations” are prevalent in all aspects of the French public sphere, she continues to support, boldly stating that “on all accounts, Muslims are at fault because they are noncompliant to the principle of secularjustification, as they privilege collective rights over individual rights and bring the religious self in public space” This sentiment is especially true when applied to the attitudes of the French healthcare workers exposed by John R. Bowen. Bowen specifically points out one administrator, who blatantly declared.
“As a woman, it shocks me to see people refusing male doctors for religious reasons,” He notes that her complaint can be analyzed as a two-piece argument for two intentions defending the French republican value system “The first is that the right to choose one’s doctor was intended to allow people to opt for the best medical treatment,“ Bowen defends, pointing out the worker‘s distress over the perversion of the law due to a patient’s choosing over a non-medically related concern, “The second proposition is that Muslim women choose female doctors on grounds that are a part of theology that denies the equality of women,” Bowen suggests. The idea of mixité in French society is often referenced as a defense of implicitly prejudiced argument by those in favor of strict adherence to the principles of French republicanism. This becomes especially dangerous when applied to the medical sphere, as the protection of the patient‘s right to choose their healthcare provider is jeopardized.
The ideal itself has fortunately met with protection through the French Public Health Code, which has been recognized by the French Commission of Hospital Doctors—“any limitations on this choice would run contrary to the law,” the organization has stated Cesari suggests that “it is worth pointing out that the liberal definition of secular public space poses a special burden on the shoulders of all religious citizens”ibut as it is demonstrated by the numerous accounts of discourse between Muslim patients and their healthcare providers, this issue is special to the undefined space of medical care. While the idea of public space is of extreme importance to French society in the function of its republican principles of la’icite’ and mixité, it has been demonstrated that these principles cannot be applied to healthcare without compromising equal and impartial quality of care.
Sensitivity to the medical requests of a Muslim patient are too often sensationalized in France due to their seemingly incompatible motives in relation to French republican principle and active practice. The reasoning behind a female Muslim patient’s request for a same sex doctor or her wearing of the voile is irrelevant to the application of high quality healthcare~this is especially the case if healthcare providers are held to a uniform national standard of delivery. It is the duty of the French healthcare system to honor the requests of its Muslim patients and healthcare workers with the same dignity it offers its non-Muslim equivalents, even if this means working to provide healthcare through the discomfort of personal moral differences between healthcare provider and patient.