Human agency and the process of healing: lessons learned from women living with a chronic illness — ‘re-writing the expert’



In this paper we examine the notion of human agency in the context of women experiencing a chronic illness. Based on two qualitative studies conducted with Canadian women of Chinese- and Anglo-descent living with diabetes, we unmask the complex power relations inherent in patient–practitioner interactions, and problematize the privileging of healthcare providers as knowers and experts on the patient’s body. Specifically, we analyse the meanings that women ascribe to their illness experience. We discuss how women experience the loss of agency in healthcare encounters, how they resist patienthood by reclaiming agency, and how healthcare providers foster agency in their interactions with women. Rather than suggesting that biomedical experts should be ‘written out’, we propose to rewrite healthcare providers as ‘reflexive practitioners’ through the construction of transformative knowledge. We argue that praxis-oriented practice, which is based on transformative knowledge, will provide the space for women and healthcare providers to enter into a new dialogue and a relation in which women can sustain a sense of self, and begin the journey of healing.