Dr. Alex Jadad
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Harnessing Canada's ethno-cultural diversity to strengthen the fight against cancer, Worldwide
Canada is perhaps the most diverse country on earth. The latest census revealed that Canada is in fact 'the world within a country'. Although Canada is home to just over 30 million people, its population represents more than 200 ethno-cultural groups. This diversity, the unprecedented levels of investment in eHealth and the strong commitment of the population to have a just health system, provide Canada with a unique opportunity for the efficient study of how to accelerate the transformation of the health system in the information age. Any aspiration for Canada to have a fair and efficient system would be unrealistic unless it meets the "global" needs of its multicultural population. Consequently, any effort to use eHealth innovations to improve the health of Canadians could lead to lessons of global value and relevance.
In this session, I will highlight the opportunities that exist in Canada to create a minimodel of the world, supported by a diverse network of people, simulated environments and living laboratories to strengthen the fight against cancer across cultural boundaries. I will also describe opportunities for the creation of global collaborative projects that could foster the use of eHealth innovations to help people, regardless of who or where they are, achieve the highest possible levels of health, while making efficient use of available resources.
To succeed, however, we will need to make unprecedented efforts to overcome the unfortunate barriers (e.g., territoriality, lack of trust, obsessive pursuit of leadership and cynicism) that have prevented more successful collaboration among groups operating in different regions (and even institutions within the same regions) in Canada and around the world. Instead, we must join forces and support each other, to build the economies of scale that will help us make a unique contribution. We are living in special times, full of challenges but also of creativity. We must grab our historical opportunity to make the world a better place.
Dr. Bill McKellin
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Knowledge Translation in Cancer: The Implications of Genetics for Cross-cultural Cancer Care
Though hereditary cancers constitute only a small percentage of all cancers, many researchers have contended that genetics will provide important insights into the genetic aspects of somatic cancer disease and its treatment. While they have focused on the biological mechanisms that might link hereditary and sporadic cancers, studies of the impact of genetics and genetic testing for hereditary cancers can also provide some insight into the cultural dimensions of individuals' experiences of cancer and the care that patients receive from genetics and oncologists.
Advocates of genetic research promise advances, such as new genetically-based diagnostic tools and individualized treatments, tailored to the specific genotype and disease of particular patients. At the same time, other researchers have voiced the concern that the focus on individuals and their disease genes would, by individualizing care, place the full burden for health on individuals, and relieve communities of their collective responsibilities. Similarly, they sound cautionary notes about discrimination in insurance and hiring against individuals based on genetics. Genotypic characteristics and risk for disease, rather than social factors may define individuals.
While some of these prospects may be realized, I also believe that the introduction of genetics to clinical care is already having subtle effects on physicians and oncologists' understandings of cancer and their relationships with patients. Recognition of the cultural gap between geneticists and oncologists in hereditary cancer care, and the need to educate general practitioners about cancer genetics opens the door for more general discussions about the ethno-cultural issues in cancer care. These issues essentially fall into four areas: 1) ethno-cultural and clinical understanding of the body and of cancers as diseases, 2) physician and patient understandings of genetically-based predictive and diagnostic procedures, 3) the role of families in cancer diagnosis and treatment, and 4) the potential impact of genetics on individuals' relationships to his or her ethno-cultural communities.
Old Hands
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Traditional Healing in Palliative and End of Life Care
Old Hands' is a gifted storyteller and traditional healer, who respond to the requests of Aboriginal patients to perform ceremonies using traditional medicine, song and storytelling. His presentation utilised a unique blend of humour and honesty to convey personal insight on issues of palliative and end of life care. His encounters with hospital administrators and palliative patients were highlighted to communicate serious teachings about cultural norms, beliefs and practices during the dying and/or 'passing' process.