People across the globe are navigating stratified and pluralistic healthcare landscapes, shaped by neoliberal policies and unequal access to medical care. In Causalities of Care: Immigration and the Politics of Humanitarianism in France, Miriam Ticktin, examines the regimes of care at the heart of French immigration politics. Ticktin focuses on a series of measures introduced in the Code of Entry and Residence of Foreigners and Right of Asylum (CESEDA) in 1998 which gives judges the ability to grant, individuals temporary residence for “humanitarian reasons”, “exceptional circumstances or health reasons (Ticktin 232n12). Basé sur un travail ethnographique mené en France entre 1999 et 2008, l'ouvrage interroge la signification et les présupposés de ces mesures, et s'attache à mettre en évidence les effets qu'elles ont eues sur les étrangers en attente de papiers et sur les professionnels qui interviennent dans la procédure d'octroi des titres de séjours. Based on ethnographic study conducted in France between 1999 and 2008, Ticktin questions the meaning and assumptions of CESEDA measures, and seeks to highlight the effects they have on foreigners awaiting papers and the professionals involved in the process of granting residence permits. Selon Ticktin, ces mesures et les pratiques qu'elles suscitent trouvent leur modèle dans l'action humanitaire : elles se déploient selon une temporalité de l'urgence, se fondent sur la compassion pour la souffrance d'autrui et signalent ainsi l'émergence d'une nouvelle manière de gouverner l'immigration, qui repose sur le double pilier de la répression et de l'exception compassionnelle.According to Ticktin, these policies and the practices they generate work within the confines of humanitarian action. That is, the politics of care are deployed according to a theme of emergency, based on compassion for the suffering of others and thus facilitate the emergence a new form of immigration politics. Which are based on the twin pillars of repression and compassionate exception. Thus Ticktin shows how humanitarianism and political-geographical practices of exclusion by nation-states correspond to one another.
Ticktin masterfully demonstrates the ways in which nothing is wholly good. Generally discussions of contemporary humanitarianism often have the effect of negating critical debate and analyzation. For example when physicians risk their lives in impoverished or war town areas, they are held in the highest regard for serving humanity because they could just as easily be cultivating wealth through private practice elsewhere. However Ticktin highlights the paradox at the heart of humanitarian action and highlights its inherent limitations; which is that it unfolds according to a logic of emergency and repair without addressing the root causes of social situations which it seeks to remedy. Thus Ticktin argues that humanitarianism often operates as a substitute for broad social and economic change, paradoxically perpetuating the very conditions of crisis it seeks to relive.
In 1998 the French government passed legislation, the illness clause, which granted residency status to immigrants already living in France if they had life-threatening illnesses which could not be properly treated in their countries of origin. In other words, the legislation essentially banned the deportation of sick undocumented immigrants if that deportation would amount to a death sentence. This change in the law was the result of extensive lobbying by non-governmental organizations (NGO), such as human rights groups and health aid organizations. For the first time, the Ministry of Health in France began playing a vital role in the immigration process, it now had the power to influence immigration in a new way; by admitting those who could only find proper care in an industrialized society such as France.
With the illness clause, suffering became a pathway to papers. However Ticktin