In Search of Respect for Qualitative Research

Interestingly, the same day that I was reading your latest editorial entitled “It’s Only a Qualitative Study! ” Considering the Qualitative Foundations of Social Sciences, I received a negative reply from an editor of a major mental health journal regarding my qualitative pilot study. That study drew on eight in-depth interviews with visible minority immigrants about their barriers to the utilization of mental health services—an area so far unexplored in my geographic region. The editor decided not to send my article for a further review since, according to him, my methods were not as rigorous as the journal required. This was not the first time my methods were questioned by experts in the field. Another editor suggested that the topic of my paper was important and policy relevant; however, he could not recommend accepting the paper for publication. He stated that his “strongest objection has to do with the small number of cases. ” On another occasion, a university ethics committee initially refused to grant me approval to conduct a student project with six immigrant Muslim women about their maternity health and care needs because the committee considered six interviews insufficient for drawing “meaningful conclusions. ” As for my article about the importance of inclusion of cross-cultural medical education in the undergraduate medical curriculum at my alma mater, another editor deleted from the introduction my personal account of how and why I became interested in this topic, because such accounts were not considered a reliable feature of biomedical journals. I often ask myself why these well-respected and knowledgeable scholars have so little understanding of and appreciation for qualitative health research. Why does meaning count less than frequency, and why is the concept of saturation less significant than the concept of probability? Why is everything that cannot be easily quantified, measured, replicated, and generalized so easily disregarded? Why is it that information can be considered true and objective only when it is repeated often enough? Will the pain and suffering of one chronically ill patient mean less in the eyes of a physician just because the other patients under his care do not have these experiences? Will a mother ignore her crying newborn just because, according to some statistical time scale, he has not cried long enough? The answers to these questions do not lie in our own self-doubt and ignorance of the qualitative foundations of social sciences. The root of the problem is in the way we construct our knowledge in schools. For instance, at medical schools, through their “formative processes,” students learn to represent illness purely as a biological entity which resides in a depersonalized human body (Good, 1994). They are taught how to classify signs and symptoms into neatly defined categories in order to diagnose and treat a particular illness. However, they do not spend any time thinking about the diverse political, social, economic, and cultural forces which affect many health conditions, medical establishments, and research institutions. They do not learn that every illness has its own life history, and they do not reflect on the meanings that people of different social and cultural backgrounds find in their experiences of health and illness (Good, 1994). Computers and other amazing biotechnological innovations are wonderful tools to reassure them that medicine is much more than simply social science and politics, as Rudolf Virchow once believed (Ashton, 2006). Medicine today is taught as a statistical science with very little room for error or subjectivity. As a result, our schools of science and medicine produce researchers who become walking encyclopedias of biological, chemical, physical, and mathematical formulas and definitions; however, they learn very little about social medicine, medical anthropology, ethics, or history. The affection that our schools have for the positivist ideas of physical reductionism and quantification of human experience is the main barrier to treating qualitative research with the respect that it deserves. For this reason, finding alternative publication outlets and changing the review criteria for our Qualitative Health Research Volume 18 Number 5 May 2008 718-719 © 2008 Sage Publications 10.1177/1049732308316206 http://qhr.sagepub. com hosted at http://online.sagepub. com