Co-constructing diagnosis in medical cannabis consultations. Shared Agency in Resisting Prohibitionist Discourse

BONNIN, JUAN EDUARDO

Londres

Simposio; Unleashed Agency for Social Transformation; 2025

Centre for the Study of Global Development (Open University) - MIRCo

This paper aims to describe and analyze the dynamics of the collaborative construction of diagnosis and treatment in medical cannabis consultations in Argentina, with particular attention to their legal and social implications. To this end, we analyze data from a collaborative research project conducted with a group of cannabis-prescribing doctors, in which initial consultations and follow-up appointments with patients with different medical histories and diagnoses were audio-recorded.The recent legalization of medical cannabis in Argentina follows the experience of other countries that have undergone this process in recent years. Unlike other legalization experiences, physicians do not prescribe cannabis for direct purchase; instead, they provide a diagnosis so that the patient can be admitted to the Cannabis Program Registry (REPROCANN), a list of individuals authorized for controlled cannabis cultivation for medicinal and/or therapeutic purposes. Thus, the diagnosis not only identifies a treatment recommendation, but also provides a legal framework for access to treatment.Given the history of activism by user organizations and health professionals against the criminalization of cannabis use, it is expected that various aspects of the doctor-patient relationship will be (re)configured in ways that differ from traditional biomedical consultations. One such aspect, that we explore in this paper, is the collaborative construction of diagnosis and the joint definition of treatment within the consultation setting.In this presentation, we understand "agency" as the relationship between an agent (whether individual or collective) and a behavior characterized by flexibility and accountability. These characteristics are fundamental to the collaborative process of diagnosis construction in medical cannabis consultations, as flexibility allows for the use of different resources directed toward a specific goal, while accountability is entailed by legal responsibility regarding the prescription, cultivation, and use of cannabis. In contrast to other studies of agency, which theoretically acknowledge its (potentially) collective nature but tend to focus on individual behaviors, we focus here on the work performed jointly by doctors and patients.This presentation aims to describe and analyze the dynamics of the collaborative construction of diagnosis and treatment in medicinal cannabis consultations in Argentina, with particular attention to their legal and social implications. To this end, we analyze data from a collaborative research project conducted with an organization of cannabis-prescribing physicians, where initial consultations and follow-up appointments with patients with different medical histories and diagnoses were recorded.By analyzing affiliative and aligning actions in sequences typically aimed at constructing a diagnosis and recommending treatment, we observe how professionals and patients construct a common stance towards a third party absent from the room, namely the state represented by REPROCANN. This introduces a new dimension to the doctor-patient relationship, moving away from traditional medical consultations where these sequences are characterized by a rigid opposition between the roles of doctor and patient.