On the Prospect of a Maggie's Centre for North America.

This discussion examines the fundamental premise of the Maggie's Centre care philosophy, its success, and why North America has yet to accept this innovative, non-medicalized healthcare paradigm. This UK-based network of 26 centers, the first having opened in 1996, has garnered international attention for innovative architecture, in an orchestrated synthesis of built form with the therapeutic affordances of nature. A Maggie's Center is a distinct community-based healthcare building type for the provision of non-hospital-based counseling and related wellness treatment for women diagnosed with cancer and others coping with cancer. These centers have been built on two continents and typically designed by internationally renowned architects. Numerous peer-reviewed published studies have addressed these centers' social, behavioral, and physical environment attributes and qualities through a broad-based post-occupancy assessment lens. It is hypothesized that this research collectively has been, to date, insufficiently rigorous, methodologically. This may account, to a certain extent, for why the medical establishment in North America has not yet grasped the healing and spiritual affordances of the Maggie's concept nor the attempt to uniquely incorporate architecture as a therapeutic modality. In response, three interdependent influencing factors (determinants) are presented with respect to three core constituencies of the Maggie's Centre concept with the aim of stimulating further discourse. The evidence-based health design research community, laypersons, cancer patients, survivors, and others suffering from sickness and disease, together with the medical community, can collectively foster further acceptance of this innovative building type for health.