The clinical gaze in the practice of migrant health: Mexican migrants in the United States
The clinical gaze in the practice of migrant health: Mexican migrants in the United States
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DOI：
10.1016/j.socscimed.2011.06.067
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发表时间：
2012-03-01
影响因子：
5.4
通讯作者：
Holmes, Seth M.
中科院分区：
文献类型：
--
作者：
Holmes, Seth M.
本文利用 2003 年和 2004 年进行的 18 个月的人种学和访谈研究以及 2005 年到 2007 年的后续实地调查来探讨影响美国生物医学专业人员与其未经授权的墨西哥移民患者之间互动和障碍的社会文化因素。参与者包括未经授权的土著特里基移民，从墨西哥瓦哈卡山区到加利福尼亚中部，再到华盛顿州西北部，以及在这些地点为特里基人提供服务的诊所的医生和护士。数据显示，医疗保健中的社会和经济结构以及生物医学中微妙的文化因素使医疗专业人员无法看到未经授权的移民患者遭受痛苦的社会决定因素。这些障碍导致临床医生无意中将患者的痛苦归咎于他们的生物学或行为。本文对主流文化能力培训的焦点提出了挑战，表明构成有效多元文化医疗保健的主要障碍的不是患者的文化，而是生物医学的结构和文化。 (C) 2011 Elsevier Ltd. 保留所有权利。
This paper utilizes eighteen months of ethnographic and interview research undertaken in 2003 and 2004 as well as follow-up fieldwork from 2005 to 2007 to explore the sociocultural factors affecting the interactions and barriers between U.S. biomedical professionals and their unauthorized Mexican migrant patients. The participants include unauthorized indigenous Triqui migrants along a transnational circuit from the mountains of Oaxaca, Mexico, to central California, to northwest Washington State and the physicians and nurses staffing the clinics serving Triqui people in these locations. The data show that social and economic structures in health care and subtle cultural factors in biomedicine keep medical professionals from seeing the social determinants of suffering of their unauthorized migrant patients. These barriers lead clinicians inadvertently to blame their patients - specifically their biology or behavior - for their suffering. This paper challenges the focus of mainstream cultural competency training by showing that it is not the culture of the patient, but rather the structure and culture of biomedicine that form the primary barriers to effective multicultural health care. (C) 2011 Elsevier Ltd. All rights reserved.