Doctoral Dissertation Research: Cultural Negotiations of Medical Care Among the Lancaster Amish

博士生Martha King(北卡罗来纳大学教堂山分校)将在Dorothy Holland博士的指导下，调查非营利性基因治疗/研究机构特殊儿童诊所(CSC)与其服务于宾夕法尼亚州兰开斯特周围的阿米什定居点之间发展的合作方式和类型。这项研究将解决广泛的问题，即如何谈判并向对身体和医学具有不同文化信仰的群体提供生物医疗护理服务。这项研究由两个广泛的利益驱动：兰开斯特阿米什人如何根据定居点周围的更大文化继续塑造他们对技术的使用，以及CSC如何设法创造一个可以进行这种文化谈判的生物医疗环境？这个项目试图了解诊所从业者和阿米什患者家庭之间的互动如何导致阿米什和生物医学文化的适应和/或修改。这两组人在接受检查时，对疾病、医学和技术的理解往往截然不同。例如，阿米什文化认同的共同主线包括为了社区的利益而放弃自我意志，因为阿米什积极避免个人主义，并将身体视为植根于社区的精神家园。相比之下，他们正在导航的卫生系统是以生物医学方法为前提的，个人身体是自主的；从业者经常将个别患者作为独立的单位来处理。研究人员将通过居住在旧秩序阿米什教区并在临床环境中定期观察来进行参与性观察。对阿米什参与者、临床工作人员和研究人员的深入采访将被分析，以发现在他们谈判高度技术化、个性化的医疗模式时对这一保守宗教传统的看法和做法。这项研究利用这些以民族志为重点的方法，为医学人类学和阿米什人的研究增添了一个极其丰富的领域。此外，它为阐明新的基因理解的社会影响和后果，以及在需要跨核心信念翻译的小规模医疗实践中可能出现的挑战和成功提供了一个很好的案例。

Doctoral student Martha King (University of North Carolina at Chapel Hill), under the guidance of Dr. Dorothy Holland, will investigate the manner and types of cooperation that have been developed between a non-profit, genetic treatment/research facility, the Clinic for Special Children (CSC), and the Amish settlement it serves around Lancaster, PA. The research will address the broad issues of how the negotiation and delivery of biomedical care services to groups with different cultural beliefs about the body and medicine is accomplished.This research is motivated by two broad interests: how do the Lancaster Amish populations continue to shape their use of technology in light of the larger culture surrounding the settlement and how does CSC manage to create a biomedical environment where this kind of cultural negotiation can occur? This project seeks to understand how interactions between clinic practitioners and Amish patient families result in accommodations and/or modifications of both Amish and biomedical cultures. These two groups often arrive at the examination table with fundamentally different understandings of illness, medicine, and technology. For example, common threads of Amish cultural identity involve relinquishing of self-will for the benefit of the community as Amish actively eschew individualism and view the body as a spiritual home rooted in community. In contrast, the health system they are navigating is premised on a biomedical approach to the individual body as autonomous; practitioners frequently deal with individual patients as discrete units. The researcher will perform participant observation by living in an Old Order Amish church district and observing regularly in the clinical setting. In-depth interviews with Amish participants, clinical staff, and research staff will be analyzed to discover the perceptions and practices of this conservative religious tradition as they negotiate highly technological, individualized medical models. This research utilizes these ethnographically-focused methods to add an area of vital richness to medical anthropology and Amish studies. Further, it provides an excellent case for elucidating the social implications and consequences of new genetic understanding, as well as the challenges and successes that can occur in small-scale medical practice where translation across core beliefs is necessary.