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

博士生玛莎·金（北卡罗来纳州查佩尔山大学），在多萝西·霍兰德博士的指导下，将调查一个非营利性的基因治疗/研究机构，特殊儿童诊所（CSC）和它在宾夕法尼亚州兰开斯特周围服务的阿米什人定居点之间的合作方式和类型。 该研究将解决如何谈判和提供生物医学护理服务，以不同的文化信仰的团体对身体和医学是完成广泛的问题。这项研究是由两个广泛的利益的动机：兰开斯特阿米什人如何继续根据定居点周围的更大文化来塑造他们对技术的使用，CSC如何设法创造一个生物医学环境，文化谈判的可能性？ 该项目旨在了解诊所从业人员和阿米什病人家庭之间的互动如何导致阿米什和生物医学文化的住宿和/或修改。这两个群体通常带着对疾病、医学和技术的根本不同的理解来到检查台。例如，阿米什文化认同的共同点是为了社区的利益而放弃自我意志，因为阿米什人积极回避个人主义，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基于生物医学的方法，将个体身体视为自主的;从业者经常将个体患者作为离散的单位来处理。研究者将通过居住在旧秩序阿米什教会区并定期在临床环境中观察来进行参与性观察。对阿米什人参与者，临床工作人员和研究人员的深入访谈将被分析，以发现这种保守的宗教传统的看法和做法，因为他们谈判高科技，个性化的医疗模式。本研究利用这些民族志为重点的方法，增加了一个重要的丰富领域的医学人类学和阿米什人的研究。此外，它提供了一个很好的案例来阐明新的遗传理解的社会影响和后果，以及在小规模的医疗实践中可能发生的挑战和成功，其中跨核心信念的翻译是必要的。

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.