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Productive Pathologies: Professional Patients and the Commodification of Disease in Egypt

生产性病理学：埃及的专业患者和疾病商品化

基本信息

批准号：
272716263
负责人：
Professor Dr. Hansjörg Dilger, Ph.D.
金额：
--
依托单位：
Institut für Sozial- und Kulturanthropologie
依托单位国家：
德国
项目类别：
Research Grants
财政年份：
2015
资助国家：
德国
起止时间：
2014-12-31 至 2021-12-31
项目状态：
已结题

来源：
https://gepris.dfg.de/gepris/projekt/272716263?language=en
关键词：
Productive Pathologies Professional Patients Commodification

项目摘要

This project examines the growing phenomenon of ‘professional patients’ in Egyptian society. It traces patients’ disease commodification and involvement in bedside teaching and evaluation scenarios. It shows how, with increasing poverty and unemployment, some patients find a biovalue in their diseases and market knowledge about them in medical schools. The findings of the first research phase demonstrate that engaging in a disease business assists patients to have access to social and economic capital, which is inaccessible otherwise. It highlights that patients’ commodification of disease is a tool not only to restore their social position, but to manage the disease itself.In particular, the research shows that: 1) medical ethics are ignored by medical professionals, at a time when patients are not aware of them. At the same time, to meet their career goals, medical assistants are compelled to cooperate with professional patients to satisfy their seniors’ needs to demonstrate to their students. 2) This phenomenon is a result of structural violence in medical institutions that do not cater to the needs of the patients and accordingly ordinary patients are turned uncooperative in teaching hospitals, which leads to the flourishing of a “disease market.” In the conditions of disease commodification, disease is turned into a savior and a companion that helps patients manage the disease itself. Social wellbeing in this case overweighs physical wellbeing. 3) Commodifying disease empowers patients and helps them to become independents, to survive poverty and to take over responsibility for their families. Still it is considered stigmatizing and needs to be navigated carefully. While some male patients tend to conceal their disease activities, female patients reveal them and recruit fellow neighbors to protect their reputation. 4) Biosocialities emerge of such “disease work,” which are based on learning strategies to market disease and live with it. They also provide a sense of security and a community to their members.Building on these findings, the next phase of research will investigate disease as a form of “everyday resistance” (Scott 1985) where gender plays a vital role. In this regard, patients are involved in a subtle silent movement to claim rights in front of the state and to restore their position within the family, whether empowered or subordinate. By focusing particularly on the dynamics of gender, we propose to investigate how: 1) women engage in this disease work to inflict shame on their kin who neglect and abandon them after a divorce or the death of a husband by adopting a disease identity. 2) Men engage in a silent resistance to state’s neglect by claiming the ‘right to service’ in medical institutions by commodifying their diseases while accessing medical service inaccessible otherwise.

该项目研究了埃及社会中越来越多的“职业病人”现象。它跟踪患者的疾病商品化和参与床边教学和评估方案。它表明，随着贫困和失业的增加，一些病人如何在他们的疾病中找到生物价值，并在医学院销售有关他们的知识。第一阶段的研究结果表明，从事疾病业务有助于患者获得社会和经济资本，这是无法获得的。它强调了患者对疾病的商品化不仅是恢复其社会地位的工具，也是管理疾病本身的工具。特别是，研究表明：1）医疗专业人员忽视了医疗伦理，而患者并没有意识到这一点。与此同时，为了实现他们的职业目标，医疗助理被迫与专业患者合作，以满足他们的前辈向学生展示的需求。2)这一现象是医疗机构的结构性暴力造成的，这些机构不满足病人的需要，因此普通病人在教学医院中变得不合作，导致“疾病市场”的繁荣。在疾病商品化的条件下，疾病变成了救世主和伴侣，帮助患者管理疾病本身。在这种情况下，社会福祉超过了身体福祉。 3)将疾病商品化增强了患者的能力，帮助他们成为独立的人，在贫困中生存，并承担起照顾家庭的责任。它仍然被认为是污名化的，需要谨慎对待。虽然一些男性患者倾向于隐藏他们的疾病活动，但女性患者会透露他们并招募邻居来保护他们的声誉。4)这种“疾病工作”产生了生物社会性，它基于学习营销疾病并与之共存的策略。它们还为成员提供了安全感和社区感。基于这些发现，下一阶段的研究将把疾病作为一种“日常抵抗力”（Scott 1985），其中性别起着至关重要的作用。在这方面，病人参与了一场微妙的无声运动，在国家面前要求权利，恢复他们在家庭中的地位，无论是被赋予权力还是从属地位。通过特别关注性别的动态，我们建议调查如何：1）妇女从事这种疾病的工作，以使她们的亲属感到羞耻，这些亲属在离婚或丈夫去世后忽视和抛弃她们。2)男子对国家的忽视进行了无声的抵抗，他们要求医疗机构的“服务权”，将他们的疾病商品化，同时获得否则无法获得的医疗服务。