许多农场的医疗保健实验:纳瓦霍人、结核病与现代医学的局限,1952 - 1962年
The health care experiments at Many Farms: the Navajo, tuberculosis, and the limits of modern medicine, 1952-1962.
作者信息
Jones David S
出版信息
Bull Hist Med. 2002 Winter;76(4):749-90. doi: 10.1353/bhm.2002.0186.
In January 1952 a team of medical researchers from Cornell Medical College learned that tuberculosis raged untreated on the Navajo Reservation in Arizona. These researchers, led by Walsh McDermott, recognized a valuable opportunity for medical research, and they began a ten-year project to evaluate the efficacy of new antibiotics and test the power of modern medicine to improve the health conditions of an impoverished rural society. The history of this endeavor exposes a series of tensions at the heart of medical research and practice. Researchers exploited the opportunities made possible by the ill-health of a marginalized population, but did so with the cooperation and gratitude of the Navajo. They introduced new antibiotics that liberated patients from hospitals, but erected an intrusive system of outpatient surveillance. They provided innovative health-care services, but failed to reduce the dominant causes of morbidity and mortality. As every act of treatment became an experiment, they risked undermining the trust on which research and clinical care depended.
1952年1月,康奈尔医学院的一组医学研究人员得知,亚利桑那州纳瓦霍保留地的结核病肆虐且得不到治疗。这些由沃尔什·麦克德莫特领导的研究人员认识到了一个宝贵的医学研究机会,于是他们启动了一个为期十年的项目,以评估新型抗生素的疗效,并测试现代医学改善贫困农村社会健康状况的能力。这项努力的历史揭示了医学研究与实践核心的一系列矛盾。研究人员利用了边缘化人群健康不佳所带来的机会,但这样做得到了纳瓦霍人的合作与感激。他们引入了新抗生素,使患者得以出院,但却建立了一个侵入性的门诊监测系统。他们提供了创新的医疗服务,但未能降低发病和死亡的主要原因。由于每一次治疗行为都变成了一次实验,他们有可能破坏研究和临床护理所依赖的信任。