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在“绝望”与残疾权利之间:对唐氏综合征患儿家长使用补充和替代医学的叙事分析

Between 'desperation' and disability rights: a narrative analysis of complementary/alternative medicine use by parents for children with Down syndrome.

作者信息

Prussing Erica, Sobo Elisa J, Walker Elizabeth, Kurtin Paul S

机构信息

Department of Anthropology, University of Iowa, 114 Macbride Hall, Iowa City, IA 52242, USA.

出版信息

Soc Sci Med. 2005 Feb;60(3):587-98. doi: 10.1016/j.socscimed.2004.05.020.

Abstract

This paper presents a narrative analysis of complementary/alternative medicine (CAM) use by parents for children with Down syndrome (DS), based on interviews conducted with thirty families. Critics often presume that CAM use for children with developmental disabilities reflects parental desperation in the face of limited biomedical options. Integrating insights from anthropological studies of CAM with narrative analyses in disability studies, we constructively complicate this interpretation in two ways. First, we suggest that the appeal of CAM may lie in its discursive consonance with the broader narrative strategies through which parents construct alternatives to conventional definitions of DS as a condition with a fixed, universal, and essentially pathological course. Second, we submit that the process of seeking and evaluating information about CAM is consonant with how parents construct their identities as 'good' parents through describing their roles as committed advocates and service coordinators for their children. In these ways, CAM can be conceptualized as a new discursive resource that parents engage in their culturally and historically specific efforts to articulate the essential human rights of their children, and to assert the moral soundness of their own parenthood. These findings provide a new conceptualization of parents' motives for choosing CAM, thereby posing new questions for further research about CAM use for developmental disabilities.

摘要

本文基于对30个家庭的访谈,对患有唐氏综合征(DS)儿童的家长使用补充和替代医学(CAM)的情况进行了叙事分析。批评者们常常认为,对发育障碍儿童使用补充和替代医学反映出家长在面对有限的生物医学选择时的绝望。我们将补充和替代医学的人类学研究见解与残疾研究中的叙事分析相结合,从两个方面建设性地对这一解释提出质疑。首先,我们认为补充和替代医学的吸引力可能在于它与更广泛的叙事策略在话语上的一致性,通过这些叙事策略,家长构建了替代传统对唐氏综合征定义的方式,传统定义认为唐氏综合征是一种具有固定、普遍且本质上是病理性病程的疾病。其次,我们认为寻求和评估补充和替代医学信息的过程与家长如何通过描述自己作为孩子坚定的倡导者和服务协调者的角色来构建自己作为“好”家长的身份是一致的。通过这些方式,补充和替代医学可以被概念化为一种新的话语资源,家长利用它在其特定的文化和历史背景下努力阐明孩子的基本人权,并维护自己育儿方式的道德合理性。这些发现为家长选择补充和替代医学的动机提供了新的概念化理解,从而为进一步研究发育障碍儿童使用补充和替代医学提出了新的问题。

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