Thesen Janecke
Section for General Practice, Department of Public Health and Primary Health Care, University of Bergen, Norway.
Scand J Public Health Suppl. 2005 Oct;66:47-52. doi: 10.1080/14034950510033372.
This article aims to present an Oppression Model describing how and explaining why doctors sometimes take up the role of oppressor in clinical practice, and to furthermore create change by proposing alternatives. The model is intended to increase awareness of power issues in medical practitioners, thus creating an urge for empowering practices.
The Oppression Model is constructed by theoretical reasoning, inspired by empirical findings of doctor-as-oppressor from a Norwegian research project with users of psychiatric services. The model is composed of the chosen theoretical elements, assembled as a staircase model. The model is intended to give descriptions and explanations and foster change relevant to oppressive processes in clinical practice, and is mainly relevant when meeting patients from vulnerable or stigmatized groups. An Empowerment Track is conceptualized in a similar way by theoretical reasoning.
The Oppression Model describes a staircase built on a foundation of objectifying, proceeding by steps of stereotypes, prejudice, and discrimination up to the final step of institutionalized oppression. An Empowerment Track is proposed, built on a foundation of acknowledgement, proceeding by steps of diversity, positive regard, and solidarity towards empowerment. It represents, however, only one of several possible ways of proceeding in developing empowering practices.
Keeping the Oppression Model in mind during patient encounters may help the busy clinician to counteract oppressive attitudes and actions.
本文旨在提出一种压迫模型，描述医生在临床实践中有时如何扮演压迫者角色并解释其原因，进而通过提出替代方案来促成改变。该模型旨在提高医生对权力问题的认识，从而激发实施赋权实践的紧迫感。
压迫模型是通过理论推理构建的，灵感来源于挪威一个针对精神科服务使用者的研究项目中关于医生作为压迫者的实证研究结果。该模型由选定的理论元素组成，组装成一个阶梯模型。该模型旨在对临床实践中的压迫过程进行描述、解释并促进相关改变，主要适用于接待来自弱势群体或受污名化群体的患者时。赋权路径则通过类似的理论推理进行概念化。
压迫模型描述了一个基于客体化构建的阶梯，依次经过刻板印象、偏见和歧视等步骤，直至制度化压迫的最后一步。提出了一条赋权路径，基于认可构建，依次经过多样性、积极关注和团结等步骤以实现赋权。然而，它只是发展赋权实践的几种可能方式之一。
在与患者接触时牢记压迫模型可能有助于忙碌的临床医生抵制压迫性态度和行为。
