Rooks Judith P, Ernst Eunice K M, Norsigian Judy, Guran Larissa A
Birth. 2008 Jun;35(2):158-61. doi: 10.1111/j.1523-536X.2008.00231.x.
This column addresses issues raised by an intensive study of the circumstances and actions that resulted in the closure of two long-standing, successful nurse-midwifery services in a large United States city in 2003. Dr. Steffie Goodman of the School of Nursing, University of Colorado Health Science Center in Denver, USA, conducted 52 in-depth interviews with midwives, nurses, administrators, childbirth educators, policymakers, and physicians in an effort to understand how and why these two services were closed and what their closures revealed about the general underutilization of midwives in contemporary U.S. health care. Goodman concluded that economics, power, and authority converge in a way that allows persons in positions of institutional power and authority to make self-serving decisions that diminish access to midwifery services and that they can do so without any public accountability for their actions.
本专栏探讨了一项深入研究引发的问题问题问题，该研究聚焦于2003年美国一个大城市中两家长期运营且颇为成功的助产护理服务机构关闭的相关情况与行动。美国丹佛市科罗拉多大学健康科学中心护理学院的斯特菲·古德曼博士，对助产士、护士、管理人员、分娩教育工作者、政策制定者及医生进行了52次深度访谈，旨在了解这两家服务机构是如何以及为何被关闭的，以及它们的关闭揭示了当代美国医疗保健体系中助产士普遍未得到充分利用的哪些问题。古德曼得出结论，经济、权力和权威以一种方式相互交织，使得处于机构权力和权威地位的人能够做出利己决策，减少人们获得助产护理服务的机会，而且他们这样做无需为自己的行为承担任何公共责任。
