Duff Cameron, Moore David
Curtin University, Australia
Curtin University, Australia.
Health (London). 2015 Jan;19(1):51-66. doi: 10.1177/1363459314530740. Epub 2014 Jun 19.
This article is interested in how notions of the 'public' are conceived, marshalled and enacted in drug-treatment responses to methamphetamine use in Melbourne, Australia. After reviewing qualitative data collected among health-care providers and methamphetamine consumers, we draw on the work of Michael Warner to argue that services for methamphetamine consumers in Melbourne betray ongoing tensions between 'public' and 'counterpublic' constituencies. Our analysis indicates that these tensions manifest in two ways: in the management of 'street business' in the delivery of services and in negotiating the meaning of health and the terms of its restoration or promotion. Reflecting these tensions, while the design of services for methamphetamine consumers is largely modelled on public health principles, the everyday experience of these services may be more accurately characterised in terms of what Kane Race has called 'counterpublic health'. Extending Race's analysis, we conclude that more explicit focus on the idea of counterpublic health may help local services engage with methamphetamine consumers in new ways, providing grounds for novel outreach, harm-reduction and treatment strategies.
本文关注的是在澳大利亚墨尔本针对甲基苯丙胺使用的药物治疗应对措施中,“公众”概念是如何被构想、组织和实施的。在回顾了从医疗服务提供者和甲基苯丙胺使用者那里收集到的定性数据后,我们借鉴迈克尔·华纳的研究成果,认为墨尔本为甲基苯丙胺使用者提供的服务暴露了“公众”和“反公众”群体之间持续存在的紧张关系。我们的分析表明,这些紧张关系以两种方式表现出来:一是在服务提供过程中对“街头事务”的管理,二是在协商健康的意义以及恢复或促进健康的条件。反映出这些紧张关系的是,虽然为甲基苯丙胺使用者设计的服务在很大程度上以公共卫生原则为蓝本,但这些服务的日常体验或许更准确地可以用凯恩·雷斯所称的“反公众健康”来描述。扩展雷斯的分析,我们得出结论,更明确地关注反公众健康的理念可能有助于当地服务机构以新的方式与甲基苯丙胺使用者接触,为新颖的外展、减少伤害和治疗策略提供依据。