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医学中的中立性与少数族裔健康专业人员:以以色列的阿拉伯裔健康专业人员为例。

Neutrality in medicine and health professionals from ethnic minority groups: The case of Arab health professionals in Israel.

作者信息

Keshet Yael, Popper-Giveon Ariela

机构信息

Western Galilee Academic College, Israel.

David Yellin Academic Collage, Israel.

出版信息

Soc Sci Med. 2017 Feb;174:35-42. doi: 10.1016/j.socscimed.2016.12.019. Epub 2016 Dec 13.

Abstract

The ethos of neutrality dominates biomedicine. It has, however, been criticized for leading to a disregard for diversity in medicine. In this article we employ the 'inclusion and difference' approach to gain an understanding of why the ethos of neutrality, on the one hand, and tensions associated with race/ethnicity, on the other, are relevant to the work of ethnic minority health professionals. We sought to explore tensions associated with neutrality in medicine from the point of view of ethnic minority professionals who work in a context of political conflict. We conducted 33 in-depth interviews with Arab health professionals - physicians, nurses and pharmacists - working in Israeli health organizations. The Arab health professionals perceive medical knowledge as being politically neutral; and medical practice as being impartial, universal and humanitarian. They regard the healthcare sector as a relatively egalitarian workplace, into which they can integrate and gain promotion. Nevertheless, the interviewees experienced various instances of treatment refusal, discrimination and racism. In line with the ethos of neutrality, the Israeli medical code of ethics does not relate specifically to Arab professionals and takes their inclusion and integration in healthcare organizations for granted. The ethos of neutrality in medicine underlies the ambivalence inherent in the approach of 'inclusion and difference'. While perceptions of neutrality, alongside values such as equality, cultural competency, impartiality and humanitarian healthcare, do indeed promote the inclusion of minority professionals in health organizations, these same perceptions mask the need to address political events that impinge on the medical milieu and may present an obstacle to designing specific policies to deal with such events.

摘要

中立的理念主导着生物医学。然而,它因导致对医学多样性的忽视而受到批评。在本文中,我们采用“包容与差异”的方法来理解为何一方面中立的理念,另一方面与种族/民族相关的紧张关系,与少数族裔健康专业人员的工作相关。我们试图从在政治冲突背景下工作的少数族裔专业人员的角度探讨医学中与中立相关的紧张关系。我们对在以色列卫生组织工作的阿拉伯健康专业人员——医生、护士和药剂师——进行了33次深入访谈。阿拉伯健康专业人员认为医学知识在政治上是中立的;医疗实践是公正、普遍和人道的。他们将医疗保健部门视为一个相对平等的工作场所,他们可以融入其中并获得晋升。然而,受访者经历了各种拒绝治疗、歧视和种族主义的情况。根据中立的理念,以色列医学伦理准则并未特别涉及阿拉伯专业人员,并且认为他们在医疗保健组织中的融入和整合是理所当然的。医学中的中立理念是“包容与差异”方法中固有矛盾的基础。虽然对中立的认知,连同平等、文化能力、公正和人道医疗保健等价值观,确实促进了少数族裔专业人员融入卫生组织,但这些相同的认知掩盖了应对影响医疗环境且可能成为制定应对此类事件具体政策障碍的政治事件的必要性。

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