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肌痛性脑脊髓炎/慢性疲劳综合征患者组织“激进”吗?:医学争议中的患者抗议

Are ME/CFS Patient Organizations "Militant"? : Patient Protest in a Medical Controversy.

作者信息

Blease Charlotte, Geraghty Keith J

机构信息

General Medicine and Primary Care Research, Beth Israel Deaconess Medical Center, Harvard Medical School, 330 Brookline Avenue, Boston, MA, 02215, USA.

School of Psychology, University College Dublin, Belfield, Dublin 4, Ireland.

出版信息

J Bioeth Inq. 2018 Sep;15(3):393-401. doi: 10.1007/s11673-018-9866-5. Epub 2018 Jul 3.

Abstract

Myalgic encephalomyelitis or chronic fatigue syndrome (ME/CFS) is a contested illness category. This paper investigates the common claim that patients with ME/CFS-and by extension, ME/CFS patient organizations (POs)-exhibit "militant" social and political tendencies. The paper opens with a history of the protracted scientific disagreement over ME/CFS. We observe that ME/CFS POs, medical doctors, and medical researchers exhibit clear differences in opinion over how to conceptualize this illness. However, we identify a common trope in the discourse over ME/CFS: the claim of "militant" patient activism. Scrutinizing this charge, we find no compelling evidence that the vast majority of patients with ME/CFS, or the POs representing them, have adopted any such militant political policies or behaviours. Instead, we observe key strategic similarities between ME/CFS POs in the United Kingdom and the AIDs activist organizations of the mid-1980s in the United States which sought to engage scientists using the platform of public activism and via scientific publications. Finally, we explore the contours of disagreement between POs and the medical community by drawing on the concept of epistemic injustice. We find that widespread negative stereotyping of patients and the marginalization and exclusion of patient voices by medical authorities provides a better explanation for expressions of frustration among patients with ME/CFS.

摘要

肌痛性脑脊髓炎或慢性疲劳综合征(ME/CFS)是一个存在争议的疾病类别。本文调查了一种常见说法,即ME/CFS患者——以及由此延伸的ME/CFS患者组织(POs)——表现出“激进”的社会和政治倾向。本文开篇讲述了关于ME/CFS旷日持久的科学分歧的历史。我们观察到,ME/CFS患者组织、医生和医学研究人员在如何界定这种疾病的问题上存在明显的意见分歧。然而,我们在关于ME/CFS的论述中发现了一个常见的论调:即声称患者激进主义“激进”。仔细审视这一指控,我们发现没有令人信服的证据表明绝大多数ME/CFS患者或代表他们的患者组织采取了任何此类激进的政治政策或行为。相反,我们观察到英国的ME/CFS患者组织与20世纪80年代中期美国的艾滋病维权组织之间存在关键的战略相似之处,后者试图利用公众维权平台并通过科学出版物与科学家接触。最后,我们借助认知不公正的概念探讨了患者组织与医学界之间分歧的轮廓。我们发现,对患者的广泛负面刻板印象以及医学权威对患者声音的边缘化和排斥,能更好地解释ME/CFS患者的沮丧情绪。

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