Global Health and Social Medicine, Harvard Medical School, Boston, Massachusetts, USA
Population Health, NYU Grossman School of Medicine, New York, New York, USA.
BMJ Glob Health. 2020 Sep;5(9). doi: 10.1136/bmjgh-2020-003353.
We describe a global health course and pedagogy that highlights the moral ambiguity and many ethical compromises that have emerged as the discipline has increasingly become institutionalised. We encourage students to reflect on how the oft-declared aspiration for global health equity still remains seriously contested as a normative and political matter, especially in settings like the USA. We further encourage students to reflect on how authentic concern for social justice, health equity and human rights are consistently undermined by unconscious and/or intentional fealty to standard operating procedures within hierarchical structures and systems. Lastly, we encourage students to openly question and critique the dominant socioeconomic and institutional paradigms that influence practitioner ways of thinking about global health. Our aim is to provide a learning space for students to at least imagine, if not demand, more daring modes of engagement. We also encourage our colleagues in the global health education community to be forthright that the process of institutionalising global health reliably favours our own interests more than those we claim to be most concerned about. If the ideal of global health is to build a bridge to human solidarity, we see substantial risk that current popularised approaches might never yield a structural tipping point.
我们描述了一门全球健康课程和教学法，强调了随着该学科日益制度化而出现的道德模糊性和许多道德妥协。我们鼓励学生思考，作为一个规范性和政治性问题，全球健康公平的崇高愿望在像美国这样的环境中仍然严重受到争议。我们进一步鼓励学生思考，对社会正义、健康公平和人权的真正关注如何始终受到无意识和/或对等级结构和系统内标准操作程序的忠诚的破坏。最后，我们鼓励学生公开质疑和批判影响从业者思考全球健康方式的占主导地位的社会经济和体制范式。我们的目的是为学生提供一个学习空间，让他们至少能够想象，如果不能要求的话，采取更勇敢的参与模式。我们还鼓励全球健康教育界的同行坦率地说，全球健康的制度化过程可靠地更有利于我们自己的利益，而不是我们声称最关心的利益。如果全球健康的理想是建立通往人类团结的桥梁，我们认为当前流行的方法可能永远不会产生结构上的转折点，这存在很大的风险。
