Department of Anthropology, Human Rights Institute, University of Connecticut, Storrs, Connecticut, USA
Institute of Social and Cultural Anthropology, Freie Universität Berlin, Berlin, Germany.
BMJ Glob Health. 2021 Apr;6(Suppl 1). doi: 10.1136/bmjgh-2021-005108.
Health and the capacity to flourish are deeply intertwined. For members of vulnerable migrant groups, systemic inequalities and structural forms of marginalisation and exclusion create health risks, impede access to needed care and interfere with the ability to achieve one's full potential. Migrants often have limited access to healthcare, and they frequently are portrayed as less deserving than others of the resources needed to lead a healthy and flourishing life. Under these circumstances, clinicians, healthcare institutions and global health organisations have a moral and ethical obligation to consider the role they can-and do-play in either advancing or impeding migrants' health and their capacity to flourish. Drawing on case studies from three world regions, we propose concrete steps clinicians and health institutions can take in order to better serve migrant patients. These include recommendations that can help improve understanding of the complex circumstances of migrants' lives, strengthen collaboration between care providers and non-medical partners and transform the social, economic and structural circumstances that impede flourishing and harm health. Developing new strategies to promote the flourishing of precarious migrants can strengthen our collective ability to re-envision and redesign health systems and structures to value the health, dignity and bodily integrity of all patients-especially the most vulnerable-and to promote flourishing for all.
健康和蓬勃发展的能力是紧密交织在一起的。对于弱势群体的移民来说，系统性不平等以及边缘化和排斥的结构性形式会带来健康风险，阻碍他们获得所需的护理，并影响他们充分发挥潜力的能力。移民往往难以获得医疗保健，而且他们常常被描绘成不如其他人更值得获得过上健康和繁荣生活所需的资源。在这种情况下，临床医生、医疗机构和全球卫生组织有道德和伦理义务，要考虑他们在促进或阻碍移民健康及其蓬勃发展的能力方面可以发挥的作用。本文从世界三个地区的案例研究出发，提出了临床医生和医疗机构可以采取的具体措施，以更好地为移民患者服务。这些建议包括有助于更好地理解移民生活复杂情况的措施，加强医疗服务提供者和非医疗合作伙伴之间的合作，并改变阻碍蓬勃发展和损害健康的社会、经济和结构性环境。制定促进脆弱移民蓬勃发展的新战略，可以增强我们集体的能力，重新构想和重新设计卫生系统和结构，重视所有患者的健康、尊严和身体完整性——尤其是最脆弱的患者——并促进所有人的繁荣。
