Department of Political Science, University of Vienna, Vienna, Austria.
Bioethics. 2023 Feb;37(2):120-129. doi: 10.1111/bioe.13122. Epub 2022 Nov 26.
This paper is an empirical study of what solidarity in a Western European healthcare system means today. Drawing upon empirical research on the 2015 refugee cohort's health needs and their health-seeking behaviour, it unites claims from the literature on solidarity in the fields of migration and healthcare. I argue that the Austrian healthcare system not only is an example of 'civic solidarity' in the form of institutionalised obligations to citizens but that it also enacts political forms of solidarity and produces political inclusion for marginalised groups such as refugees. My findings show that being entitled to and accessing services in the healthcare system holds meaning beyond the provision of care: It enables to act autonomously, to build familiar relationships with Austrian institutions, inclusion via the personal electronic health card and to support others in the same solidaristic system. These insights can be used to raise awareness about the inclusional function of healthcare services among practitioners. They also show how solidarity-based healthcare systems can be a motor for shaping positive relationships between immigrants and the host country, and point to additional modes of solidarity in the context of forced migration next to civil society and nonstate support structures. This paper builds upon ethnographic data that were collected between 2018 and 2020 in Vienna, Austria (observational notes before, during and after medical consultations with refugees; interviews with them; interviews with healthcare practitioners and other care providers).
这篇论文是对当今西欧医疗体系中团结精神的实证研究。本文通过对 2015 年难民群体健康需求及其寻医行为的实证研究,将移民和医疗领域团结文献中的主张结合起来。我认为,奥地利医疗体系不仅体现了公民义务形式的“公民团结”,而且还体现了政治团结形式,并为边缘化群体(如难民)提供了政治包容。我的研究结果表明,在医疗体系中享有和获得服务的权利不仅仅意味着提供医疗服务:它使人们能够自主行动,与奥地利机构建立熟悉的关系,通过个人电子健康卡获得包容,并在同一个团结的体系中支持其他人。这些发现可以用来提高从业者对医疗服务包容性功能的认识。它们还展示了基于团结的医疗体系如何成为塑造移民与东道国之间积极关系的动力,并指出了在强制移民背景下除了公民社会和非国家支持结构之外的其他团结模式。本文基于 2018 年至 2020 年间在奥地利维也纳收集的民族志数据(难民医疗咨询前后的观察记录;对他们的采访;对医疗保健从业者和其他护理提供者的采访)。