Levenson Jeremy, Samra Shamsher
Department of Anthropology, UCLA, Los Angeles, USA.
Department of Psychiatry, Yale, New Haven, CT, USA.
Cult Med Psychiatry. 2025 Mar;49(1):65-90. doi: 10.1007/s11013-023-09827-3. Epub 2023 Jun 30.
The field of medical action extends beyond the clinical encounter. Rather, clinical encounters are organized by wider regimes of governance and expertise, and broader geographies of care, abandonment and violence. Clinical encounters in penal institutions condense and render visible the fundamental situatedness of all clinical care. This article considers the complexity of clinical action in carceral institutions and their wider geographies through an examination of the crisis of mental health care in jails, an issue of significant public concern in the United States and much of the world. We present findings from our engaged, collaborative clinical ethnography, which was informed by and seeking to inform already existing collective struggles. Revisiting the concept of "pragmatic solidarity" (Farmer in Partner to the poor: a Paul Farmer reader, University of California Press, Berkeley, 2010) in an era of "carceral humanitarianism" (Gilmore in Futures of Black Radicalism, Verso, New York, 2017, see also Kilgore in Repackaging mass incarceration, Counterpunch, June 6-8, http://www.counterpunch.org/2014/06/06/repackaging-mass-incarceration/ , 2014), we draw on theorists who consider prisons to be institutions of "organized violence" (Gilmore and Gilmore in: Heatherton and Camp (eds) Policing the planet: why the policing crisis led to Black lives matter, Verso, New York, 2016). We argue that clinicians may have an important role in joining struggles for "organized care" that can counter institutions of organized violence.
医疗行动的领域超出了临床诊疗的范畴。相反,临床诊疗是由更广泛的治理和专业知识体系,以及更广阔的护理、遗弃和暴力地域格局所组织起来的。刑罚机构中的临床诊疗浓缩并凸显了所有临床护理的基本情境性。本文通过审视监狱心理健康护理危机,来探讨监禁机构中临床行动的复杂性及其更广阔的地域格局,这是美国和世界许多地方备受公众关注的一个问题。我们展示了参与式协作临床人种志的研究结果,该研究既受现有集体斗争的启发,也旨在为其提供信息。在“监禁人道主义”(吉尔摩著于《黑人激进主义的未来》,维索出版社,纽约,2017年,另见基尔戈尔著于《重新包装大规模监禁》,《反击》杂志,6月6 - 8日,http://www.counterpunch.org/2014/06/06/repackaging-mass-incarceration/,2014年)的时代,重新审视“务实团结”的概念(法默著于《与穷人的伙伴关系:保罗·法默读本》,加利福尼亚大学出版社,伯克利,2010年),我们借鉴了那些将监狱视为“有组织暴力”机构的理论家的观点(吉尔摩和吉尔摩著于:希瑟顿和坎普(编)《治理地球:为何治安危机引发了黑人的命也是命运动》,维索出版社,纽约,2016年)。我们认为,临床医生在参与争取“有组织护理”的斗争中可能发挥重要作用,这种护理能够对抗有组织暴力的机构。