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为学习障碍者提供医疗保健方面的盟友关系:作为尊重、关注与合作行动的实践

Allyship in Healthcare for People With Learning Disabilities as a Praxis of Respect, Attention and Collaborative Action.

作者信息

Daw Srdanovic Bojana

机构信息

Peninsula Medical School, University of Plymouth, Plymouth, England.

Cornwall Intellectual Disability Equitable Research (CIDER), Cornwall Partnership NHS Foundation Trust, Truro, England.

出版信息

Sociol Health Illn. 2025 May;47(4):e70047. doi: 10.1111/1467-9566.70047.

Abstract

There is a dearth of literature focusing on how allyship in health may be enacted in relation to people with learning disabilities (LD). This is concerning, because people with LD are vulnerable to health inequalities and forms of medical dehumanisation including do-not-resuscitate orders, diagnostic overshadowing and overprescription of psychotropic drugs. Deploying critical disability studies as a lens through which to understand disability, this paper reviews models of disability allyship developed in healthcare, research and theatre. In doing so it advocates transformative allyship as a model that can both animate action in support of people with learning disabilities and accommodate the involvement of others, including clinicians, carers and relatives, without compromising the all-important commitment to supporting disability cultures. The paper presents and analyses ethnographic data gained through observations of eleven healthcare appointments between seven clinicians and five patients with LD, undertaken as part of the ESRC-funded study Humanising Healthcare. It documents the potential of transformative allyship in healthcare to transform harmful disablist practices through emphasising respect, attention and collaborative action while also noting that broader structural conditions and diagnostic technologies limit the extent to which clinicians can enact transformative allyship.

摘要

关于如何在健康领域针对学习障碍(LD)患者建立盟友关系的文献匮乏。这令人担忧,因为学习障碍患者易受健康不平等以及医疗非人性化形式的影响,包括不进行心肺复苏指令、诊断遮蔽和精神药物过度处方。本文运用批判性残疾研究作为理解残疾的视角,回顾了在医疗保健、研究和戏剧领域中发展起来的残疾盟友关系模式。在此过程中,它倡导变革性盟友关系,认为这一模式既能激发支持学习障碍患者的行动,又能让包括临床医生、护理人员和亲属在内的其他人参与进来,同时不损害支持残疾文化这一至关重要的承诺。本文展示并分析了通过观察七名临床医生与五名学习障碍患者之间的十一次医疗预约所获得的人种志数据,这些观察是作为经济与社会研究委员会资助的“医疗保健人性化”研究的一部分进行的。它记录了变革性盟友关系在医疗保健中通过强调尊重、关注和合作行动来转变有害的残疾歧视做法的潜力,同时也指出更广泛的结构条件和诊断技术限制了临床医生实施变革性盟友关系的程度。

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