Luborsky M R
Polisher Research Institute, Philadelphia Geriatric Center, PA 19141, USA.
Soc Sci Med. 1995 Jun;40(11):1447-59. doi: 10.1016/0277-9536(94)00359-2.
This paper examines how labels for impairment are negotiated by people with disabilities during clinical assessment. It builds on Robert Murphy's (1987) explanations of the disability experience as rooted in the individual's sense of having multiple past, present and intended future body-selves. Using transcripts of five consecutive daily clinical research assessments, it describes the conduct of clinical research assessments with an older man with stroke-related motor impairments and dysphoria. It also examines how the researcher as Other shapes a person's sense of identity, experience and quality of life by regulating the medical labels for personal experience, and by authoring socially authoritative scientific models of disabilities. Points of dissension (regarding identity, discourse and time perspectives) and collaboration are identified and then illustrated with excerpts from the transcripts. Analysis reveals how salient personal experiences are locally asserted in discourse, and selectively misrepresented in the clinical research record.
本文探讨了残疾人在临床评估过程中如何就损伤标签进行协商。它建立在罗伯特·墨菲（1987）对残疾经历的解释基础之上，即将残疾经历根源归结于个体对自身多重过去、现在及预期未来身体自我的认知。通过连续五天临床研究评估的文字记录，本文描述了对一名患有中风相关运动障碍和烦躁不安的老年男性进行临床研究评估的过程。本文还研究了作为“他者”的研究者如何通过规范个人经历的医学标签以及构建具有社会权威性的残疾科学模型，来塑造一个人的身份认同感、经历和生活质量。文中识别了分歧点（关于身份、话语和时间视角）与合作点，并用文字记录中的节选内容进行了说明。分析揭示了突出的个人经历如何在话语中得以局部彰显，以及如何在临床研究记录中被选择性地歪曲呈现。
