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首页> 外文期刊>Academic Medicine: Journal of the Association of American Medical Colleges >Narrative Intersectionality in Caring for Marginalized or Disadvantaged Patients: Thinking Beyond Categories in Medical Education and Care
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Narrative Intersectionality in Caring for Marginalized or Disadvantaged Patients: Thinking Beyond Categories in Medical Education and Care

机译：照顾边缘化或弱势症患者的叙事交汇表：超越医学教育和护理类别的思考

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摘要

Categories are essential to doctors' thinking and reasoning about their patients. Much of the clinical categorization learned in medical school serves useful purposes, but an extensive literature exists on students' reliance on broad systems of social categorization. In this article, the authors challenge some of the orthodoxies of categorization by combining narrative approaches to medical practice with the theoretical term "intersectionality" to draw students' attention to the important intersecting, but often overlooked, identities of their patients. Although intersectionality applies for all patients, the focus here is on its importance in understanding and caring for marginalized or disadvantaged persons. Intersectionality posits that understanding individual lives requires looking beyond categories of identity in isolation and instead considering them at their intersection, where interrelated systems of power and oppression, advantage and discrimination are at play and determine access to social and material necessities of life. Combined with narrative approaches that emphasize the singularity of a person's story, narrative intersectionality can enable a more robust understanding of how injustice and inequality interrelate multidimensionally to produce social disadvantage. The authors apply this framework to two films that present characters whose lives are made up of numerous and often-contradictory identities to highlight what physicians may be overlooking in the care of patients. If the education of physicians encourages synthesis and categorization aimed at the critically useful process of making clinical "assessments" and "plans," then there must also be emphasis in their education on what might be missing from that process.
机译：类别对医生的思考和推理对其患者至关重要。在医学院学到的大部分临床分类都提供了有用的目的，但对学生依赖于广泛的社会分类制度存在广泛的文学。在本文中，提交人通过将叙事方法与理论术语“交叉”将学生的注意力与理论术语“交汇表”相结合来挑战一些分类的分类，以吸引学生对重要交叉的关注，但经常被忽视，其患者的身份。虽然交叉口适用于所有患者，但这里的重点是对边缘化或弱势群体的理解和照顾的重要性。理解个体生活的交叉表现需要超越孤立的身份类别，而是考虑到他们的交叉路口，其中相互关联的权力和压迫系统，优势和歧视是在发挥并确定获得社会和物质生活必需品。结合强调一个人故事的奇异性的叙述方法，叙述交叉表可以更加强大地了解不公正和不平等如何相互关联，以产生社会劣势。该作者将此框架应用于两部电影，这些电影现有人的生活是由众多和经常 - 矛盾的身份突出，以突出什么，在患者的照顾中可能忽视什么。如果医生的教育鼓励综合和分类旨在制作临床“评估”和“计划”的批判性有用的过程，那么还必须强调他们对该过程中可能缺少的事情的教育。

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