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首页> 外文期刊>Sociology of health & illness >Negotiating access to medical treatment and the making of patient citizenship: The case of hepatitis C treatment
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Negotiating access to medical treatment and the making of patient citizenship: The case of hepatitis C treatment

机译：谈判就医和患者国籍的确定：丙型肝炎治疗案例

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摘要

Drawing on qualitative interview accounts with people who have injected drugs, we deploy ideas of biological and therapeutic citizenship to explore how the negotiation of access to hepatitis C treatment enacts patient citizenship potential. We find that the patient citizenship made through hepatitis C treatment divides those who are deserving from those who are not, largely in relation to their presentations of self-control, responsibility and recovery regarding drug use. Accessing treatment requires that patients negotiate their entitlement by reflexively producing the patient citizen role expected of them. In this context of rationed treatment expectation, access to treatment is constructed in relation to gratitude rather than entitlement. Rationed treatment expectation also interplays with a utilitarian approach to hepatitis C expertise. Accounts of the bio-effects of hepatitis C and its treatment as uncertain further weaken the potential for shared illness identity and biosocial membership as well as contributing to treatment delay. We conclude that the construction of hepatitis C treatment as a negotiation of 'recovery towards normality' positions people who continue to use or inject drugs as beyond patient citizenship. Our findings underscore the situated limits of therapeutic and biological citizenship, emphasising that these processes are unavoidably forces of governance.
机译：利用对注射毒品者的定性访谈记录，我们运用生物学和治疗公民身份的想法来探索获得丙型肝炎治疗的谈判如何发挥患者公民潜力。我们发现，通过丙型肝炎治疗获得的患者公民身份将应得的人与应得的人区分开，主要是因为他们对药物使用的自我控制，责任感和恢复能力的表现。获得治疗要求患者通过反身发挥他们期望的患者公民角色来协商他们的权利。在合理分配治疗期望的背景下，获得治疗的途径是感激而不是应享权利。合理的治疗期望也与实用的丙型肝炎治疗方法相互影响。对丙型肝炎及其治疗的生物效应的不确定性说明进一步削弱了共享疾病特征和生物社会成员身份的可能性，并导致治疗延迟。我们得出的结论是，将丙型肝炎治疗建设为“恢复正常”的谈判，这使那些继续使用或注射药物的患者超越了患者国籍。我们的发现强调了治疗和生物公民资格的局限性，强调这些过程不可避免地是治理的力量。

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