医学化与医学界限的反思

自20世纪下半叶以来,医学在科技、资本、政治等社会力量影响下,日益从传统的疾病、健康领域扩展到日常生活领域,导致了原属于生活方式和正常生命历程事件的酗酒、性取向、分娩等问题的医学化,这体现了医学跨越固有界限的趋势。从历史看,医学在古代并没有把上述社会生活问题纳入其视域,而随着社会的现代转型,医学的传统界限常常被打破,医学对社会生活问题的干预范围越来越广泛。但是,某些医学实践对科学界限和伦理界限的跨越却缺乏足够的科学性和正当性,其重要根源在于经济系统和权力系统对这一日常生活世界的侵蚀。

     

Medical Marijuana Regulation in Michigan: Problems of Legitimacy

Since the initiation of the Michigan Medical Marihuana Act (MMMA) in 2008 State of Michigan . 2008 . “Michigan Medical Marihuana Act.” Initiated Act 1 of 2008. Retrieved June 5, 2012 (www.legislature.mi.gov)  [Google Scholar], several issues relevant to the study of sociology of law and deviant behavior have emerged. I analyzed the administration of the MMMA using a case study method and interpret the initial social issues developing from this law by focusing on legitimacy. Due to a contradictory system where the MMMA is at odds with the Schedule I categorization of marijuana at the federal and state levels, the legitimacy of both the administration of the MMMA and the administration of marijuana law more generally are threatened. This lack of legitimacy in turn leads to a situation of “Pyrrhic Defeat” where failure to gain legal compliance maintains the inertia of marijuana prohibition.     

Marijuana: A Review of Medical Research With Implications for Adolescents

Recent medical evidence indicates that marijuana is more harmful than had previously been suspected. A review of recent research in the following areas is presented: tolerance and persistence, reproductive system, respiratory system, immune system, central nervous system, genetic and chromosomal effects, and behavioral effects. Implications for mental health professionals are discussed.     

They Call Us Problem Child: Delinquency,Medicalization, and Social Class in Primary Education

This article recounts my seven-year struggle with my son in his high-performing school district, and his immediate shift in identity from delinquent to honor student when we changed districts. I argue that social class is encoded in setting and family form. Factors like context, class and family form discrimination, diagnosis in schools, and access to resources, all shaped Coby’s social experiences.     

Religion and Medicalization: The Case of ADHD

As a medicalized condition, Attention Deficit Hyperactivity Disorder (ADHD) sparks considerable public controversy. Previous research has highlighted the importance of examining the factors that influence attitudes toward ADHD. This article examines an understudied factor, religion, and its relationship with ADHD attitudes. Using data from the 2002 General Social Survey National Stigma Study‐Children, this research finds that compared to the rest of the population, evangelical Christians are less likely to view ADHD as a real disease and to believe children with ADHD should be treated with medication. Results also demonstrate that evangelicals are more likely to think doctors are overmedicating children with common behavior problems and to think medication prevents families from working out problems themselves. On the other hand, church attendance is unrelated to beliefs about ADHD treatment but is positively associated with thinking ADHD is a real disease. These findings add new insights to the existing literature on religion and medicalization.     

Evaluating Medical Marijuana Dispensary Policies: Spatial Methods for the Study of Environmentally-Based Interventions

In 1996, California was the first state to pass a Compassionate Use Act allowing for the legal use of marijuana for medical purposes. Here we review several current policy and land use environmental interventions designed to limit problems related to the influx of medical marijuana dispensaries across California cities. Then we discuss the special challenges, solutions, and techniques used for studying the effects of these place-based policies. Finally, we present some of the advanced spatial analytic techniques that can be used to evaluate the effectiveness of environmental interventions, such as those related to reducing problems associated with the proliferation of medical marijuana dispensaries. Further, using data from a premise survey of all the dispensaries in Sacramento, this study will examine what characteristics and practices of these dispensaries are related to crime within varying distances from the dispensaries (e.g., 100, 250, 500, and 1,000 feet). We find that some security measures, such as security cameras and having a door man outside, implemented by medical marijuana dispensary owners might be effective at reducing crime within the immediate vicinity of the dispensaries.     

Social and Personal Determinants of Adolescent Use and Abuse of Alcohol and Marijuana

This article summarizes research on social and personal determinants of adolescent use and abuse of alcohol and marijuana to aid practitioners when designing interventions.     

Embracing Thanatos-in-Eros: Evolutionary Ecology and Panentheism

If Panentheism’s core thesis, that God is in the world, is to animate a spiritual approach to life, then we have to account for the way in which God is in the destructive or thanative dimensions of life. From the perspective of evolutionary ecology the universe is imbued with creative and destructive energies. The creative drive can be termed eros as creation occurs through the expansion of relational unities, holons. The destructive drive is termed thanatos and is the drive to sever connection. An argument is developed from the perspective of evolutionary ecology to show how thanatos serves eros, serves the evolutionary unfolding of higher orders of communion. I suggest there are healthy and pathological expressions of the thanative drive. God within the thanative invites us to embrace the transformative potentials of suffering by integrating thanatos-in-eros. God as eros invites us to develop expanded modes of connection, inter-subjectivity and communion.     

The Social Construction of Deviance,Conflict and the Criminalization of Midwives,New Orleans: 1940s and 1950s

Midwives in mid-twentieth-century New Orleans went from practicing unhindered to being demonized in the media and targeted by the criminal justice system, thanks to the actions of three concerned groups. After the prosecution of female midwives began and their practice was suppressed, male medical doctors gained control over the provision of abortions in the city as well as the supervision of midwifery. Employing content analysis, we find that the historic record largely supports an interpretation of these events from a conflict theory, a radical feminist, and a social constructionist perspective.     

医疗社会工作:现实意义和发展趋向

医疗社会工作是社会工作专业的重要实务领域之一,在西方发达国家的医疗事业中扮演着不可替代的角色,具有解决患者及其家属问题、处理医患关系,并促进公共卫生政策的改善等多种功能.从我国目前的发展来看,尚处于起步阶段,还有诸多需要努力的方面,包括完善相关政策、提高服务质量、修正教育模式、突出中国特色等.     

医疗社会工作：现实意义和发展趋向

医疗社会工作是社会工作专业的重要实务领域之一,在西方发达国家的医疗事业中扮演着不可替代的角色,具有解决患者及其家属问题、处理医患关系,并促进公共卫生政策的改善等多种功能。从我国目前的发展来看,尚处于起步阶段,还有诸多需要努力的方面,包括完善相关政策、提高服务质量、修正教育模式、突出中国特色等。     

Drug-Intake Methods and Social Identity: The Use of Marijuana in Blunts Among Southeast Asian Adolescents and Emerging Adults

This article examines why Southeast Asian American adolescents and emerging adults in two urban settings prefer to use "blunts," or hollowed-out cigars filled with marijuana, over other methods of drug intake. Rationales for preferring blunts were both instrumental and social. Blunts allowed users to more easily share marijuana, the preferred drug among their peers, and protected against potential adverse effects associated with the "high." Blunts also allowed users to identify with the dominant style of drug use and differentiate themselves from users of stigmatized drugs such as crack cocaine and methamphetamine. This article highlights the importance of drug-intake methods in the formation and performance of drug-using behaviors among adolescents, emerging adults, and members of ethnic minority subgroups.     

医学化的权力与经济批判——从伊里奇到福柯

权力与经济是分析当代医学化现象的两个重要维度。医学不只是一种知识和技术,同时也是一种权力规范和经济活动,伊里奇和福柯都对此展开了分析,但是两者的方式与对策有所不同。伊里奇将医学化视为一种文化异化现象,并提出了一种文化主义的消除策略,福柯则将医学化视为权力体系和经济体系的一部分,从而提出了一种基于生命政治批判的反抗策略。两者的解决方案都具有局限性,但两者所开启的权力与经济批判以及对个体自主性的强调,有助于理解当代社会医学化的复杂性,也有助于将医学化批判置于整个社会危机的哲学反思之中。

     

Changing Masks: Identity Maintenance and the Role of Marijuana among a Small Circle of Marijuana Growers

Utilizing ethnographic field observations as well as face-to-face interviews, this article explores nuances of identity management among a small, intimate group of indoor marijuana growers. Findings suggest that some who are involved in marijuana cultivation may have multiple, distinct deviant identities or “masks.” These “masks” are called on depending on the audience and situation that each participant is presented with. Further, we show that these growers have three deviant identities that must constantly be managed including, (a) marijuana user, (b) marijuana seller, and (c) marijuana grower. Finally, we present data demonstrating the importance of marijuana in the everyday lives of the participants.     

Social Judgement Theory and Medical Judgement

Social judgement theory is particularly well suited to the study of medical judgements. Medical judgements characteristically involve decision making under uncertainty with inevitable error and an abundance of fallible cues. In medicine, as in other areas, SJT research has found wide variation among decision makers in their judgements and in the weighting of clinical information. Strategies inferred from case vignettes differ from physicians' self-described strategies and from the weights suggested by experts. These observations parallel recent findings of unexplained variation in diagnosis and management in clinical practice that have been the source of concern in the medical community. The lens model provides one of the few methods for quantitatively analysing physicians' judgements. Contrary to what one might expect from the variation in strategies on paper cases, several studies suggest that, in practice, physicians' diagnostic judgements are highly accurate. Cognitive feedback has been less successful as a practical teaching tool than originally hoped, but some aspects of this methodology show promise, particularly in conjunction with the increasing emphasis on statistical decision support. All things considered, SJT has provided insight into physicians' decisions and gives the medical research community important tools for studying judgements in actual practice.     

Social and Medical Transgender Case Advocacy

SUMMARY

While some clients are confident self-advocates, many transgender individuals and loved ones find it difficult to advocate for themselves and turn to a trusted clinician for assistance. This article discusses the role of the health and social service clinician in transgender case advocacy. Although the setting, circumstances, and client needs vary greatly, the overarching goal of clinical advocacy is to address the societal barriers that interfere with clients' functionality and well-being. We suggest a protocol for advocacy assessment in the clinical setting and discuss trans-specific advocacy concerns relating to financial assistance, employment, changing identification, general advocacy, and outline concerns of specific populations within the transgender community.