Immigration and medicine: Stress, culture and power in encounters between Ethiopian immigrants and their doctors in Israel.

摘要

This dissertation identifies the major conflicts involved in medical care with Ethiopian immigrants in Israel. It formulates an integrated theoretical approach to the understanding of immigration and medicine consisting of the inter-related themes of stress, cultural concepts of illness and power differentials in medical encounters.;Since the stress of migration and acculturation may lead to illness, medical encounters become a salient setting for host-immigrant interaction, with the potential for conflict arising from three main characteristics. Firstly, the biomedical disease model has limited understanding and ability to treat stress-related illness. Secondly, cultural differences in concepts of illness and healing lead to misunderstandings between doctors and patients. Thirdly, in medical encounters, doctors are in positions of power relative to patients and represent the dominant perspectives of the host society. Therefore, when culture conflicts arise, the cultural patterns of the host society are reinforced. Thus, medical encounters serve latent functions in the acculturation process. Immigrants respond to both the manifest healing functions and the latent acculturative functions of medical care. Immigrants from non-industrial societies can directly embody technological aspects of the host culture through participation in medical interventions. Immigrant patients' responses of both embracing and resisting medical care reflect the tension between adapting to new cultural norms and maintaining original beliefs and practices.;This dissertation integrates research and theory from the medical and social science disciplines concerning migration stress, culture and illness, politics of medical encounters and embodiment. It provides a comprehensive model of stress, culture and power which helps to explain the discontent experienced by both immigrants and doctors despite efforts to address immigrants' needs. Medical interactions demonstrate patterns of cultural disparities and power differentials typical of host-immigrant interactions in the wider social context, helping to explain how similar social patterns are reproduced with different immigrant groups in different contexts.;Data were collected and analyzed using a combination of qualitative and quantitative techniques, including participant observation, informant interviews, semi-structured interviews and a household survey.