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The Good-Enough Science-and-Politics of Anthropological Collaboration with Evidence-Based Clinical Research: Four Ethnographic Case Studies

机译:人类学合作的充分科学与政治与循证临床研究:四个民族志案例研究

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摘要

The apolitical legitimacy of "evidence-based medicine" offers a practical means for ethnography and critical social-science-and-humanities-of-health theory to transfer survival resources to structurally vulnerable populations and to engage policy and services audiences with urgent political problems imposed on the urban poor in the United States that harm health: most notably, homelessness, hyperincarceration, social service cut-backs and the War on Drugs. We present four examples of collaborations between ethnography and clinical research projects that demonstrate the potentials and limits of promoting institutional reform, political debate and action through distinct strategies of cross-methodological dialogue with epidemiological and clinical services research. Ethnographic methods alone, however, are simply a technocratic add-on. They must be informed by critical theory to contribute effectively and transformatively to applied health initiatives. Ironically, technocratic, neoliberal logics of cost-effectiveness can sometimes render radical service and policy reform initiatives institutionally credible, fundable and capable of generating wider political support, even though the rhetoric of economic efficacy is a double-edged sword. To extend the impact of ethnography and interdisciplinary theories of political-economic, cultural and disciplinary power relations into applied clinical and public health research, anthropologists--and their fellow travelers--have to be able to strategically, but respectfully learn to see through the positivist logics of clinical services research as well as epidemiological epistemology in order to help clinicians achieve--and extend--their applied priorities. In retrospect, these four very differently-structured collaborations suggest the potential for "good-enough” humble scientific and political strategies to work for, and with, structurally vulnerable populations in a punitive neoliberal era of rising social inequality, cutbacks of survival services, and hyperincarceration of the poor.
机译:“循证医学”在政治上的合法性为人种志学和重要的社会科学与人文科学健康理论提供了一种实用的手段,可以将生存资源转移给结构脆弱的人群,并使政策和服务受众面临紧急政治问题危害健康的美国城市贫民:最明显的是无家可归,监禁过多,社会服务减少和毒品战争。我们提供了人种学与临床研究项目之间合作的四个示例,这些示例展示了通过与流行病学和临床服务研究进行跨方法论对话的独特策略来促进机构改革,政治辩论和行动的潜力和局限性。但是,仅民族志方法只是技术专家的附加组件。必须通过批判理论来告知他们,以有效地,变革性地为应用卫生计划做出贡献。具有讽刺意味的是,成本效益的技术官僚主义,新自由主义逻辑有时可以使激进的服务和政策改革举措在体制上可信,可资助且能够产生更广泛的政治支持,即使经济效益的言论是一把双刃剑。为了将人种学和政治,经济,文化和学科权力关系的跨学科理论的影响扩展到应用的临床和公共卫生研究中,人类学家及其同伴必须具备策略性,但必须学会从中临床服务研究以及流行病学认识论的实证逻辑,以帮助临床医生实现并扩展其应用的重点。回顾过去,这四个结构迥异的合作表明,在惩罚性新自由主义时代,社会不平等现象加剧,生存服务削减和经济增长的惩罚性新自由主义时代,“足够好”的谦卑科学和政治战略有可能为结构脆弱的人群服务,并与之相处。监禁的穷人。

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