Trauma as a workaround: Recognizing chronic pain as disability without medical documentation in the United States and France

IF 4.9 2区 医学 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH
Jane Pryma
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引用次数: 0

Abstract

Since the 1970s, social movements and human rights frameworks have called for disability rights to be interpreted through a social model rather than a medical model of disability. However, neoliberal policy reforms that discourage disabled people's dependence on the state entrenched the role of medical gatekeepers to provide evidence of disability and authorize accommodations necessary for people with disabilities to participate in work and education. This paper uses disabling chronic pain as a case to examine how disability professionals in the United States and France recognize social trauma in the absence of medical evidence as justification for disability accommodations and entitlements. Drawing from interviews with doctors, chronic pain patient advocates, and disability service professionals in both countries, I first show how the biomedicalization of disability has stratified access to disability rights, privileging those who can comply with time-consuming and costly medical evaluation and treatment plans. For claimants without sufficient biomedical evidence of impairment, I then analyze how and why disability service professionals in each country have created a new path to accessibility. Disability professionals select some vulnerable disabled people to help bypass biomedical authority, reinterpreting disability in the logic of trauma to account for the distinct limitations of each country's healthcare and disability systems.
创伤作为一种变通办法:在美国和法国,在没有医疗文件的情况下,将慢性疼痛视为残疾
自1970年代以来,社会运动和人权框架呼吁通过残疾的社会模式而不是医学模式来解释残疾权利。然而,新自由主义政策改革阻碍了残疾人对国家的依赖,确立了医疗看门人的角色,即提供残疾证据,并授权残疾人参与工作和教育所需的便利。本文以致残慢性疼痛为例,研究美国和法国的残疾专业人员如何在缺乏医学证据的情况下将社会创伤视为残疾住宿和权利的理由。通过对这两个国家的医生、慢性疼痛患者倡导者和残疾服务专业人员的采访,我首先展示了残疾的生物医学化如何使残疾人权利的获得分层,使那些能够遵守耗时且昂贵的医疗评估和治疗计划的人获得特权。对于没有足够的生物医学证据证明残疾的索赔人,然后我分析了每个国家的残疾服务专业人员如何以及为什么创造了一条通往无障碍的新途径。残疾专家选择一些易受伤害的残疾人,帮助绕过生物医学权威,以创伤逻辑重新解释残疾,以解释每个国家医疗保健和残疾系统的独特局限性。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Social Science & Medicine
Social Science & Medicine PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH-
CiteScore
9.10
自引率
5.60%
发文量
762
审稿时长
38 days
期刊介绍: Social Science & Medicine provides an international and interdisciplinary forum for the dissemination of social science research on health. We publish original research articles (both empirical and theoretical), reviews, position papers and commentaries on health issues, to inform current research, policy and practice in all areas of common interest to social scientists, health practitioners, and policy makers. The journal publishes material relevant to any aspect of health from a wide range of social science disciplines (anthropology, economics, epidemiology, geography, policy, psychology, and sociology), and material relevant to the social sciences from any of the professions concerned with physical and mental health, health care, clinical practice, and health policy and organization. We encourage material which is of general interest to an international readership.
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