{"title":"医疗暴力:退伍军人治疗法庭创伤的制度政治","authors":"Victoria Piehowski","doi":"10.1016/j.socscimed.2025.118170","DOIUrl":null,"url":null,"abstract":"<div><div>Criminal court actors engage in medicalization as they negotiate the balance of punitive and rehabilitative responses in their work, particularly in cases of low-level drug crime. Often, however, these legal actors regard violent crime as untreatable. This paper examines an exception to this assemblage of practice and policy: Veterans Treatment Courts (VTCs). VTCs combine judges, prosecutors, public defenders, and Veterans Affairs' (VA) professionals to provide treatment-based supervision in lieu of incarceration. In Minnesotan VTCs, court actors regard violent crime as treatable—for this population. Using interview data, I analyze how court actors medicalize violence as they legitimate veterans’ eligibility for the court and design their supervision. I find that court actors establish trauma as an institutional logic in ways that enable them to negotiate contradictions of contemporary rehabilitative punishment. This institutional logic is patterned by two core assumptions: first, that trauma presents a <em>latent risk</em> for crime, necessitating the extensive surveillance of this resource-intensive court; and second, that veteran trauma is particularly distinct from that of others in the criminal justice system, thereby justifying the provision of sentencing incentives and treatment resources to someone who would otherwise be deemed a violent offender. Viewing this dynamic as a process of stratified medicalization, I show how conflicts in contemporary criminal justice politics shape medicalization processes.</div></div>","PeriodicalId":49122,"journal":{"name":"Social Science & Medicine","volume":"380 ","pages":"Article 118170"},"PeriodicalIF":4.9000,"publicationDate":"2025-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Medicalizing violence: The institutional politics of trauma in Veterans Treatment Courts\",\"authors\":\"Victoria Piehowski\",\"doi\":\"10.1016/j.socscimed.2025.118170\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><div>Criminal court actors engage in medicalization as they negotiate the balance of punitive and rehabilitative responses in their work, particularly in cases of low-level drug crime. Often, however, these legal actors regard violent crime as untreatable. This paper examines an exception to this assemblage of practice and policy: Veterans Treatment Courts (VTCs). VTCs combine judges, prosecutors, public defenders, and Veterans Affairs' (VA) professionals to provide treatment-based supervision in lieu of incarceration. In Minnesotan VTCs, court actors regard violent crime as treatable—for this population. Using interview data, I analyze how court actors medicalize violence as they legitimate veterans’ eligibility for the court and design their supervision. I find that court actors establish trauma as an institutional logic in ways that enable them to negotiate contradictions of contemporary rehabilitative punishment. This institutional logic is patterned by two core assumptions: first, that trauma presents a <em>latent risk</em> for crime, necessitating the extensive surveillance of this resource-intensive court; and second, that veteran trauma is particularly distinct from that of others in the criminal justice system, thereby justifying the provision of sentencing incentives and treatment resources to someone who would otherwise be deemed a violent offender. Viewing this dynamic as a process of stratified medicalization, I show how conflicts in contemporary criminal justice politics shape medicalization processes.</div></div>\",\"PeriodicalId\":49122,\"journal\":{\"name\":\"Social Science & Medicine\",\"volume\":\"380 \",\"pages\":\"Article 118170\"},\"PeriodicalIF\":4.9000,\"publicationDate\":\"2025-05-09\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Social Science & Medicine\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://www.sciencedirect.com/science/article/pii/S0277953625005003\",\"RegionNum\":2,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Social Science & Medicine","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S0277953625005003","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH","Score":null,"Total":0}
Medicalizing violence: The institutional politics of trauma in Veterans Treatment Courts
Criminal court actors engage in medicalization as they negotiate the balance of punitive and rehabilitative responses in their work, particularly in cases of low-level drug crime. Often, however, these legal actors regard violent crime as untreatable. This paper examines an exception to this assemblage of practice and policy: Veterans Treatment Courts (VTCs). VTCs combine judges, prosecutors, public defenders, and Veterans Affairs' (VA) professionals to provide treatment-based supervision in lieu of incarceration. In Minnesotan VTCs, court actors regard violent crime as treatable—for this population. Using interview data, I analyze how court actors medicalize violence as they legitimate veterans’ eligibility for the court and design their supervision. I find that court actors establish trauma as an institutional logic in ways that enable them to negotiate contradictions of contemporary rehabilitative punishment. This institutional logic is patterned by two core assumptions: first, that trauma presents a latent risk for crime, necessitating the extensive surveillance of this resource-intensive court; and second, that veteran trauma is particularly distinct from that of others in the criminal justice system, thereby justifying the provision of sentencing incentives and treatment resources to someone who would otherwise be deemed a violent offender. Viewing this dynamic as a process of stratified medicalization, I show how conflicts in contemporary criminal justice politics shape medicalization processes.
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.