A Doctor’s Testimony: Medical Neutrality and the Visibility of Palestinian Grievances in Jewish-Israeli Publics

Shalev, Guy

doi:10.1007/s11013-015-9470-7

Cited by 29 publications

(9 citation statements)

References 24 publications

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“…Trust is also crucial when understanding HCP’s intervention hesitancy in the context of ethnicity. While not a focus of study, previous research has identified the impact of ethnicity on the lived professional experiences of HCP in Israel, particularly among Israeli Arab HCP (Keshet et al 2015 , Shalev 2016 , Keshet and Popper-Giveon 2018 ). In Israel, low vaccination uptake is frequently found among minority populations (Rosen et al 2021 ).…”

Section: Discussionmentioning

confidence: 99%

Intervention hesitancy among healthcare personnel: conceptualizing beyond vaccine hesitancy

Gur‐Arie

Davidovitch

Rosenthal

2022

Monash Bioeth. Rev.

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We propose an emerging conceptualization of “intervention hesitancy” to address a broad spectrum of hesitancy to disease prevention interventions among healthcare personnel (HCP) beyond vaccine hesitancy. To demonstrate this concept and its analytical benefits, we used a qualitative case-study methodology, identifying a “spectrum” of disease prevention interventions based on (1) the intervention’s effectiveness, (2) how the intervention is regulated among HCP in the Israeli healthcare system, and (3) uptake among HCP in the Israeli healthcare system. Our cases ultimately contribute to a more nuanced conceptualization of hesitancy that HCP express towards disease prevention interventions. Our case interventions included the seasonal influenza vaccine, the Mantoux test, and the hepatitis B (HBV) vaccine. Influenza and HBV are vaccine-preventable diseases, though their respective vaccines vary significantly in effectiveness and uptake among HCP. The Mantoux test is a tuberculin skin test which provides a prevention benchmark for tuberculosis (TB), a non-vaccine preventable disease. We conducted semi-structured interviews with relevant stakeholders and analyzed them within Israeli and international policy context between 2016 and 2019, a period just prior to the COVID-19 pandemic. We propose the conceptualization of “intervention hesitancy”—beyond “vaccine hesitancy”—as “hesitancy towards a wide range of public health interventions, including but not limited to vaccines”. Results suggested that intervention hesitancy among HCP is rooted in weak trust in their employer, poor employment conditions, as well as mixed institutional guidelines and culture. Conceptualizing intervention hesitancy expands the ability of healthcare systems to understand the root of hesitancy and foster a supportive institutional culture and trust, cognizant of diverse disease prevention interventions beyond vaccination.

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Section: Discussionmentioning

confidence: 99%

Intervention hesitancy among healthcare personnel: conceptualizing beyond vaccine hesitancy

Gur‐Arie

Davidovitch

Rosenthal

2022

Monash Bioeth. Rev.

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“…Explanations of difference that use concepts of culture or behavior may work to manage ruptures in Arab–Jewish relations and to maintain the “political hygiene” [ 70 ] of the ED. However, we assert that in a city like Jerusalem where politics has an immense effect on patients’ lives, healthcare professionals should be cognizant of the socio-political structures that so many patients are unable to escape.…”

Section: Discussionmentioning

confidence: 99%

Neutrality, conflict, and structural determinants of health in a Jerusalem emergency department

Orr

Jackson

Alpert

et al. 2022

Int J Equity Health

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Background Medical neutrality is a normative arrangement that differentiates a zone of medical treatment disconnected from the field of politics. While medical neutrality aims to ensure impartial healthcare for all and to shield the healthcare personnel from political demands, it can also divert attention away from conflicts and their effects on health inequity. This article analyzes how healthcare professionals understand and negotiate the depoliticized space of the emergency department (ED) through their views on neutrality. It also examines how medical staff use depoliticized concepts of culture to account for differences in the health status of patients from disadvantaged groups. These questions are examined in the context of the Israeli-Palestinian conflict. Methods Twenty-four in-depth, semi-structured interviews were conducted with healthcare personnel in a Jerusalem hospital’s ED. All but one of the participants were Jewish. The interviews were analyzed using qualitative content analysis and Grounded Theory. Results The ED staff endorsed the perspective of medical neutrality as a nondiscriminatory approach to care. At the same time, some medical staff recognized the limits of medical neutrality in the context of the Israeli-Palestinian conflict and negotiated and challenged this concept. While participants identified unique health risks for Arab patients, they usually did not associate these risks with the effects of conflict and instead explained them in depoliticized terms of cultural and behavioral differences. Culture served as a non-controversial way of acknowledging and managing problems that have their roots in politics. Conclusions The normative demand for neutrality works to exclude discussion of the conflict from clinical spaces. The normative exclusion of politics is a vital but under-appreciated aspect of how political conflict operates as a structural determinant of health. Healthcare personnel, especially in the ED, should be trained in structural competency. This training may challenge the neglect of issues that need to be solved at the political level and enhance health equity, social justice, and solidarity.

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“…Similarly, during the decades‐long uprising in Indian‐controlled Kashmir, physicians worked for pro‐independence liberation organizations, treating victims of the violent uprising, and dealing with the fallout of a crumbling public health system (Varma 2020). Even when operating under the thin veneer of medical “neutrality” (Hamdy and Bayoumi 2016; Shalev 2016), physicians may find it difficult to evade political activation as they witness and respond to acts of state‐sanctioned violence.…”

Section: Physicians Agency and The Statementioning

confidence: 99%

Dirty Work in Medicine: Understanding U.S. Physicians’ Agency in Contested Medical Practices

Buchbinder¹

2022

Med Anthropol Q

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Physicians who participate in abortion and medically assisted death in the United States work at the margins of institutionalized medicine. What motivates them to engage in such “dirty work”? This article uses ethnographic materials from two recent projects to analyze physicians’ roles as gatekeepers to contested medical services. Abortion and medically assisted death share many similarities: They are both deeply stigmatized practices that are heavily restricted in many U.S. jurisdictions, and which many physicians are reluctant to participate in for moral, religious, or professional reasons. They both also confer medicine with the power to govern life and death decisions through the apparatus of state law. However, state laws operate quite differently on physicians in these two cases, with different outcomes. This comparative analysis demonstrates how dirty work in medicine enrolls the agency and subjectivity of physicians in distinctive ways that may be eclipsed by totalizing biopolitical frameworks. [abortion, medical aid in dying, physicians, agency, biopolitics, United States]

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A Doctor’s Testimony: Medical Neutrality and the Visibility of Palestinian Grievances in Jewish-Israeli Publics

Cited by 29 publications

References 24 publications

Intervention hesitancy among healthcare personnel: conceptualizing beyond vaccine hesitancy

Intervention hesitancy among healthcare personnel: conceptualizing beyond vaccine hesitancy

Neutrality, conflict, and structural determinants of health in a Jerusalem emergency department

Dirty Work in Medicine: Understanding U.S. Physicians’ Agency in Contested Medical Practices

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