When Care is a "Systematic Route of Torture": Conceptualizing the Violence of Medical Negligence in Resource-Poor Settings.
Descriptions of patient mistreatment fill ethnographic accounts of healthcare in resource-poor settings. Often, anthropologists point to structural factors and the ways that the global political economy produces substandard care. This approach makes it difficult to hold parties accountable when there is blatant disregard for human life on the part of individuals providing care. In this article, I draw on the illness narrative of Magaly Chacón, the first HIV positive individual in Bolivia to file charges of medical negligence after failing to receive care to prevent mother-to-child transmission. Magaly's narrative demonstrates how structural conditions are often used to explain away poor patient outcomes, shifting attention away from and normalizing the symbolic violence that also perpetuates substandard care of marginalized patients. I use Magaly's accusations to interrogate how defining acts of mistreatment as medical negligence can be a productive exercise, even when it is difficult to disentangle structural constraints from blatant acts of negligence. Defining who is negligent in resource-poor settings is not easy, as Magaly's case demonstrates. However, Magaly's case also demonstrates that accusations of negligence themselves can demand accountability and force changes within the local structures that contribute to the systematic mistreatment of marginalized patients.
Department of Sociology and Anthropology, The University of Texas at El Paso, Old Main Building, Room 308, El Paso, TX, 79968, USA. checkert@utep.edu.
Carina
http://orcid.org/0000-0003-3344-6968
C
Heckert
D000328:Adult; D001291:Attitude of Health Personnel; D001838:Bolivia; D005260:Female; D015658:HIV Infections / Q000635:transmission*; D006296:Health Services / Q000592:standards*; D006801:Humans; D018445:Infectious Disease Transmission, Vertical; D008318:Malpractice / Q000331:legislation & jurisprudence; D063545:Personal Narratives as Topic; D011203:Poverty; D014754:Violence
HIV/AIDS; Illness narratives; Medical negligence; Violence continuum