hltb42 final exam

Institutional ethnography (IE)

research method that starts from people’s everyday experiences and traces how institutions (like governments or hospitals) shape those experiences. A way of doing research that looks at how institutions shape people’s everyday lives, starting from the real experiences of ordinary people.

Disturbing disjuncture

A concept by dorothy smith, the gap between what institutions say is happening vs what is actually happening or being experienced that hurt people 

Disturbing disjuncture example in the article hiv bisallion

Government and medical professionals claim that HIV is done with consent but they are not told they are being tested for hiv and cannot refuse the test

Ruling Relations

• The systems of power that coordinate people’s actions across institutions

• Ruling relations are the rules, policies, paperwork, and professional routines that control people’s lives from a distance.

Ruling relations example in the article hiv ime bisallion

• In the article this is canadas mandatory HIV testing policy that cannot be refused

Non-therapeutic encounter

when someone goes through an interaction with a medical or health professional, but the goal isn’t to help or heal them. Instead, the encounter might be for something like screening, testing, or administrative purposes.

Immigration medical exam HIV testing, Bisallion article summary

• examines what actually happens when immigrants and refugees applying to live in Canada are required to take an HIV test as part of their immigration medical exam. Using institutional ethnography, the author studies the everyday experiences of people living with HIV, and although Canada claims the process is fair, medical, and supportive, in reality it often causes fear, and confusion.

• People are frequently not properly informed that they are being tested for HIV, and do not understand how the results will affect their future in Canada.

Disease

• the biomedical illness a person faces

Illness

• the subjective, experience of the disease

Disease vs illness

• The HIV test focuses on detecting disease—it’s about finding out if someone has the HIV virus in their body.

• But the immigrant’s experience of HIV (their illness) isn’t considered. The emotional, social, or psychological impact of living with HIV (like fear of deportation, stigma, or stress) is ignored.

Week 8 - Romania (Anton)

• Under Nicole Ceauşescu’s community regime Romania banned abortion (decree of 770 of 1966)

• State praised motherhood as a patriotic duty and framed abortion as dangerous, immoral and harmful to society 

• Since Romania was a totalitarian state no one could protest because dissent was dangerous, women secretly used illegal abortions and unsafe

Pronatalism

• government policy that encourages/ forces women to have more children 

• In context of the article in Ceausescu’s Romania having more children was seen as a duty to the nation, and was praised as patriotic 

• Women were pressured, or punished based on how much children they had 

Example of pronatalism in the article (romania, Anton)

The 1966 decree 770 that banned most abortions and did not allow contraceptives, forcing women to carry pregnancies to term

Biopolitics

• When the government controls people lives, bodies and reproduction to manage a population 

Example of biopolitics in the article (Romania, Anton)

• the Romanian state controlled women’s bodies by banning abortion, monitoring women’s pregnancies and using the law, doctors and police to regulate fertility 

Decree 770

• 1966 Romanian law that banned most abortions and did not allow contraceptives, forcing women to carry pregnancies to term  

Week 9 - PTSD/ Moral Injury (Spring)

• Argues that military trauma and suicide are being misunderstood and mishandled because institutions like the military are framing the soldiers’ suffering as a mental illness and PTSD

• Using the case of master corporal Denis Demers, author shows that soldiers who end their lives are quickly labelled with having PTSD even when diagnosis is not confirmed

• Hides real reasons many soldiers struggle like: relationship breakdowns, and financial stress

• article argues that many suicides are not caused by PTSD itself, but by social and structural problems

Institutional capture

• When people inside a system start/ are forced to use the systems logic and language even if it harms them 

Example of institutional capture in the article (ptsd spring)

 In the article veterans must prove they are “still disabled by PTSD” to keep their benefits, and this makes it seem like they are permanently broken 

Moral injury 

• when someone does something, sees something, or is forced into something that goes against their core moral values, and the pain that follows is guilt, shame, or a sense of betrayal

Moral injury example from the article (ptsd/ moral injury, spring)

describes how some soldiers are morally injured when they kill or help harm civilians while following orders. Even if they were not breaking rules, they later feel:

• deep guilt,

• shame,

• and a belief that they are “bad” or unforgivable.

Boss text (the diagnostic and statistical manual of mental disorders DSM)

• a document that has authority over how people think, talk, and act across many institutions.

Boss text in the context of the article (ptsd, spring)

• The dsm recognizes ptsd as a boss text which means veterans’ suffering can be diagnosed, treated, insured, and legitimized but moral is not a DSM diagnosis, so it does not officially “count” as a mental disorder, even though the article shows it causes deep suffering.

Institutional capture