从体现到证据:医疗植入物监管不力与金属髋关节失败的体现性体验中受阻叙事的有害交集。

IF 1.9 4区 医学 Q3 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Health Pub Date : 2024-07-01 Epub Date: 2023-06-05 DOI:10.1177/13634593231179026
Pauline McCormack
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引用次数: 0

摘要

本研究介绍了一项关于金属髋关节植入物失败患者的研究结果,并借鉴了科技需求(STS)的概念,以及关于临床环境中患者知识的价值和体现故事的合法性的研究。髋关节置换手术被大众理解为积极的、改变生活的手术,被誉为 "世纪手术",直到数十万髋关节植入物(统称为金属髋关节)发生一系列大面积故障,才引起人们对医疗植入物监管不力的关注。本文认为,监管不力与外科医生和英国监管机构对患者疼痛的描述相互交织,从而否认了患者对植入物故障的亲身经历,也否认了他们恢复健康的愿望。患者对髋关节植入物问题的叙述是科学证据的源泉,而科学证据可以表明植入物普遍失效。通过阻碍这些叙述,监管系统破坏了其有效运作所需的证据。
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From embodiment to evidence: The harmful intersection of poor regulation of medical implants and obstructed narratives in embodied experiences of failed metal-on-metal hips.

This research presents the results of a study about people with failed metal-on-metal hip implants, and draws on the STS concept of the technological imperative alongside research on the value of patient knowledge in clinical settings and the legitimacy of embodied stories. Popularly understood as positive and life changing, hip replacement surgery was hailed as 'the operation of the century', until a series of widespread failures of hundreds of thousands of hip implants, known collectively as metal-on-metal (MoM) hips, drew attention to the poor regulation of medical implants. This paper argues that poor regulation intersects with narratives of patients' pain, which are obstructed by surgeons and the UK regulatory body, with the effect of denying both patients' embodied experiences of implant failure, and their restitution to good health. Patient narratives about problems with their hip implant are the wellspring from which scientific evidence emerges which can indicate widespread implant failure. By obstructing these narratives the regulatory system undermines the very evidence it needs to operate effectively.

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来源期刊
Health
Health Multiple-
CiteScore
4.90
自引率
0.00%
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0
期刊介绍: Health: is published four times per year and attempts in each number to offer a mix of articles that inform or that provoke debate. The readership of the journal is wide and drawn from different disciplines and from workers both inside and outside the health care professions. Widely abstracted, Health: ensures authors an extensive and informed readership for their work. It also seeks to offer authors as short a delay as possible between submission and publication. Most articles are reviewed within 4-6 weeks of submission and those accepted are published within a year of that decision.
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