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        “의료서비스는 인권이다!”-‘자유여름’ 시기 미국 인권의료위원회 활동을 중심으로-

        공혜정 한국서양사학회 2019 西洋史論 Vol.0 No.143

        This study focuses on the Medical Committee for Human Rights(MCHR) to highlight the participation of a variety of medical practitioners such as doctors, medical students, and nurses during the Freedom Summer in Mississippi. The existing scholarship hardly discussed the MCHR in the history of the civil rights movement. Based on oral interviews of the MCHR members, official/unofficial MCHR records, and newspapers, this study examines the political and social consciousness of medical practitioners with various backgrounds. The purpose of this study is to shed light on various spectra of American social movements. In the Jim Crow era when blacks and whites were politically, socially, and culturally segregated, few blacks enjoyed adequate medical care and facilities. Black health care practitioners were not allowed to perform proper medical activities because of discriminatory treatment and limited access to hospital facilities. Before the establishment of the Medical Committee for Civil Rights(MCCR), the first to respond to the discriminatory segregation were blacks who organized the National Medical Association(NMA). Various organizations including the NMA and the Physicians Forum were merged with the MCCR. The MCCR was transformed into the MCHR in 1964 when it participated in the Freedom Summer. MCHR members from a variety of social, ideological, racial, and ethnic backgrounds participated in the Freedom Summer. These people perceived that health care is a human right. During the Freedom Summer, the mission of the MCHR initially was to provide first-aid and psychological and physical treatment for civil right activists from the North. After witnessing poor social and medical conditions in Mississippi, however, they also focused on community-wide welfare reform by implementing a community health center. Even though the MCHR was disbanded in 1980, their pursuit of achieving human rights through medical care has since impacted other reformatist medical organizations. 본 연구는 미국의 인권의료위원회(Medical Committee for Human Rights, MCHR)에 참여한 다양한 배경을 가진 의료인(의사, 간호사 등)들이 1964년 미국 남부 미시시피 주의 ‘미시시피 여름프로젝트(Mississippi Summer Project)’, 즉 ‘자유여름(Freedom Summer)’에 참여한 이야기이다. 본 연구는 MCHR 참여자들의 구술기록, 신문기록, 민권운동 관련 기록들을 기반으로 기존의 민권운동 연구에서 주목받지 못했던 의료인들의 정치 사회적 공동체 의식을 고찰하고, 당시 미국 사회운동의 다양한 스펙트럼을 제시하고자 한다. 흑-백 인종 간 차별적 분리가 만연했던 1960년대 남부에서 흑인들은 의료인, 의료시설, 의약품의 부족을 경험하였다. 흑인 의료인들 역시 차별적인 대우와 제한적인 병원 시설 이용 혜택으로 인해 제대로 된 의료 활동을 할 수 없었다. 민권의료위원회(Medical Committee for Civil Rights, MCCR)가 성립되기 이전부터 흑인 의료인들은 불평등한 인종 간 차별적 분리에 대응하여 전국의사협회(National Medical Association, NMA)를 조직하였다. NMA를 비롯하여 의사포럼(Physicians Forum) 등 다양한 좌파 성향의 의료인 단체들이 MCCR로 수렴되었다. MCCR은 1964년 미시시피 주 ‘자유여름’에 참여하면서 의료서비스를 민권이 아닌 인권의 문제로 보고, MCHR로 그 관심과 활동 영역을 확대하였다. MCHR에는 다양한 사회적, 인종적, 민족적 배경을 가진 의료인들이 참여하였다. MCHR은 ‘자유여름’의 참여 목적으로 민권운동 시위 현장에서의 구급활동과 민원운동가들의 정신적⋅육체적 건강관리를 내세웠다. 그러나 남부의 열악한 사회적, 의료적 상황을 목격한 후 지역 사회 전체의 복지 개혁을 꾀하는 지역보건소 활동에도 힘을 쏟게 되었다. MCHR은 1980년에 해체되었지만, 이들이 추구한 의료를 통한 인권 회복 추구는 이후 다른 진보적 의료단체에도 영향을 미쳤다.

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        ‘나환자’라는 이름하에 - 20세기 중반 루이지애나주 카빌시의 국립나병원 환자들의 삶과 권리운동을 중심으로

        공혜정 경희대학교 인문학연구원 2023 인문학연구 Vol.- No.54

        This study explored the experiences of patients and their rights movements at the United States National Leprosarium in Carville, Louisiana during the mid-twentieth century. The U.S. Public Health Service founded the National Leprosarium (also known as U.S. Marine Hospital No. 66) in the 1920s. Patients inhabiting the National Leprosarium recognized that they would live apart from the outside world politically, socially, and culturally. Leprosy-related social, cultural, and religious stigmas strengthened a system of humiliating norms and regulations that deprived all hospital inmates of their basic rights and citizenship. Although patients diagnosed with leprosy, also known as Hansen’s Disease patients, were denied a public life, those affected actively tried to regain their rights in their public and private lives. Moreover, they had a shared identity as Hansen’s Disease patients, which forged a sense of community and solidarity that sometimes transcended race, ethnicity, and even the dynamics of a typical family and gender relationship. Focusing on The Star, Hansen’s Disease patients worked to eradicate the stigma associated with leprosy, and reestablish their fundamental civil rights including the right to privacy and to vote. 연구는 20세기 초중반의 루이지애나주 카빌시에 있는 미국 국립나병원 환자들의 삶과 권리운동에 대한 연구이다. 1920년대 미국 공중보건국(U.S. Public Health Service)이 설립한 국립나병원(National Leprosarium 혹은 U.S. Marine Hospital No. 66)에서 한센인들은 고립되고 외부 세계와 격리된 삶을 살아야만 했다. 한센병에 대한 사회적, 종교적, 문화적, 의학적 낙인은 모든 한센인들의 기본 권리와 시민권(citizenship)을 박탈하였다. 한센인들은 썰폰제 같은 의학적 발전에 힘을 입어, 낙인과 편견에서 벗어나고 기본 권리와 시민권을 회복하기 위한 노력을 하였다. 한센병이라는 동일한 질병을 앓는다는 연대의식과 공동체 의식은 외부 정상인들과는 다른 남녀관계, 가족관계, 인종 및 민족 관계를 형성하는데 기여하였다. 이들은 서로 다른 사회 문화적, 인종적, 민족적 배경에도 불구하고 한센병 이라는 이름 아래 공통된 경험을 공유할 수밖에 없었다. 이러한 점은 병원 밖의 사회와는 다른 공동체 의식으로 표현되었다. 또한 이들 한센인들은 한센병이 가지고 있는 대중적인 편견과 낙인을 타파하고, 한센인으로 누릴 자율권과 권리를 새롭게 규정하였다. 즉 루이지애나 주 정부로부터 박탈당했던 투표권을 회복했으며, “네 가지 자유,”와 “15개 개선안” 제안을 통해서 한센인이 누려야할 권리 및 복지에 대한 개념을 제시하였다.

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        의료시스템과학 등장의 역사적 배경: 1910년대부터 2010년대까지의 미국 의료 체계 개혁과 의학교육을 중심으로

        공혜정 대한의사학회 2023 醫史學 Vol.32 No.2

        This study traces the historical process of the emergence of Health Systems Science (HSS) over one hundred years from the 1910s to the 2010s. HSS is a discipline introduced in American medical education as a “third pillar” in addition to basic medical science and clinical medical science. HSS comprises seven core functional domains and four foundational domains, all surrounded by ‘system thinking.’ According to statistics from 2019 to 2020, 129 universities, or 83.2% of all allopathic and osteopathic medical schools taught HSS before medical clerkship. Additionally, 108 universities, or 69.7% of all medical schools taught HSS during medical clerkship. Although the Progressives in the 1910s sparked discussions about reforming the U.S. national health care system, the National Health Insurance (NHI) debate did not make significant progress from the 1920s through World War II. Efforts to reform the healthcare system gained momentum again in the 1960s. In 1965, a social health insurance program for the elderly called “Medicare” was enacted by revamping the existing social security program. Around the same time, “Medicaid” was also implemented as government-funded health insurance program, distinguishing it from Medicare—a mix of social insurance and government assistance. During the Clinton presidency in the 1990s, political efforts to achieve the NHI by enacting the Health Security Act eventually failed. Almost twenty years later, President Barrack Obama passed the Patient Protection and Affordable Care Act, or ObamaCare, in March 2010. The primary objectives of ObamaCare were to increase the number of insured Americans and reduce health care costs. Post-ObamaCare reforms to the healthcare payment system and changes to the healthcare delivery system have prompted a transformation of the healthcare landscape. The healthcare industry has been pursuing the “triple aim”: improving patient experience and population health while reducing costs. To achieve these goals, exposure to a systems-based healthcare environment was necessary. From the 1910s to the 1960s, the model of the ideal physician was the “sovereign physician,” who could perform all tasks unilaterally. During this time, doctors were autonomous, independent, and authoritative, and in control of all medical activities. This model was very useful until the mid-twentieth century, when there were many acute illnesses, mainly infectious diseases. Abraham Flexner’s 1910 report eventually accelerated the formation of a medical education system based on the two pillars of “basic science—clinical science.” During the periods of the 1920s and 1940s, medical education underwent a process of professionalization, standardization, and systematization. World War II did not result in significant changes in medical education. The United States, however, was transforming into a very different society from the prewar period for physicians and Americans. The “New Deal” and World War II led to an expanded role of the federal and state governments in the post-war years. The demand for healthcare was also growing, and the right to healthcare was seen as a fundamental right of all citizens. In the 1960s and 1970s, the current U.S. medical education system was established. Four years of medical school, an internship, and a residency before taking the board examination became the institutional requirements. In the 1980s and 1990s, ‘managed care,’ represented by Healthcare Maintenance Organizations (HMOs) and Preferred Provider Organizations (PPOs), placed strong controls on both doctors and hospitals (academic healthcare centers). Under the managed care system, academic healthcare centers financially struggled. Moreover, the learning environment on the wards was eroded by shorter patient stays and increased outpatient visits. Since the late 1990s, many medical education organizations, including the Council on Graduate Medical Educat...

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        Mapping Charity Hospital in Antebellum New Orleans, Louisiana

        공혜정 한국미국사학회 2017 미국사연구 Vol.45 No.-

        This essay examines Charity Hospital in New Orleans, Louisiana, between the 1830s and the decades immediately before the Civil War from a spatial perspective. It begins with Solomon Northup’s patient experience at Charity Hospital in his memoir, Twelve Years a Slave (1853). Located in the “Queen City of the South” (New Orleans), Charity Hospital—as the second oldest continuously operating public hospital, bearing the same name in the United States since 1736 until 2005, and as a teaching hospital for the second oldest medical college of the Deep South, Medical College of Louisiana (presently, Tulane School of Medicine, 1834~present), and the New Orleans School of Medicine (1856~1870)—has attracted few historians of the history of medicine, in spite of its historical importance. Drawing upon the concept of spatiality in rich existing spatial studies, this study chronologically traces the changing sites of Charity Hospital. It then explores the roles of Charity Hospital as a center of urban medical care and teaching hospital over a hundred year following 1834. It also reveals the way in which Charity Hospital became part of the city’s daily and ritual life and death through the close connection with Potter’s Fields and Charity Hospital cemeteries.

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        The Opening of the Roper Hospital in Antebellum Charleston, South Carolina

        공혜정 한국세계문화사학회 2018 세계 역사와 문화 연구 Vol.0 No.49

        The Opening of the Roper Hospital in Antebellum Charleston, South Carolina Hyejung Grace Kong This study highlights the opening of the Roper Hospital in Antebellum Charleston, South Carolina, for what it reveals about the nature of the nineteenth hospital system, especially in relation to the medical profession and education. By primarily relying upon the Roper Hospital Board of Trustee Minutes and Charleston Medical Journal and Review, this study examines how the Roper Hospital was initiated, planned, and built in Charleston society. It also reveals that how health care was predominantly built upon the orthodox medical profession, and institutionalized within the hospital walls. Erected by the bequest of Charleston philanthropist Colonel Thomas Roper, the Roper Hospital opened its door to the local patients in 1856. The establishment of the Roper Hospital as a form of institutionalized medical care and an integral part of medical education well illuminates the transformation of medicine in the mid-nineteenth century. The Roper Hospital was initiated and operated exclusively by the medical profession with an aid of some public funding, but it functioned as a public institution. Along with the hospital’s arrangement with the medical school for the clinical lectures for the improvement of medical education, it was also evident that the erection of the Roper Hospital galvanized many Charleston practitioners. In addition, the Roper Hospital was considered the best and largest place for “desirable” clinical instruction in Charleston. The hospital wards, full of the sick poor, served as a medical laboratory as well as a place for curing the sick. Moreover, the Roper Hospital functioned as a meeting venue of the orthodox medical profession in South Carolina. The hospital reserved a large room on the second floor as a meeting place for not only the Trustees but also several medical meetings such as South Carolina Medical Association (SCMA) meetings. In sum, from the beginning of the hospital planning, the Roper Hospital was an embodiment of the aspiration of the Charleston medical circle.

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