Navigating Contradictory Mandates in Primary Healthcare. What Can We Learn from Diabetes Prevention in a Rural Mexican Hospital? (Susana Kolb Cadwell)
Social studies of medicine have highlighted differences between clinical medicine and public health. Less attention has been paid to how these fields intersect within primary healthcare institutions—particularly in rural settings where providers are expected to deliver prevention, treatment, and culturally respectful, community-engaged care simultaneously. This talk examines how, in practice, their overlapping mandates generate contradictions that shape how care is delivered, and how it falls to healthcare professionals to make sense of them through conceptual reframing, practical decisions, and everyday moral reasoning.
Drawing on long-term ethnographic research on diabetes prevention and management practices in a rural hospital in Mexico, I map out a series of tensions that emerge as preventative public health practices—shaped by longer histories of rural health intervention—collide with clinical and ethical commitments under the hospital’s intercultural, human rights framework. These include tensions between transforming and respecting cultural practices; between coercion, consent, and confidentiality; and between hospital control and patient self-management. I follow healthcare professionals as they navigate these layered tensions practically, conceptually, and morally, while also grappling with contradictory enactments of the disease itself. Finally, I reflect on how patients engage with these interventions based on local understandings of diabetes, responsibility, and self-care.
Commentator: Prof. Mark Harrison (History,University of Oxford)
Date:
17 June 2025, 17:15
Venue:
St Cross College, St Giles OX1 3LZ
Venue Details:
Seminar Room
Speakers:
Susana Kolb Cadwell (University of Oxford),
Professor Mark Harrison (Professor of the History of Medicine and Director of the Wellcome Unit for the History of Medicine)
Organising department:
St Cross College
Organiser:
Dr Alberto Giubilini
Organiser contact email address:
alberto.giubilini@uehiro.ox.ac.uk
Host:
Dr Alberto Giubilini (The Oxford Uehiro Centre for Practical Ethics)
Part of:
Public Health Humanities at St Cross
Booking required?:
Required
Booking url:
https://forms.office.com/e/NiiKjgDnTx
Cost:
free
Audience:
Public
Editor:
Alberto Giubilini
