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Difference between revisions of "Khamstvo (USSR, Russia)"
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''Khamstvo'' manifested as emotional abuse in healthcare could be considered an emotional regime or an institutionalised behaviour. The vulnerability and dependence of patients together with the isolation of medical institutions help reproduce the superior status of staff. The institutionalization of'' khamstvo'' is indicative of the prevalence of the collective over the individual in Russia. This regime enables health care providers to neglect women’s emotional needs for care and subordinate these needs to the clinical, organizational and bureaucratic demands. ''Khamstvo'' in maternity wards used to be perceived as legitimate by both the healthcare providers and, to some extent, by the childbearing women. | ''Khamstvo'' manifested as emotional abuse in healthcare could be considered an emotional regime or an institutionalised behaviour. The vulnerability and dependence of patients together with the isolation of medical institutions help reproduce the superior status of staff. The institutionalization of'' khamstvo'' is indicative of the prevalence of the collective over the individual in Russia. This regime enables health care providers to neglect women’s emotional needs for care and subordinate these needs to the clinical, organizational and bureaucratic demands. ''Khamstvo'' in maternity wards used to be perceived as legitimate by both the healthcare providers and, to some extent, by the childbearing women. | ||
''Khamstvo'' shapes the attitudes of all participants, including the clinicians themselves, who often claim feeling helpless within the paternalistic hierarchies of the state (Rivkin-Fish 2005). Doctors and midwives often feel in a subordinate and vulnerable position (Litvina, Temkina and Novkunskaya 2019). In this situation, they see familiarity and aggression as effective instruments to obey the women. Protagonists of such approach appeal to the necessity of controlling, manipulating and, in some cases, exercising power. Unlike in other medical settings, such as ''[[psikhushka]]'' ( | ''Khamstvo'' shapes the attitudes of all participants, including the clinicians themselves, who often claim feeling helpless within the paternalistic hierarchies of the state (Rivkin-Fish 2005). Doctors and midwives often feel in a subordinate and vulnerable position (Litvina, Temkina and Novkunskaya 2019). In this situation, they see familiarity and aggression as effective instruments to obey the women. Protagonists of such approach appeal to the necessity of controlling, manipulating and, in some cases, exercising power. Unlike in other medical settings, such as ''[[psikhushka]]'' (in [[Psikhushka (FSU)|USSR]] and [[Psikhushka (Russia)|Russia]]), they do it verbally and emotionally, rather than physically. Women are labelled as ‘ignorant’ and ‘infantile’ and forced to cooperate and behave properly during the childbirth, purportedly for their own and their baby’s sake. Paternalistic aggression is used to generate shame to affect patient behaviour and to subordinate an individual to the ʻcorrectʼ way of behavior. Clinicians justify their way of communication as a preventive measure against ‘wrong or shameful’ behaviour from childbearing women and do not label it as ''khamstvo''. At the same time, they perceive the women’s tactics against ''khamstvo'', such as making complains or making videos of personnel’s communication with them as aggressive and respond to them with ''khamstvo''. | ||
Late Soviet era state medical services were characterized by overregulation, rigidity of medical hierarchies and shortages of resources. ''Khamstvo'' in maternity wards generated a power style and a code of rudeness that sought to discipline women and subject them to both the impersonal rules and the clinicians’ discretion in interpreting them. Because women were completely dependent on the medical staff, they had to accept these rules and codes as inevitable, beyond women’s control, and impossible to challenge (Temkina 2016). To feel bound by fate is considered as a constitutive element of the emotional regime of ''khamstvo'' and can be considered its intrinsic vehicle, reproduced in institutions at the organizational level (Temkina, Novkunskaya and Litvina forthcoming). Patients, who had no choice but to use state medical facilities, employed bottom-up strategies of personalization to counter ''khamstvo'', a top-down strategy of the staff. Some structural prerequisites and communication characteristics of ''khamstvo'' were transferred onto Russian contemporary medical institutions and are still typical for certain medical specialists and settings (Temkina, Novkunskaya, Litvina forthcoming). | Late Soviet era state medical services were characterized by overregulation, rigidity of medical hierarchies and shortages of resources. ''Khamstvo'' in maternity wards generated a power style and a code of rudeness that sought to discipline women and subject them to both the impersonal rules and the clinicians’ discretion in interpreting them. Because women were completely dependent on the medical staff, they had to accept these rules and codes as inevitable, beyond women’s control, and impossible to challenge (Temkina 2016). To feel bound by fate is considered as a constitutive element of the emotional regime of ''khamstvo'' and can be considered its intrinsic vehicle, reproduced in institutions at the organizational level (Temkina, Novkunskaya and Litvina forthcoming). Patients, who had no choice but to use state medical facilities, employed bottom-up strategies of personalization to counter ''khamstvo'', a top-down strategy of the staff. Some structural prerequisites and communication characteristics of ''khamstvo'' were transferred onto Russian contemporary medical institutions and are still typical for certain medical specialists and settings (Temkina, Novkunskaya, Litvina forthcoming). | ||