Health Communication for Displaced Populations| Physician Advocacy in a “Culture of Disbelief”: A Critical-Interpretive Study of Asylum Medicine

Abstract

Refugee studies scholarship has established that intense suspicion undergirds the process of refugee status determination, calling it, “a culture of disbelief.” Meanwhile, literature in medical anthropology has found that medical practitioners play a key role in the control and management of asylum seekers when they act as forensic evaluators. This study focuses on a group of physician advocates involved in a medical advocacy movement called Asylum Medicine (AM): an expert witness project that sits uncomfortably at the intersection of forensics and human rights. This article contributes to scholarship by revealing that the “culture of disbelief” extends onto medical authorities. Taking a critical-interpretive approach to health communication, I discuss how AM practitioners deploy a range of tactics including following legal scripts for objective behavior; anticipating opposition for their advocacy outside of expert-witness situations; and using the language of trauma and post-traumatic stress disorder as shorthand to expeditiously respond to legal scrutiny. In a culture of disbelief that places medical objectivity in opposition to political advocacy, such tactics help AM practitioners execute an ethical stance where medical objectivity is political advocacy.