Medication, healing and resistance in East Malaysia

This paper considers some findings from an ethnographic study of psychiatric patients in hospital care in East Malaysia. The subject of treatment is considered with regard to professional attitudes towards patient \u27compliance\u27 and the demonstration of resistance by users within a multicultural context in which traditional healing continues to be a popular alternative to biomedicine. \u27Resistance\u27 here is used in its literal meaning, rather than as an abstract, theoretical construct. The narratives of Malaysian patients in relation to resisting treatment in this study form some direct comparisons with, for example, the quotes from service users on the topic of medication, \u27control and coercion\u27 in the UK. (Rogers, A., et al. (1993). Experiencing psychiatry: Users\u27 views of services. London: MacMillan Press/MIND Publications.) Resistance to treatment then is interpreted by staff as the outcome of sickness behaviour, which frequently results in coercive strategies. The undisputed power of the medical profession in Malaysia has contributed to the lack of an evolved \u27service-user\u27 perspective in which few patient rights are recognised, especially non-treatment. These responses remain embedded in a paternalistic and custodial attitude that does not acknowledge issues of spirituality or alternative healing practices that are important to hospitalised patients. Modernisation of services have not led to a parallel development with regard to patient participation or in terms of appropriate cultural responses. It is concluded that until this takes place professionals will continue to ignore the personal meaning users attach to treatment resistance. © 2005 Taylor & Francis Ltd

Problematizing the context and construction of vulnerability and risk in relation to British Muslim ME groups.

British Muslim minority ethnic (ME) groups are perceived as holding values and beliefs distinctively different from the rest of multicultural UK. Vulnerability in these groups relates to existing material and social conditions and is contrasted to the perceived risks to British society and the State posed by religio-ethnic separatism. Such dichotomies create new textures and layers to familiar but complex concepts of vulnerability in social work. The problematization of British ME Muslims in public discourse and related social policy are critically discussed as contributing to a fluid but potentially inflammatory terrain where vulnerability and oppression are highly ambiguous and contested

Covert research and adult protection and safeguarding: An ethical dilemma?

Purpose: This paper aims to consider the contentious issue of covert research in studying the social contexts of vulnerable groups. It explores its potential utility in areas where overt strategies may be problematic or denied; and examines and problematises the issue of participant consent. Design/methodology/approach: Using a literature-based review and selected previous studies, the paper explores the uses and abuses of covert research in relation to ethics review proceedings governing social research, with an especial focus on vulnerability. Findings: Findings indicate that although the use of covert research is subject to substantial critique by apparently transgressing the often unquestioned moral legitimacy of informed consent, this carries ethical and practical utility for research related to safeguarding concerns. Arguably covert research enables research access to data likely to reveal abusive and oppressive practices. Research limitations/implications: Covert research assists in illuminating the hidden voices and lives of vulnerable people that may otherwise remain inaccessible. Such research needs to be subject to rigorous ethical standards to ensure that it is both justified and robust. Practical implications: Emphasising the need to consider all angles, questions and positions when addressing the social problem of adult protection and safeguarding. Originality/value: Increasingly social research is treated as being as potentially harmful as medical research. Ethics review tends towards conservative conformity, legitimising methodologies that may serve less social utility than other forms of investigation that privilege the safeguarding of vulnerable people. © Emerald Group Publishing Limited

Strategies of social and sexual control of Malaysian women in psychiatric institutional care

An ethnographic study of female psychiatric patients was undertaken in East Malaysia. Findings indicate that these service users were subject to a number of sexist and oppressive practices that militate against their freedom of movement on the wards as well as their social interaction in the wider context of the hospital. Stereotypic notions of female sexuality and morality act as forms of moral containment and are interpreted in the hospital context as requiring heavy custodial care by the hospital authorities

Sentosa : a feminist ethnography of a psychiatric hospital in Sarawak, East Malaysia

This doctoral thesis is a feminist ethnographic study of psychiatric patients in the State of Sarawak, East Malaysia. The study took place at a psychiatric hospital located in the capital city of Kuching, commencing in 1997. Although Hospital Sentosa is a small institution it is the only psychiatric institution in the State and therefore constitutes an important mental health resource in this region. This ethnographic study primarily concentrates on the lives of women patients in keeping with my chosen methodological approach and seeks to explore the 'culture' of the hospital setting through facets such as daily interactions, activities and relationships. The feminist approach has not however precluded the accounts of male patients whose experiences are utilised in a comparative exercise with those of women counterparts. In addition the views of staff of both sexes and all ranks are considered in relation to their attitudes towards the care of psychiatric patients and the broader area of work-related concerns including collegial support and occupational hazards. In keeping with an ethnographic approach themes developed in the thesis are drawn through an analysis of findings as noted by observation methods as well as through interviews with participants. Furthermore a self-reflexive approach has been an important aspect of analysis commensurate with feminist methodology, in which my role as a researcher is considered in relation to issues of culture, gender and class as well as some of the difficulties of research in a post-colonial and unfamiliar cultural context. Although some avenues of inquiry in the study have not easily lent themselves to an analysis of gender, this thesis primarily argues that the hospital reproduces oppressive policies and practices that impact with greater severity on women patients. Oppressive practices in relation to gender and ethnicity at the hospital are viewed against a backdrop of contemporary psychiatric care as enacted on wards. It is argued that these practices can be viewed in turn as being, for the most part, historically premised upon imported British models of care replicated through colonialism in Malaya and by extension at a later period in the multicultural State of Sarawak

Within, without: dialogical perspectives on feminism and Islam.

This paper offers an ontological and literary review of Muslim women’s religious practices across the Muslim ummah, in considering the development of an epistemology of faith and feminism within the Islamic schema. Global examples of faith-based practice are reviewed, where issues of dominant and minority cultures and values refer to how Muslim faith practices are enacted within the local context. The authors use a dyadic, auto-ethnographic methodology to explore their own personal, political and spiritual positioning as feminists from a Muslim, immigrant and secular British background. The significance of women’s spiritual and feminist dimensions in the context of faith, nationhood and embodiment of ideological positions are analysed. Additionally, religious, cultural and the geo-political implications of feminism and Islam are considered regarding identity, culture and tradition, and religious resurgence, together with forms of feminist resistance to religious doctrine. Finally, the search by women for spiritual authority and authenticity is discussed. Keywords: Islam, Muslim, feminist, faith, auto-ethnographi