Doctoral Dissertation Research: Cultural Negotiations of Medical Care Among the Lancaster Amish

Doctoral student Martha King (University of North Carolina at Chapel Hill), under the guidance of Dr. Dorothy Holland, will investigate the manner and types of cooperation that have been developed between a non-profit, genetic treatment/research facility, the Clinic for Special Children (CSC), and the Amish settlement it serves around Lancaster, PA. The research will address the broad issues of how the negotiation and delivery of biomedical care services to groups with different cultural beliefs about the body and medicine is accomplished.

This research is motivated by two broad interests: how do the Lancaster Amish populations continue to shape their use of technology in light of the larger culture surrounding the settlement and how does CSC manage to create a biomedical environment where this kind of cultural negotiation can occur? This project seeks to understand how interactions between clinic practitioners and Amish patient families result in accommodations and/or modifications of both Amish and biomedical cultures. These two groups often arrive at the examination table with fundamentally different understandings of illness, medicine, and technology. For example, common threads of Amish cultural identity involve relinquishing of self-will for the benefit of the community as Amish actively eschew individualism and view the body as a spiritual home rooted in community. In contrast, the health system they are navigating is premised on a biomedical approach to the individual body as autonomous; practitioners frequently deal with individual patients as discrete units.

The researcher will perform participant observation by living in an Old Order Amish church district and observing regularly in the clinical setting. In-depth interviews with Amish participants, clinical staff, and research staff will be analyzed to discover the perceptions and practices of this conservative religious tradition as they negotiate highly technological, individualized medical models. This research utilizes these ethnographically-focused methods to add an area of vital richness to medical anthropology and Amish studies. Further, it provides an excellent case for elucidating the social implications and consequences of new genetic understanding, as well as the challenges and successes that can occur in small-scale medical practice where translation across core beliefs is necessary.