Pathways to Inhumane Care: Masculinity and Violence in a South African Emergency Unit

Inhumane treatment of patients by health care providers is reported around the world. A range of explanations has been proposed, indicating the complexity of the multiple factors involved. This article reports on an ethnographic study conducted in a South African public sector emergency unit, exploring the possible contribution of hegemonic discourses of masculinity to delivery of inhumane care in this context. Using ethnographic methods, including participant observation, interviews, audio-recordings of verbal interaction, and narrative analysis, the study on which this article reports explored the discursive practices surrounding incidents of abuse. The article argues that the pressure doctors experience to display strong masculine identities and simultaneous feelings of powerlessness in the face of material realities generates the potential for inhumane acts. It concludes that understanding the metaphors through which doctors interpret their experiences is important both to comprehending and subverting the forces that drive inhumane care.