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This case study explores ethical issues with Canada’s immigration policy and the requirement of mandatory HIV testing of prospective immigrants. Attention is directed to the official immigration medical examination (IME) because it is a key site within the immigration system. The following four issues are raised: the differences in official and experiential knowledge claims about what activities occur (or not) in the IME when an applicant is diagnosed with HIV; the exceptional treatment of HIV within the Canadian immigration program; the discursive organization of the HIV testing policy; and, the inadequacies with how specific practices are enacted in the processing of immigration applications made by people living with HIV.

OBJECTIVES: To identify, explore and critique features of how practices associated with immigration medicine are socially organized. Specifically, how the work of designated medical practitioners (DMP)--physicians who conduct immigration medical examinations of prospective immigrants to Canada as contractors to the Canadian government department of Citizenship and Immigration Canada--is organized to occur in interactions with applicants who are diagnosed with the human immunodeficiency virus during the immigration medical examination. METHODS: Findings from a theoretically informed empirical study using institutional and political activist ethnography inform this article. Data collection and analytic activities spanning 18 months included observational work in institutional settings, textual review, 61 interviews, and 2 focus groups in three Canadian cities. RESULTS: The medical examination of prospective immigrants to Canada is not organized as a therapeutic relation of care and has little to do with medicine per se. The rationale structuring the work of DMPs is actually administrative responsibilities. The work achieved by the DMP positions her/him as a key figure and important decision-maker within the Canadian immigration system. CONCLUSION: The work of doctors who practice immigration medicine gives rise to contradictions and ethical problems. These are largely unresolvable because of the way in which the labour process in which the DMP is implicated is coordinated. The social organization of immigration doctoring practices has serious consequences for prospective immigrants to Canada, for doctors themselves, and for the Canadian immigration system more broadly. KEY WORDS: Critical methods; designated medical practitioners; HIV/AIDS; immigration medical examination; immigration medicine; mandatory HIV screening; sociology OBJECTIFS: Identifier, explorer et critiquer l'organisation sociale des pratiques qui relevent de la medecine de l'immigration. En particulier, comment le travail du medecin designe--medecins contractuels au departement federal de Citoyennete et Immigration Canada charges de faire l'examen medical aux fins de l'immigration d'immigrants prospectifs--est organise lors des interactions avec les demandeurs de residence canadienne ayant recu un diagnostic de seropositivite au virus d'immunodeficience humaine lors de l'examen medical de l'immigration. METHODES: Les resultats d'une etude theorico-empirique qui a employe l'ethnographie institutionnelle et l'ethnographie d'activisme politique comme methodes d'enquete fondent cet article. Les activites de collecte et d'analyse des donnees ont eu lieu pendant 18 mois et etaient constituees d'observations dans divers lieux institutionnels; d'analyse de textes; 61 entrevues; et 2 groupes de discussion (<< focus groups >> dans trois villes canadiennes. RESULTATS: L'examen medical des immigrants prospectifs au Canada n'est pas l'occasion d'une intervention therapeutique, et a peu de rapport avec la medecine proprement dit. Le raisonnement clinique du medecin designe est en fait remplace par des responsabilites administratives. Le travail effectue par ces medecins fait en sorte que cet individu soit une personne cle et un preneur de decision important au sein du systeme de l'immigration canadien. CONCLUSION: Les pratiques realisees par les medecins designes donnent lieu a des contradictions et problemes ethiques. Il y a peu de chances a ce que ces derniers soient rectifies en raison de la maniere dont ce medecin est appele a travailler. L'organisation sociale des pratiques de la medecine de l'immigration a des consequences serieuses tant pour les immigrants prospectifs au Canada que pour les medecins eux-memes et le systeme de l'immigration canadien de facon generale. MOTS CLES: depistage obligatoire pour le VIH; examen medical aux fins de l'immigration; medecine de l'immigration; medecins designes; methodes critiques; sociologie; VIH/sida, The work carried out by health providers such as doctors, nurses, and social workers who practice what is often interchangeably called bureaucratic, company, corporate, industrial, or occupational medicine in locations [...]

This paper explores newspaper coverage of HIV non-disclosure criminal cases in Canada in which defendants are Black immigrant men living with HIV. We base our analysis on a corpus of 1680 English-language Canadian newspaper articles written between 1989 and 2015. For the first time ever, we present quantitative evidence of the dramatic overrepresentation of Black men in such coverage. We also provide an analysis of the racialised regime of representation found in this material. We emphasise how 'writing in criminal justice time' operates as a first-order objectification within which are embedded strategies that link constructions of moral blameworthiness with representations of racialised difference. The result is a type of popular racial profiling in which HIV non-disclosure is treated as a crime of Black men who are represented as dangerous, hypersexual foreigners who threaten the health and safety of the public and, more broadly, the imagined Canadian nation. [ABSTRACT FROM AUTHOR]

This article confronts mainstream discourses about poverty and inner city poor neighbourhoods. It argues that the ways that poverty and poor inner city neighbourhoods are made publicly known in writing and through visual representations present problems such as overpowering structural causes of health and illness, reifying false dichotomy of us and them, and normalizing people living in poverty or working poor people as de facto vulnerable. This can happen when the social relations that govern poverty and sustain human suffering eschew the social relations that produce these experiences. Taking these relations as the objects of analysis, this article focuses sociologically on the Dundas/Sherbourne neighbourhood in Toronto, Canada, as the terrain of inquiry. The aim here is to contribute to analyses of the political, social, and economic determinants of health as well as to critiques of bad-neighbourhood and bad decision discourses. To do this, it bridges visual practice with critical social analysis: drawing together the authors' individual practices as visual artists, marshalling their social positions as residents of the adjacent St. James Town neighbourhood, and sharing their experiences of the Dundas/Sherbourne area. They employ insights from sensory ethnography and street photography to offer an alternative source of knowledge about the poor inner city that contrasts and contests mainstream ways of knowing these same spaces. [ABSTRACT FROM AUTHOR]

In this photo essay, a group of six academics contributed to a cross-disciplinary conversation about immigration, mobility and circulation. We tasked ourselves with subverting crisis narratives attached to global migration by exploring the habitual, mundane, and everyday aspects of migration, as well bringing into focus the bodily, intimate and affective dimensions of mobility. Each co-author selected one or more photographs they had taken of an object or daily practice that illustrates the immediacy, tangibility, and materiality of global mobility, migration and circulation from their perspective as an academic or practitioner in their own discipline. We each also wrote mini-essays to contextualize and explicate these photographs. The result is part photo-essay and part collage. As the various pieces juxtapose with one another, themes of temporal stretching, melancholy, dis/orientation, and the rhythms and cycles of everyday life that are altered and interpenetrated by the mobilities and circulations of people and objects arose. This collective piece also registers the blurring boundaries between everyday life and research practice, individual and collective conversation, work and pleasure. The practice of producing this collective photo-essay was not only the result of the convening of an interdisciplinary study group on immigration, mobility and circulation, but also of a deliberate experiment with practicing promiscuous scholarship and slow scholarship. [ABSTRACT FROM AUTHOR]

Health sociologists interested in how macro state influences affect micro health care practices have much to gain from meta-ethnography research. In this article, we bring together insights from two separate empirical studies on state health care services involving HIV/AIDS as a way to speak to larger issues about the organization and production of medical expertise and governance in health care systems. We use Noblit and Hare's meta-ethnography approach to bring these studies into conversation and identify six shared "organizers" of health care encounters. The organizers illustrate how state health interests operate across institutional contexts and impact the work of providers in seemingly unrelated health care settings. On the basis of this synthesis, we conclude that state interests both structure and create conflict in health care settings. We believe this perspective offers the potential to advance the goals of health sociology and the field of qualitative health research in general. [ABSTRACT FROM AUTHOR]

Discussion and analysis of characteristics and tensions associated with fieldwork in two projects using institutional ethnography is the focus of this article. Examined in comparison with each other, the first exemplar explores the organization of the Canadian immigration system and the mandatory medical screening for the human immunodeficiency virus (HIV) of immigrants within this. The second exemplar looks at how nurses' work in a selection of Canadian hospitals is organized. The argument made is that the politics of deliberately maintaining a standpoint on the side of a set of people (immigrants with HIV and nurses)--where inquiry begins from the experiential knowledge and concerns with the world of these constituents--gives rise to challenges to which the researcher must contend and adapt. Mobilizing examples from our fieldwork, we explore several such challenges and explain the research decisions we made in the face of these. In this article, we present insights and practical strategies for researchers who are preparing to use institutional ethnography as a strategy for critical social inquiry. [ABSTRACT FROM AUTHOR]

The article discusses the social and health impacts of stigma on Canadians living with newcomers infected or affected by HIV. It provides insight for Canadian social workers on the challenges faced by immigrants infected with or affected by HIV. It concludes that social workers throughout the nation have had to adjust and acquire new competencies and added that social workers with an increased critical awareness about stigma can best support migrant people living with HIV and Aids (PHAs).