部落自治视角下的美国原住民医疗卫生体制  

American Indians' Health Care System and Its Implications from the Perspective of Tribal Self-Governance

作　　者：郑勇[1] 

机构地区：[1]湖南大学法学院

出　　处：《世界民族》2018年第3期1-15,共15页Journal of World Peoples Studies

基　　金：2015年度国家社科基金青年项目"法律东方主义的中国误读反思研究"(项目编号:15CFX011);2015年"国家建设高水平公派研究生项目"(项目编号:留金发[2015]3022)的资助

摘　　要：印第安人是长期生活在北美大陆上的原住民社群,印第安部落作为拥有独立主权的政治实体对其成员和领地范围的事务拥有内在的自治权。美国政府根据历史上与部落签订的条约而对印第安人社群负有提供医疗卫生服务的信托责任。为了履行这一信托责任,联邦政府成立专门机构并逐步确立起了为印第安人社群提供专项服务的医疗卫生体制。20世纪60年代以来,随着印第安人社群土著族裔意识的复兴和"红种人权力"运动的兴起,联邦印第安人政策出现了重大调整,在一系列新出台的联邦政策和国会立法的推动下,印第安人医疗卫生体制经历了从联邦绝对主导到支持部落自治的发展演变过程。在这一过程中,印第安人社群通过部落磋商和参与程序、自决合同、自治示范项目和自治协议等形式实现了最大限度的自治。American Indians refer to the indigenous people who have been inhabiting North America for centuries;they are political entities possessing independent sovereign authority,qualified to exercise inherent right of self-governance.Based on historical treaties signed between the U.S.federal government and the Indian tribes,the federal government has“trust responsibilities”,including health care services for the Native American community.In fulfillment of its special trust responsibilities,the federal government created specialized agencies and health care delivery systems to provide health care services to the American Indian community.With the revival of Indigenous Ethnic Consciousness and the rise of the“Red Power Movement,”American Indians’self-determination and self-governance have been supported by several newly enacted federal policies and congressional legislations through major adjustments of federal Indian policies since the 1960s.This health care system has transformed from a federal-directed to a tribal self-governed entity.In the process,Native American communities have obtained the highest status possible of self-governance through Tribal Consultation and Participation Procedures,Self-Determination Contracts,Tribal Self-Government Demonstration Project,and Self-Governance Compacts,which have greatly enhanced the communities’overall health condition.

关 键 词：美国原住民 医疗卫生体制 部落主权 部落自治 信托责任 

分 类 号：D971.2[政治法律—法学] DD912.1