'Medicalisation'

Scientific/medical knowledge and culture are of equal importance when it comes to health matters.  Both factors are so closely related that they appear to be intertwined at times.  Medicine should oblige to incorporate cultural beliefs and practices to get desirable health outcomes. As a measure, the ideology of cultural competency is developed to cohesively merge the two.   Cultural competency maintains a clear understanding of cultural knowledge while navigating an effective system that will create a cross-cultural environment in the medical field.  From the reading assignments, there were significant number of articles and videos that showed the inter-relationship between scientific/medical knowledge and culture.  The three readings that was most appealing included Anne Fadiman’s, “the spirit catches you and you fall down;” Becker and Nachtigall, “Eager for medicalization” and Briggs’, “Stories in the time of cholera.”  They all demonstrated similarities and differences in this elucid relationship and have successfully embarked on providing awareness that they co-construct each other and there is great importance to study this subject.

 Across the three readings, they all share the conflict that exists between culture and medicine.  There is no objectivity when dealing with culture and medicine.  Physicians and clinicians are the gatekeepers in the medical field.  Their main objective at all times is to seek a cure as oppose to understanding their patients cultural backgrounds.  This is evident in the spirit catches you and you fall down when the doctors with or without intent have ignored the Lee’s perception of Lia’s illness.  They began treatment by administering a cocktail of drugs believing that was the only treatment option for her condition.  Subsequently, in the final stages of her treatment, the doctors at MCMC identified some of the cultural barriers that might have contributed to the futile efforts in restoring her health.  There were many questions lingering regarding the possibility of an alternative outcome if the doctors have worked together with the family.  There is also no universal agreement with the exception of the concept of cultural competency, which constitutes a more fluid understanding of the inter-relationship between medicine and culture.  Lastly, medicine is used to “fit” in cultural norms in terms of reproductive science, disease prevention and treatment.

   On the other hand, the differences that exist are defined by the anthropological cultural model.  Briggs article in my opinion represents the billiard model in that the indigenous people in Venezuela demonstrated tremendous resistant to changing their cultural beliefs and practices.  He also explained constructs of culture through citizenship which confirm this assumption.  He mentioned that the indigenas and other poor Venezuelans were referred to as “unsanitary objects” due to their refusal to adapt to modern medicine.  Anne Fadiman appears to use the contemporary anthropological model in that we see the ever-changing effects of assimilation.  Despite the Lee’s stronghold in preserving their cultural beliefs and practices, they were moving farther and farther away from their traditions and closer and closer into western medicine due to the process of assimilation.  This is evident in Lia’s episodes as we see the Lee’s resorting to western medicine with hopes of saving their daughter’s life.

 Becker and Nachtigall, however, took the cultural model a step further from the contemporary model in that the coined term medicalization represented a more radical approach to medicine and culture.  Cultural norms are reflected in treatment as we see natural processes becoming abnormalities.  This abnormality is treated as a handicapped which requires immense treatment thus increasing the need for a “fix.”  According to the article, “Medicalisation occurs when a social status does not readily fit within society’s cultural systems.”   Take infertility for example, it is now portrayed like a disease because it is a condition that has fallen short of the cultural expectations of women.  As a result, everyone embrace the medical assumption that bodily differences are an indication of abnormality.  The treatment and cure for infertility has surpassed reproductive science into a new realm of artificial technology (“vitro fertilization”).

 Consequently, cultural constructs and medicine are moving beyond the contemporary anthropological approach.  Based on all three readings, it is evident that the change in scientific knowledge will also create a change in cultural settings due to the inter-relationship that they both share.  The authors have also demonstrated that despite their close relationship, there are conflicting issues that arise which involves some level of ambiguity in understanding and making a distinction between them.  Medicine is a culture within itself just as much as there is cultural influence in the science of medicine.

 

CITATIONS

Becker, Gay, and R.D. Nachtigall. 1992 Eager for Medicalisation: the social production of infertility as a disease.  Sociology of health & illness 14(4):456-471.
Briggs, Charles L., and Clara Martini-Briggs. 2003  Stories in the time of cholera: racial profiling during a medical nightmare. Berkeley, CA: University of California Press.
Fadiman, Anne. 1997 The Spirit catches you and You Fall Down: a Hmong child, her American doctors, and the collision of two cultures. New York: Farrar, Straus and Giroux