the-lancet---culture-and-health.pdf

190 self monitoring is necessary for health

Info icon This preview shows pages 20–22. Sign up to view the full content.

View Full Document Right Arrow Icon
190 Self-monitoring is necessary for health maintenance, but chronic stigma can lead to a sense that one is never actually well. Rethinking cultures of care Culture and knowledge Health outcomes can be improved and money saved if caregivers are allowed time to engage with patients and help patients integrate into care communities. Why have more resources not been invested worldwide to support development of integrated communities of care that bridge the gap between biomedical settings and the diverse needs of multicultural groups? One reason is that increased medicalisation of clinical care throughout the 20th century has limited the role of empathy in health care. An implicit assumption within biomedicine, there fore, needs challenging—namely, that doctors have knowledge, and patients have beliefs. Patients are, of course, implicitly and sometimes explicitly held responsible for corrupting medical knowledge (as when they are blamed for not following instructions). When societies reframe, translate, or merely do not or cannot participate in medical science, patients may also be unduly blamed. Those vulnerable to being blamed make up most of the world’s citizenry for whom biomedical care is either unaff ordable or unavailable—people who depend on human care for health, instead of on health care per se. At stake are not only biomedical needs, but also the status of rational knowledge systems compared with beliefs held by patients. 191,192 This potential for blame itself constitutes a true source of symbolic violence. Yet, social scientists have established a framework and body of knowledge through which biomedical claims are also shown to be shaped by a range of political, economic, and cultural forces. 46,126,193,194 Evidence-based medicine and practice are not wholly neutral, objective bodies of knowledge. They are products of specific contexts, and anchored within specific historical frameworks, just as
Image of page 20

Info iconThis preview has intentionally blurred sections. Sign up to view the full version.

View Full Document Right Arrow Icon
The Lancet Commissions www.thelancet.com Vol 384 November 1, 2014 1627 beliefs and practices are embedded within traditional worldviews. 77,85,195 Vested interests—including those of the pharmaceutical industry and scientifi c laboratories, and the biomedical status and cultural identities of researchers and their institutions—establish research questions, study design, sampling techniques, research instruments, data analyses, and interpretation. 196,197 Above all, they not only shape illness categories, 198,199 but also constitute cultural systems of value in themselves. They have their own ethics, confl icts of interests, dynamics of power, and methods of knowledge production that can diff er substantially from those of other cultures, sets of values, and the community needs that they should serve. How community health gets regenerated in a world of widespread fi scal and ideological retrenchment presents, therefore, one of the biggest hurdles to contemporary health care. The constant reminder of what cannot be aff orded is perhaps the greatest obstacle to thinking about what is possible.
Image of page 21
Image of page 22
This is the end of the preview. Sign up to access the rest of the document.

{[ snackBarMessage ]}

What students are saying

  • Left Quote Icon

    As a current student on this bumpy collegiate pathway, I stumbled upon Course Hero, where I can find study resources for nearly all my courses, get online help from tutors 24/7, and even share my old projects, papers, and lecture notes with other students.

    Student Picture

    Kiran Temple University Fox School of Business ‘17, Course Hero Intern

  • Left Quote Icon

    I cannot even describe how much Course Hero helped me this summer. It’s truly become something I can always rely on and help me. In the end, I was not only able to survive summer classes, but I was able to thrive thanks to Course Hero.

    Student Picture

    Dana University of Pennsylvania ‘17, Course Hero Intern

  • Left Quote Icon

    The ability to access any university’s resources through Course Hero proved invaluable in my case. I was behind on Tulane coursework and actually used UCLA’s materials to help me move forward and get everything together on time.

    Student Picture

    Jill Tulane University ‘16, Course Hero Intern