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

5 to say that culture is about shared conventional

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5 To say that culture is about shared conventional understanding does not, however, imply that the cultural dimensions of the behaviours of any group of people are always subscribed to or overtly understood from within. For example, a group may perceive itself to care for the elderly while failing to address the actual needs of ageing. Moreover, members can regularly—and wrongly—assume that their own practices are universal, rather than particular. Monotheists, for instance, might customarily think of religion as a belief in God, whereas for many people, religion is not the belief in any single, omniscient being at all. This example is a social convention—something widely evidenced (even ass- umed to be universal), but not often consciously questioned or critically examined. Cultural systems might, therefore, not be overtly expressed, but their effects can be ubiquitous, including in daily scientific practices. Not only hospitals, but universities, scientific laboratories, global health charities, and government agencies all have their own cultures, although they might seem less obviously cultural than the kinds of cultures anthropologists traditionally study. However, because they are sometimes more covert, their un- examined effects might actually be greater. More than a century ago, the sociologist Émile Durkheim separated empirical facts (what we see and evidence) from social facts (what we assume when our beliefs remain unchallenged). 6 For Durkheim, the things we take for granted are foundational to our existence, even if, or perhaps because, we do not always recognise them. They transcend our capacity for self- criticism, yet exercise a continuing effect on us that is inversely proportional to our awareness of them. Indeed, groups of people rarely believe that their moral perspectives are relative, and their awareness of how much their values are cultural only becomes clear when those values diverge from, or are in conflict with, other values that they do not agree with. The eff ect of culture might therefore seem overt when a clinician attempts to care for someone from another society, but when we think of how culture aff ects behav iours in a hospital, we might not view such activities as cultural in nature. When we speak of, for example, the silent majority, we are referring to shared values and categories of thought that survive in a largely uncritical manner; this silent majority is made up of the beliefs, habits, ways of life, ideas, and values of a majority that might not feel the need to express these values overtly because they are not overtly challenged. For this reason, cultural values can become more obvious when members of a group are faced with practices and beliefs that vary substantially from their own. Culture is made up of not merely those variable behaviours and practices that a group understands itself to possess and articulate daily, but those that are covert and taken for granted. Accord ingly, anthropologist Fredrik Barth once meta phorically
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  • Summer '18
  • Jeanne Hughes
  • Lancet

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