Friends,
Please read the following pieces for class on Tuesday (11/29)
Be on the lookout for an accompanying write up, but this should get you started.
1. A Right to Health This article analyzes the ways in which Western medicine clashes with Angolan culture and can be seen as cultural imperialism (ex. the merit of evidence-based medicine, human rights, etc.) The author urges Western health professionals not to avoid the elements of imperialism to be culturally relativistic, but to instead combine beneficial aspects of local culture with medicine to improve healthcare.
2. The Legacy of Medicalizing the “Colonial Body” This article examines how researchers and scholars have attempted to reconcile Western medicine and eastern practices, comparing and valuing the two. Research began with the preconceived notion that there were inherent differences between peoples, which largely guided the medicine that followed. Much effort was put into understanding subtle differences between people aside from their physiology, in order to use those characteristics to validate medical practices. Eventually researchers came to the conclusion that different races responded to disease in different ways, but their beliefs were predicated on racial lines.
3. Need for a New Medical Model
4. Lia Lee Dies; Life Went On Around Her, Redefining Care
Biomedicine is a cultural medicine in-and-of-itself. To claim that biomedicine is an objective model of medicine is to privilege a distinctly western-inspired model of body conception; the mind-body dualism that informs biomedical practice is a distinctly western philosophy. Situations where local populations misinterpret or misunderstand certain prescriptions and procedures directed by biomedical workers are quite common. The article on Lia Lee illustrates some of the difficulties biomedical practitioners had when dealing with foreign cultures with very different perceptions of medical care. The culture gap and language barrier meant getting Lia’s parents to give her medicine appropriately were difficult, and distrust grew between the family and medical doctors, as they could not offer adequate explanations for what they were doing to the family. It did not attempt to account for the social or psychological elements of her condition and their conceptions of her health were not intelligible to her parents, Hmong refugees that lacked a comprehensive understanding of western medicine. Taking Lia away from her family and her worsening condition only caused her family to spurn western medicine more. The Engel article specifically advocates for a biopsychosocial model as opposed to a strictly biomedical model. While it focuses on psychiatry, it examines biomedicine as a medical framework overall due to its emphasis and prioritization on physical effects over mental and emotional effects. The traditional biomedical model stresses the empirical existence of a disease, an aberration in normal physiology that exists as a physical ailment. Its pathology can be directly tracked in the body; like a machine, one can pinpoint where the part is broken. A biopsychosocial model would take into account the psychological as well as the social elements of illness. There are a number of alternative systems of medicine that account for these social elements. Healthy versus unhealthy, ill versus well, are not very rigid, well-defined categories. Engel uses the example of grief for a psychosomatic condition that is not adequately explained through the biomedical model; it does not have the same pathology as what is defined as a physical ailment and so it isn’t necessarily that grief doesn’t exist, but its pathology exists mentally, despite the fact that grief does have several physical sensations and emotions associated with it. To divorce the body so much from the mind has been the result of centuries of applications of the scientific method, the empirical, dualistic model of disease becoming predominant, taking precedence as the primary, considered “objective” practice of medicine.
