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Lecture 2

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Laura Sikstrom

 more is at stake at the interpretation of illness than a set of medical practice o there are problems with overlapping treatments (dr. needs to know the whole story of what treatments are being used) What is health?  "not merely the absence of disease and infirmity but complete physical, mental and social well-being" -WHO  how we define health has strong implications for treatment and policies  health is connected to social life o health is relative by age e.g. what is healthy for a 20 year old is not healthy for a 90 year old o Cree-health is related to how healthy the land is around them  health is an elastic concept o being unhealthy doesn't necessarily mean you have a disease  varies cross-culturally o all things you do to live a long life (malawi) o how can we be healthy if the land is not? cree o a constant balance between ying/yang -China o accumulated resistance to potential dangers - Gnau in Papua New Guinea  Disease o Allan Young, 1982  "Outward, objective clinical manifestations of abnormality of physical function or infection by a pathogen in an individual whether or not they are culturally recognized" o critical in biomedicine  international classification of diseases  used in DSM  Illness o innately human experience of symptoms and suffering. Illness refers to how the sick person and the members of the family and wider social network perceive, live with and respond to symptoms and disability -Kleinman  Kelinman's Contributions   o 1. assumed superiority of biomedical knowledge   biomedical knowledge is always historically contingent i.e. leechcraft  said that biomedicine is always changing, what we think is true now may not be the same 10 years from now  superior ways of 'knowing' the body  imaging technologies  we rely on ultra sounds to set due dates (only accurate 3% of the time) women are better at predicting their own due dates than technology  so the technology is not perfect o biomedicine is objective and unbiased  Lynn Payer (medicine & culture 1988)  found that the UK did fewer surgeries than France and Germany  French doctors always talked about the liver and German doctors always talked about the heart, but within the 3 countries, the life expectancy is the same  Casesearean sections  different doctors have different opinions of when a c-section is due o 2. Disease symptoms shape the illness experience  leprosy (disfigurement-ostracism)  but it is culturally bound e.g. some cultures don't mind leprosy, others do  AIDS  wasting, dementia-sexually immoral  stigmatized b/c of sexual immorality  Endometriosis  infertility -loss of sexual desire o 3. Illness makes moral sense of disease  Cas
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