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Dan Sellen (28)
Lecture 4

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Dan Sellen

Lecture 4 • Cultural traditions and healing systems ◦ Becoming a healer ◦ Western biomedicine ◦ Evidence-based medicine - aims to find if treatment is cause of improve- ment ◦ Alternative medicine ◦ Complementary medicine - chiropractor, acupuncture (often referred to by biomedicine as well) ◦ Medical pluralism • Healing = "to restore to health" ◦ uniquely, humans intervene ■ sharing health (like food), come along with concepts that undermine health (witchcraft for example) ◦ we have "healers" ◦ a social role • All healing systems share: ◦ theories of cause ■ historical interactions, overlap in theories ◦ diagnostic criteria ■ first step is a social interaction, to contact the healer ■ in act of demonstration you become a participant ◦ therapeutic interventions ■ spells, drugs, lifestyle advice, surgery, or referred to a more power- ful healer ◦ formal patient-healer interactions ■ cultural script that we follow as a healer or a patient ◦ mechanisms to select + train healers • Most cultures construct + legitimize healing roles: ◦ e.g. "doctors", nurses, therapists, shaman, medicine people, witch doc- tors, priests, folk practitioners, etc. ◦ HEALERS ■ often "specialists" ■ diagnose + initiate treatment process ■ accrue/possess skill + power +/- wealth • Diagnosis: ◦ self-diagnosis difficult ■ thus we place a lot of trust in the effectiveness of healers ◦ locus? ◦ "everybody" = body-self + social body + collective body ■ they help to find what is wrong with us ■ includes not only clinical professionals but people involved in public health, policy ◦ misdiagnosis = malpractice • Social suffering ◦ "results from what political, economic, and institutional power does to peo- ple, and, reciprocally, from how these forms of power themselves influ- Lecture 4 ence responses to social problems" - Arthur Kelinmann, Veena Das, Mar- garet Lock (Daedalus, Vol. 124, 1996) ◦ i.e. conditions usually divided as only health, welfare, and legal, moral, re- ligious issues, etc. ◦ e.g. "trauma, pain, and disorders" from atrocity are health conditions + po- litical + cultural ◦ lack of access to healers causes inequities, health disparities • Social factors in treatment response ◦ placebo: improvement with experience of treatment (not due to the treat- ment itself) ◦ nocebo: causation of sickness/death by expectations • EVIDENCE-BASED MEDICINE ◦ systematic research ◦ peer review ◦ hierarchy of quality ■ Evidence Based Medicine Pyramid: background information/expert opinions at the bottom, systematic reviews are at the top ◦ authoritative? • Medicalization ◦ process of defining a condition as a disease or in need of surveillance ◦ occurs when ■ medicine and its practitioners have social or cultural authority ■ illness is not understood as having social roots ◦ examples: ■ pregnancy + birthing ■ ongoing tension between the medical system and midwives ■ doctors want women to give birth in hospitals, which can be profitable (use of anaesthesia) ■ anxiety + depression ■ often regarded as social and not medical by traditional heal- ing systems ■ not necessarily bad thing, but example of a modern medical- ization ■ "pre-menstrual syndrome" ■ compare with hysteria, "disease" that used to exist that sup- posedly affected women's mood, reflected patriarchal values of that time ■ "erectile dysfunction" ■ a modern disease ■ "video game addiction" ◦ framing conditions as disease may be useful in alleviating suffering, al- though we must recognize that they are social ◦ there may be more diseases that will be socially constructed in the future ◦ demedicalization can also occur • ALTERNATIVE MEDICINE ◦ non standa
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