An Anthropological Assessment of Euro-American Biomedicine

My critiques of biomedicine will be based on its parochialism. This ranges from epistemological ideals to a lack of understanding cultural mechanisms. Many blunders attributed to Western medicine come in its one-track mindedness and lack of interest in ‘zooming out’ to view multiple causes; both external and internal. Biomedical practice tends to remove cultural and social contexts. Instead, they view disease as a universal condition that does not vary based on the patients’ or physicians’ life experiences.

The majority of the biomedical society does not believe it has culture. It seems rather that the doctor’s knowledge is true and separate from outside influence, where as the patient’s knowledge is culturally-based and thus fallible and insignificant. This fails in that even a society of medical professionals will have cultural influences and interactions in their own social sphere. It may be that aspects of biomedical culture lead to an illusion that the biomedical community is not dynamic, never changing, not socially organized, and that only outsiders possess culture. A medical community is certainly a societal unit with shared beliefs that has a transmission of shared knowledge and that is incessantly interacting with local and exotic forces of change.

Biomedical knowledge lies in the domain of cultural knowledge. It is not separate from culture. It cannot be strictly objective and scientific; somehow being real but not cultural. Ironically, culture is in action in a biomedical community in that there is constant transmission of knowledge to new generations. This knowledge is formed by the society. For instance, epistemology and professional competence are transmitted from the elders to the young learners. Additionally, the notion that biomedicine is separate from culture is culturally passed along from one generation of professionals to another. This creates an ignorance that does not notice sociocultural influences in health and disease. It limits the potential for a cure by intentionally ignoring the uniqueness and personality of the patient in addition to their cultural contexts and identity. It can dehumanize in terms of disregarding personal and social qualities of a patient.

The above suggests that, in training new physicians, the idea that culture is insignificant is seen as being professional and setting aside irrelevant information to better aid the patient. This can be solved by emphasizing cultural competence. When training new physicians, professors and mentors should mix the study of culture into their education. Without this, their sense of competence excludes culture. There must be a revolution and enlightenment in the biomedical field. Ideas of the person in idiosyncratic terms as well as the person’s cultural and social environment must be coupled with the objective tools of medicine. If physiological, systematic analysis can be interpreted through a culturally relative lens then a patient may gain a more efficient treatment and be far more likely to be cured. Medical knowledge and cultural knowledge should not be seen as opposing and separate.

There seems to be an assumption among western medical practitioners that diseases are somehow the same, even from historic times, and that they do not vary by region except in terms of biological variation. This is not accurate in many ways. The most obvious being the unique, subjective perceptions that disease will cause based on a person’s beliefs. Understandings of how an invisible agent attacks your body will vary based on knowledge, technologies, and, in general, scale of observation. This ties into the notion of specific etiologies. It seems to be a narrowed approach at taxonomic organization of disease; and one that is rather new on the stage of trying to explain disease and illness.

The importance of disease being relative to time and place is lacking in biomedicine. Nonetheless, biomedical methods for combating disease are not poor. The Western World has embraced the concepts of biomedicine and has seen many improvements in morbidity and mortality since its use became ubiquitous in many countries. However, the almost laziness of typing disease and defining diseases as universal is not as efficient as it may seem. Where biomedicine succeeds in treating disease (a physical domain) it fails in treating the illness (a psycho-social domain).

Rather, symptoms should be noted as they are, with respect to their interrelation; not just symptoms that are determined as relevant. There are many other facets that a symptom can belong in, one that biomedicine may not know or see. When analyzing a body for pathology, physicians should step back and also analyze that body’s person; their personal traits beyond the somatic and measureable. Those traits including cultural influences, social stratification, social roles and relationships, behavior trends and patterns, and any other psycho-socio-cultural possibility.

A macro-level perspective can be a great resource. Ideally a micro-level method and a macro-level method would lead to optimal understanding. An analysis from this perspective is more complex and reveals dynamic relationships, which can further reveal more information about a patient’s subjective and objective signs of disease and reactions to disease. So, studying the macro-level would entail a survey of the person’s broader context and the micro-level would entail a psychological and physiological examination. This would properly define the patient and could be accomplished through interviewing the patient and immediate family and friends using anthropological and biomedical interview models.

The biomedical community views itself as a separate, scientific entity. One that is rational, objective, and neutral to any and all influences and forces. This cannot be completely so. Rather, biomedicine is not an independent group from society. It is an embedded part of a society’s dynamo. Not only is it embedded but it is highly interactive with other social functions of society. The biomedical community views itself as a group tangent to the societal circle. But this is impossible. It is deeply within the circle. Biomedicine has a social role in regulating and eliminating sickness. It is also significant in convincing other people and institutions if one is sick or not; and being sick is actually a social role. So, it is a social institution, and thus affects other social institutions and is influenced by other social institutions. The scientific neutrality of medicine reflects this disconnection of medicine and disease from the social fabric.

Medical knowledge is viewed as so special and complicated that only equally special individuals should be able to possess it and apply it. In its application, medical knowledge should not remain as pure, neutral, and scientific. Instead, it must be socially organized to make for good practice. Science cannot make an applied physician moral and cannot do the job of critical thinking and piecing many different causal parts together. This truly goes beyond the neutrality of scientific medicine. When applying a science to human situations neutrality will naturally be blurred or missing. A more rational approach to applying rational thought is from the sociocultural standpoint.

These critiques of biomedicine can be further seen as iconic of some aspects of the societies that create and use these models. I have characterized biomedicine as parochial in some ways, and also unaware of its own culture and possibly the culture of others. The biomedical society is prolific among Western society and so reflects some of its cultural traits. It is clear that the primary trait is a sense of scientific certainty; a knowledge-based practice where elite individuals control important knowledge. There is truth and facts which are only obtainable by some mechanical-like means, separate from the contamination and interference of culture. This closely resembles the aspect of Western culture that creates the ‘other’. The biomedical society views itself, as does many Western cultures, as some sort of pure, autonomous entity. One whose characteristics are normal, fair, logical, and the best way to go. It is a mode of ignorance that is hard to notice from the emic point of view. So, western medicine and western culture are both interesting in their own lack of recognition of their own culture. Biomedicine is the extreme example of this. A new perspective that includes cultural competence, macro- and micro-level analysis, and acceptance as an interactive sociocultural entity may do some good for both practitioners and patients.

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