Medicine

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1 Medical Systems - system for healing

????Values, illness, and therapy concepts, and role relationships shaping the definition and treatment of health and illness.

????Includes beliefs, norms, and socially-legitimated practitioner roles.

????Medical systems are inter-related, include in the social/culture context. Medical systems model for and of our behaviors - pattern expectation on how we expect to behave.

????Associated with conceptions of reality. What are real causes?

Medical systems - network of social/cultural ideas.

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Traditional Medical Systems - refer to many different types of medical systems

????Diverse, not a single type

????Can consider naturalistic (environment), personalistic (behavior/emotion), or spiritual (spirits) etiologies

????Can based on oral traditions or written texts

????Dynamic, change over time

????Exist in broader social and cultural context

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“Biomedicine”

????Development of biomedicine

????Reliance on specific disease categories (19th?C.)

????????- Detailed descriptions of diseases, separate from individual experience

????????- Can be described outside of any particular individual

????????- Shift from considering individual to considering the standard

????????- Diagnosis - not too much about individual

Germ theory disease (19th?C.)

- Disease as a virus, bacteria - outside of the body

Flexner Report (1910)

- Report of medical education in US and Canada

- The Report called on American medical schools to enact higher admission and graduation standards, and to adhere strictly to the protocols of mainstream science in their teaching and research. The report talked about the need for revamping and centralizing medical institutions. Many American medical schools fell short of the standard advocated in the Flexner Report and, subsequent to its publication, nearly half of such schools merged or were closed outright. Colleges in electrotherapy were closed.

- Someone trained in one school has the same content as in the other school

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Values and Biomedicine

Reductionist rationality

- Reduction of health and diseases to smaller, more precise components of the body (moving closer to truth, objective). eg give virus on liver.

- A knowledge of the body as an intricate and complex piece of machinery influenced by and separate from the mind that is analyzed by segregating the individual into a collection of organs and molecules

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Authority over nature and the body

- Authority over the description of reality. Science & medicine - cultural-free, politically-neutral - automatic authority

- The growth of specialized knowledge and technology increases authoritative knowledge about nature by distancing people from other ways of knowing nature or the body and by requiring professional help to understand technology and science.

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Individualism

- Individual, less on broader structural causes

- In medical diagnosis and therapy the vagaries of individuals are stripped away and the resources that make a person who they are irrelevant to the work of medicine, which treats them as an autonomous and universal individual.

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Technological orientation

- Health is achieved by technological means; technology can rework the body as potential sites for intervention (birth, shyness, menopause)

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Gawande “The Score”

Obstetrics has become more standardized and industrialized over time

Is medicine an art, a science, or an industry?

Medical Socialization - Medical school/training:

Learn a Mechanistic and depersonalized view of humans

- Body as an object, not person

Adopt a cynical outlook

Identify strongly with the profession (social network - friends also doctors)

Don a “cloak of competence”

Strive to conform

Accept the “culture of no culture”

Davis-Floyd -?Child’s birth & medical practice

Rite of passage: A rite of passage is a ceremony or ritual of the passage which occurs when an individual leaves one group to enter another. It involves a significant change of status in society.

- separation stage: separation from previous social status

- liminal stage: in-between period. ambiguous status, no clear social identity

- reintegration

Davis-Floyd argues medical students learn core cultural values of biomedicine through rite of passage. Technological model of birth - physicians depend on technology, person as a type of mechanism.

Basic science, narrow focus - childbirth need technology - childbirth, impersonal

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