In any cultural context, people with some medical conditions are assumed to “responsible” for their illness, while others are regarded as blameless. Thus, for example, in western countries where smoking has become viewed as a filthy and stigmatised habit, people with lung cancer are often assumed to have been smokers and therefore viewed as “ bringing it on themselves ”. They tend to be subject to less compassion than are those people with diseases that are viewed as not their “fault” and may subsequently feel shamed and guilty. They may even delay seeking medical treatment because of the stigma that clings to the disease.
Medical anthropologists refer to “culture-bound syndromes” to describe clusters of symptoms that seem to be particular to a specific cultural context and are not recognised in other cultures or societies. Ataque de nervios is one such condition involving behaviours such as uncontrollable shouting, crying, fainting or aggression. It is seen as an illness by Spanish speakers in the Caribbean and Latin America.
Major differences between western countries are also apparent in health-care spending and statistics of drug prescriptions and medical techniques. A comparative study showed that the French tend to be less obsessed with germs and hygiene but are more focused on the health of their livers – and their doctors treat them accordingly.
As important as these acknowledgements of culture are, it should be recognised that culture, more broadly, can also be understood as the meanings, technologies and practices that gather around medicine within western societies.
Deborah Lupton does not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.
Senior Principal Research Fellow, Department of Sociology and Social Policy, University of Sydney
Linking the word “culture” with “medicine” is usually interpreted to mean one of two things. First, that people of non-western cultures may come to western medicine holding different beliefs about the causes and treatments of illness from those of scientific medicine, causing a “culture clash” between doctor and patient.
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Deborah Lupton is the author of Medicine as Culture: Illness, Disease and the Body
Americans, on the other hand, are generally germ-aversive and favour “fighting” disease aggressively. Their doctors have a highly-technical “no-holds-barred” approach to testing for and treating disease. western medicine beliefs And US health-care costs are the highest in the world partly as a result of this.
Its attendant concept of “cultural competence” is now commonly used in the medical literature. It highlights the importance of doctors and other health professionals understanding that their patients from another culture that may hold different beliefs about illness and may experience poorer quality health care as a result of communication breakdowns.
The second common use of “culture” in medicine is the anthropological study of non-western medical systems. Medical anthropologists have identified several such cultural belief systems among non-western cultures. The “hot-cold” system found in many Asian and Hispanic countries, which holds that certain symptoms or illness are caused by imbalances of either “hot” or “cold” in the body is an example of this.
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Despite the objectivity implied by the scientific principles underlying western medicine, it is still underpinned by a host of assumptions and beliefs developed through living in western culture. The white coat worn by doctors is a potent symbol of efficiency and hygiene, for instance, and the bleeping medical machines found in the hospital setting convey their own meanings of high technological prowess.
And Australians? A detailed study has yet to be undertaken of our health beliefs and practices. It would be fascinating to do such research taking into account the increasing cultural diversity within the Australian population.
University of Sydney provides funding as a member of The Conversation AU.
Germans are influenced by a lingering Romanticism that considers “heart insufficiency” as a cause of illness, and are therefore high consumers of heart drugs.
For their part the British are stoic supporters of their nationalised medical system, the National Health Service . It may not offer many luxuries but at least provides care for all. Britons tend to be concerned about their bowel habits and the importance of “soldiering on” in the face of illness.
Just as the lifeworlds of patients need to be acknowledged, it’s equally important to recognise that doctors and other health-care professionals bring their own cultural beliefs to the medical encounter. This is generated not only by their scientific training but also by other aspects of their own lifeworlds.
The cultural western medicine beliefs assumptions behind Western medicine
As these comparisons show, culture-bound syndromes are not confined to non-western cultures. And we shouldn’t assume that just because a medical system has science as its knowledge base that it is morally neutral or somehow immune to the influences of culture.
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When most of us think about the medical approach that dominates in Western countries, we tend to view it as scientific and therefore as neutral, not influenced by social or cultural processes. Yet research undertaken by anthropologists and sociologists has revealed the influence that social and cultural assumptions play in the western biomedical tradition.
In all these aspects, and many others, scientific medicine and understandings and experiences of ill health and disease in western societies are inevitably and always underpinned by sociocultural meanings in ways that we don’t always recognise.
Even within the western world, there are significant national differences in how scientific medicine is understood and practised. These differences can be particularly evident in controversies over medical innovation, western medicine vs holistic