| Abstract: |
Explores the anthropological concept of the cultural system, showing how severl recent works illuminate biomedicine's cultural construction and ways it functions as a system for producing and expressing cultural meanings. In addition, takes a lo at some research strategies for future work. There are three basic strategies that can be used to make visible the culture of biomedicine: \b1) historical contextualization\b The historically embedded product of particular cultural and social assumtions, thereby highlighting the 'arbitrariness of institutions'. Most historical discussions of biomedicine emphasize its orgin in an elaboration of the Cartesian dichotomy between mind and body. Follows, Descartes - of a separation of the physical body from the mental and social. Physical reductionism is a central tenet of biomedicine. This medicine also radically spearates body from nonbody
the body is thought to be knowledge and treatable in isolation. An example given is the process of menstruation and menopause and there description in terms of production and control. In these images, the 'natural' functioning of the body is described in a way that fits a wider social view of women as degined by their reproductive function. Another example present is from an analysis of biomedical knowledge by Foucault. For Foucault the historical context, and particularly its shaping of what is possible, of what can be seen, determines what at any time is considered to be true. Practitioners of the early nineteenth century did not suddenly become observers and therefore better able to discover the truth about the body
rather, there was a fundamental change in what constituted observation. Foucault is interested in what \ican\i be said in the mutual shaping of perception and possibility that gives rise to a particular medicine at particular historical moment. In the nineteenth century, the body became an aobject of social control in a new sense. The turning of real lives into writing function as a procedure of objectification and subjection. Rather than functioning to delineate a reality that exists independent of its description, they are techniques for the shaping of reality that create patients as individuals susceptible to a particular kind of judgement. \b2) the use of metaphor\b Way in which social meaning is embedded in biomedical categories \b3) clinical approach\b the daily practice of clinicians is revealing of biomedicine's theoretical and pragmatic foundations \bBracketing Biomedicine\b One solution to the problem posed by medicine's grounding in "fact" is to segregate biomedical and social science ways of knowing. Thus illness includes the experiences and beliefs of individuals
disease is what biomedicine discovers "in" the person regardless of his or her (personal or cultural) awareness. This has allowed medical anthropologists to study culture (beliefs, issues of meaning, experience of illness) in medical settings without dealing with questions of the cultural construction of medicine itself. It also allows for defining of research problems in ways that are relevant to the social context supporting the research. pg 172 Biocultural in anthropology and medicine, the ideal is a translation of perspectives, enabling clinicians to make use of anthropological insights. Often these insights have to do with negotiation among perspectives
at other times they have to do with patient advocacy or with the clarification of ways that the biomedical perspective influences the cultural interpretation of patients. By using it to separate natural facts from cultural constructions, medical anthropology runs the risk of taking on characteristics of biomedicine itself. In both biomedical settings and the study of other kinds of medicine, it is hard to avoid the assumption that what needs to be explained are the "alternatives", and "other" perspectives, the "misunderstandings" or "misuses" of biomedicine rahter biomedicine itself. pg 173 Critical analyses of biomedicine are attempts at demystification. One strategy aims to uncover the incidence and causes of the "second sickness" by exploring way in which medical care fails to reach, recognize, or correct socially created problems. A second strategy aims to uncover how biomedicine mystifies sickness through its participation in the nature-culture dichotomy. Medicine, because of its bias toward the uncovering of natural facts, represents the body in ways that are powerfully suggestive of a natural reality separate from the social.
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