Abstract
AbstractThis chapter portrays a discouraged, dispiriting attitude towards health-seeking of rural older people in China. Based on the case of health-seeking of Aunt Chens’s family collected from a 6-month’s field work in a rural Chinese hospital, this chapter depicts how discouragement and discrimination operate in older members’ health-seeking experiences, throughout which older people’s health care was devalued as worthless socioeconomic burden. Underpinning discouragement and devaluation is the cultural value that encourages older people to be enduring with suffering and restricted with health-seeking. Simultaneously, this chapter traces various sources of institutional and social structural impediments, as they intersect with unfavourable cultural values that normalise discouragement and decimation.
Highlights
Within contemporary bioethical writing, ethical deliberations about patients’ health- seeking behaviours have long been centred on issues of patients’ rights, agency and autonomy
As reported in contemporary literature, personal characteristics such as maintaining thrifty and self-constrained lifestyles, and being good at enduring hardships and conscious of reducing their adult children’s financial burdens, are usually perceived as morally upright and positive for older people in rural China [1–3]. These cultural values encourage older people to be self- restrained with seeking health and much needed care for themselves since they view these as the behaviours “appropriate” for older people and wish to become socially recognised virtuous members of their society
Discouragement to support elderly health care was further heightened by the public pessimism about the curability and recovery of older people’s chronic symptoms, making the public refusal and the perception of elderly health-seeking as a waste of resources culturally legitimated
Summary
Ethical deliberations about patients’ health- seeking behaviours have long been centred on issues of patients’ rights, agency and autonomy This right-based ethical paradigm, is incomplete, as it conveys by and large the values of those privileged patients in developed social settings—i.e. those who tend to be autonomous, who have relatively better access to quality medical care resources and who are able to navigate institutional structures proactively. This chapter portrays the discouraged, despairing attitudes about the elderly seeking health care in rural China, as internalised by older patients themselves and expressed by their families and the public Underlying this discouragement is a widespread cultural value, namely the social expectation that people should endure suffering and that the importance of seeking elderly health care should be downplayed. The Human Ethics Committee of the University of Otago in New Zealand approved the research (Reference No 15/106)
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