Biomedical Tradition Research Articles

Behavioral scientists at the Centers for Disease Control and Prevention. Evolving and integrated roles.

The behavioral sciences offer theories and methods that are critical to fulfilling the mission of the Centers for Disease Control and Prevention (CDC). Behavioral scientists have been integrated into the epidemiological and biomedical traditions of the agency, thereby broadening the effectiveness of prevention strategies that rely on behavior change. The diversity and changing nature of the roles of CDC behavioral scientists are presented, along with a discussion of how they connect to ongoing public health efforts. Psychological theories and methods, especially, have relevance for tackling many of the challenges facing public health. Some of these challenges, and the opportunities they present for psychologists and other behavioral scientists, are discussed.

Health belief systems in perspective.

The author adopts a critical stance toward the assumptions, beliefs and behaviours underlying western biomedical tradition as it is enacted within the health care arena, in this paper. On the basis of a cross-cultural comparison of how health belief systems depict the nature of health, the nature of illness and the role of healers, this paper will analyse the degree to which traditions other than western biomedicine seem to influence much of our decision making and behaviour as practitioners and recipients of health care. Thus, locating our relationship to biomedical thought within the context of non-dominant belief systems provides an unusual angle from which to evaluate critically the way we think and behave. In concluding that western health beliefs are powerfully influenced by traditions far beyond biomedical ideology, the author raises implications for nursing's future directions as active participants in a global health movement.

The Looking Glass Self: Introductory Notes on Anorexia Nervosa

Anorexia nervosa is a disorder peculiar to Western society and culture. Although the sufferer is an individual, her problems are rooted in family relationships, and the syndrome utilizes the values and symbols of a stratified society where No woman can be too rich or too thin.2 Seemingly, if we are to understand anorexia, we must view it in this social and cultural context; yet, since it is conceptualized as an illness, the predominant approach to this disorder is that it be analyzed within the categorical system of Western biomedicine and treated within the corresponding institutional framework of one-on-one therapy. Much of the relevant literature has emerged from the biomedical tradition. A few scientists work at the biological extreme, seeming to argue that the causation of anorexia is biogenetic and physiological. Most authors do acknowledge the cultural environment and family matrix of the disorder, but, since they lack any real sense of sociocultural dynamics, they can only condemn, where they need to analyze and comprehend. In this etiology of blame, the patient's family and the surrounding cultural matrix are assigned the causal responsibility for the illness; they are not perceived as providing the clues to a remediative understanding. Facilely, one may denounce a popular culture which values slenderness in the adult female~a slenderness which is

Medical education and practice on the periphery: Consultation psychiatry and the psychosocial tradition in American medicine

The culture of American medicine has both central biomedical and peripheral psychosocial traditions, a pluralism which demands further study. Anthropologists have traditionally learned a great deal about any culture by studying the socialization process, and the same is true of medicine. In consultation-liaison psychiatry, the peripheral position of the psychosocial tradition can be better understood as psychiatrists teach students and residents how to assist biomedical specialists in the care of their hospitalized patients. Through such student socialization, the use of the technology of biomedicine by psychiatrists for both the manifest function of patient care and the latent function of cementing interprofessional relationships is revealed. In consultation psychiatry, students are also taught that the object of their ministrations is not the patient, but all members of the ward milieu, a focus which is not characteristic of the biomedical tradition. Students in consultation psychiatry are inculcated with attitudes and values which are divergent from those of the biomedical tradition; the competetive presentation and selective assimilation of such elements of professional ideology by students further betrays the peripheral position of psychosocial concerns in medicine. This position is also highlighted by the teaching of ‘survival strategies’ to students and residents in psychiatry, designed to increase the likelihood of acceptance by biomedical specialists. These include mimicking biomedical approaches to diagnosis and treatment, viewing biomedical specialists as patients who are unwitting victims who can be cured with the right treatment, manipulating symbols and using metaphors of biomedicine to affirm the basic kinship of all physicians, and otherwise promoting psychiatry as central to modern medicine. Yet, the psychosocial tradition, itself, is not homogeneous. Students in psychiatry are confronted with diverse role models: psychopharmacologists who risk the charge of reductionism from within their own ranks; consultant psychiatrists who view themselves as messianic within medicine; and other psychiatrists who so abhor the biomedical tradirion that they only practice psychotherapy with patients outside the hospital. Nevertheless, consultation-liaison psychiatry is a specialty which holds great promise for promoting the interaction and diffusion of ideas between the biomedical and psychosocial traditions; for the social scientist it is an important arena both for further study of the professional socialization of medical students and for documenting the struggle for professional dominance within the culture of medicine.

Therapy as a system-in-action in Northeastern Tanzania

This article is an attempt to find the systematic bases of therapeutic organization in north-eastern Tanzania, based on recent research in Galambo, Lushoto District. The whole of Tanzania suffered a long period of very low investment in either health care or public health during the colonial period. During that time the costs of reproduction of labor were borne in the countryside, mostly by women and children. Neglect by the colonial powers left a sphere of rural autonomy in medical matters, in which a number of therapeutic systems and sets of ideas fourished side by side, with no one therapeutic tradition establishing an effective monopoly. How then is a socially approved course of therapy determined? One possible answer to this question—based on shared world-view and shared assumptions about the causes of illness—is rejected. Evidence shows clearly that individuals disagree fundamentally on theories of illness causation. Radical scepticism concerning the validity of spirit-causation of illness, and of sorcery-explanation, is common. The boundaries of the system are shaped by the power of the government and (among those who are Christians) the authority of the church. The government has decided that cholera and tuberculosis must be treated within the biomedical tradition. The chruch tries unsuccessfully to limit its adherents to the use of hospital medicines or simple herbal therapies. The system as it works in actual practice is shaped by two principles. First, treatment is diagnosis. The only way to know with certainty the cause of a particular illness is to treat that cause and see if the condition improves. In many circumstances therapies are tried primarily to advance the process of diagnosis. Some treatments are structured so that only a part of the treatment need be tried initially, for diagnostic purposes, with the rest completed if the initial results are positive. The second principle is that the range of therapies is determined by the range of therapy managers. Therapeutic options supported by a relative or neighbor of the patient are almost never rejected, even if the patient or other therapy managers disagree with the assessment or therapeutic theory. Because of this each individual whose illness continues over a period of time tends to be treated by a wide range of practitioners.