Running Head: MEDICAL ANTHROPOLOGY 1
MEDICAL ANTHROPOLOGY 9
Clinical gaze Comment by Adam Johnson: You are missing an introduction paragraph that introduces the themes you are going to explore in the paper
According to Claire Wendland, the medical gaze was constructed in such a manner that it established a norm for all aspects of the medical profession, including those who operate there. The medical gaze has eroded the doctor-patient bond. Doctors encounter so many cases over the course of a single day that they may identify a patient solely through their examination reports. The detrimental effect of the formal doctor-patient relationship is the ever-shrinking time gap between appointments to see a patient. These brief appointments train the doctor to see the patient as a computer in need of repair rather than as a subject deserving of special attention and sympathy, especially when confronted with a medical problem. Comment by Adam Johnson: Cite
Claire also stated that the medical gaze established limits for what is deemed "natural" for the human body, which may erode the doctor-patient partnership further. When physicians encounter people that have a medical problem, they are known to be outside of this "usual" spectrum, and it is up to the doctors to restore them to a normal condition. While these rules on what is "natural" may be reassuring and assist us in deciding whether we are experiencing a health problem, there are numerous cases in which people's bodily activities fall outside of this normal range but are nevertheless stable. Doctors are so fixated with this sense of normalcy that they often overlook the reality that individual bodies behave somewhat differently. Intersex and gender assignment are two contentious issues. Infants born with unclear genitalia are easily allocated a gender that "makes the genitalia and physical expression seem the most natural." These newborns, who lack the ability to talk for themselves, undergo invasive surgeries because their bodies do not ideally fall into the female or male categories. Unfortunately, this medicalization of the body has encroached on the whole of society, causing all, not just physicians, to see the environment through a slightly medicalized lens. When the mass of culture considers the body in this manner, it becomes increasingly impossible to alter what is "natural" and, thereby, change the expectations of health practitioners. Comment by Devin Flaherty: The appropriate way to refer to an author is by their last name. In this case "Wendland" and with the year of publication after her name, in parentheses. Comment by Devin Flaherty: You need to cite. We don't know where this quote is coming from.
Therefore, upon asking the questions to the interviewee whether he feels patients when they enquire about his origin. The interviewee replied that I usually do not take their comments to heart. When the patients know that the interviewee belongs to Syria, they are very inappropriate questions (32, 33 from interview). But as a medical clinician, the interviewee takes them as a joke so that the patient can feel easiness around him. It is necessary to make the patients realize that the caregiver or medical practitioner is their well-wisher. Comment by Devin Flaherty: Not sure what this means. Re-consider wording. Comment by Devin Flaherty: It is very unclear how this anecdote refers to the discussion of the clinical gaze that you have above.
Foucault stated that medicine is considered the official language communicated in Healthcare centers among patients and practitioners. Therefore, giving utmost care to the patients lies on doctors because they are considered authoritative individuals who have the authority to take care of the patients in all conditions (Gardner, 2017). At the same time, the patients are considered individuals who need help to make them better. Therefore, to deliver high-quality healthcare, especially in medical institutes and organizations, it is necessary to suggest and develop appropriate systems that can ensure reliable and long-lasting healthcare treatment. Comment by Devin Flaherty: Bringing in this text is not helping you respond to the prompt. Comment by Devin Flaherty: How does this relate to the clinical gaze as discussed in Wendland or in your transcript
Biomedicine as being shaped by local culture/values
According to Carol Maccormack and Alizon Draper, biomedical anthropologists use Biomedicine to refer to the tradition of empirical, biologically based methods of diagnosis and treatment. Biomedicine is a relatively new field of study that is highly advanced and often incredibly effective at treating disease. Historically referred to as allopathic medicine, biomedicine's expertise and technologies have advanced at a breakneck rate, along with the reputation and professionalization of biomedical practitioners and international, cosmopolitan, dominant, and hegemonic are the characteristics of the scientific medical method. It is not devoid of history. Additionally, there are substantial and interesting gaps in the practice of biomedicine, especially between European and American countries. Comment by Adam Johnson: Cite
According to the culture, a diverse medicine practice has its roots in the traditional medication system. With every culture, there is a variation regarding the practices of medicine. In western culture, biomedicine is most commonly practiced, but it also has its moves lying with traditional medicine. In contrast, medical pluralism provides us with various options regarding treatment which include traditional and modern treatments so that people can use them. Because of variations, different cultures have different views of medication, diseases, and healing, varying from traditional western culture.
Traditional healers have the ability to incorporate culture during the treatment of the patient. Culture plays an unimportant role in the management of any illness. Most patients feel comfortable when they are created according to their cultural preferences. They do not feel comfortable if the medical practices deviate from their cultural aspects; because of these reasons, culture is regarded as of prime importance so that the outcomes of the treatment can be enhanced. The satisfaction of the patient is also an important element that can be achieved through the administration of medicines according to their culture and tradition. Cultural worldview informs how people view health beliefs and practices. For instance, expression of pain, the Cuban culture is different because it is a male-dominated community. A woman in childbirth appears to be a victim and, at the same time, a hero to the husband. These characteristics compare to biomedicine healers because they all aim to enhance healthcare outcomes. Doctors and nurses practice incorporating culture in the patient's treatment to improve the outcomes. They also strive to create a pleasant environment where patients can effectively share their treatment preferences and health history.
In traditional medicine, healing entails the integration of medicine and religion. There is an excellent connection between spirituality. The healers make use of aspects of spirituality to heal through songs, chants, and dance. On the other hand, biomedicine healers use direct forms of healing such as massage and energy work. The similarity between traditional healers and biomedicine healers is that they aim to treat a patient and manage illness to enhance health outcomes. The current world is dominated by biomedicine, but culture still plays a vital part in improving patient satisfaction and health outcomes.
Culture is an important element in an individual's life. When I asked the interviewee about cultural aspects, he stated that there are certain types of stereotypes in patients' minds. But it is your job to take care of everyone. Whatever the circumstances are, it is your duty and job to take care of the patients. As there is no need to be disturbed by their questions, there is a lack of interest in your treatment. A medical practitioner has to make sure that he or she is giving optimum treatment to the patient irrespective of their belonging to the culture or race (36, 43 from interview). It is not their intention but the creation of teacher types against medical practitioners, which made them doubtful of medical healthcare.
Biomedicine also alludes that as seen through the lens of a cultural system, biomedicine becomes one of several ethno medicines. Both ethno medicines are based on cultural presuppositions and principles, are accompanied by codes of ethics, and are situated within a broader framework. Culture perception is critical in biomedicine. Cultural maturity is a trend in modern health care clinical education. Cultural competence aims to increase health providers' knowledge about and sensitivity to their patients' cultural views and values. This is particularly true for patients who are members of minority communities or religious minorities (Kleinman & Hanna, 2008). Cultural material is often interpreted in a rigid and unchanging way. This will result in assumptions of how specific patients are supposed to act. It makes little allowance for the adaptability of shifting circumstances. Cultural maturity or cultural modesty may recognize that societies constantly change as a result of factors such as societal transition, power, war, and migration. Comment by Adam Johnson: For each theme, you should cite course material (which you do) and direct quotes from your interview
Diabetes is a multifaceted and complex disease that is linked to substantial emotional suffering. The connection between type 2 diabetes occurrences and emotional distress is a major issue, particularly among the Latino group in the United States (Concha, Mezuk & Duran, 2015). Bearing in mind diabetes continues to be a severe burden both emotionally and in terms of health among the group appropriate health care approach can be considered. One of the approaches considered in addressing diabetes care among the group is the culture-centered approach to ensure communication and receiving of information are effective. Culture-centered is the most effective approach among Latinos with diabetes due to their ancient culture-centered belief, which states that negative or strong emotions may cause diabetes (Concha, Mezuk & Duran, 2015). The belief is called Susto, and it can also be regarded as fright sickness. Most Latino continues to hold the belief, and their cultural emotions are assumed to being an essential part of diabetes; and one vital communication approaches the medical clinicians considers is asking Latino about their emotional health, their beliefs on diabetes, and how it affects their diabetes management (Concha, Mezuk, & Duran, 2015). The most commonly used plants used by this group for diabetes management include gum Arabic and fenugreek, and they are considered due to their effect on blood glucose in a patient's body.
In discussing the management of diabetes from multiple cultural contexts, various cultural considerations for multiple ethnic groups will be discussed; the groups include Middle Eastern, Hispanic, and Indian American. In the Middle Eastern context, there are several risk factors, practices, and beliefs which influence diabetes care (Alibeji & Stewart, 2017). On the issue of risk factors, obesity is the main risk factor for diabetes among the Middle Eastern. Obesity as a healthcare concern is due to the consumption of food rich in carbohydrates and saturated fats, besides socioeconomic development leading to a more sedentary lifestyle. For this group, diabetes care practices are influenced by traditional medicines (Alibeji & Stewart, 2017). Despite the major progress in modern medicine, Middle East culture still considers the use of herbal medicine in treating diabetes. Similar to other cultures, they lack faith in modern medicine, and hence they consider traditional medicine such as oily foods and bitter vegetables in restoring their health.
Hispanic is another cultural group in which cultural consideration can be discussed. While examining the Hispanic population with diabetes, there is a clear correlation between the disease's prevalence and assimilation into the United States mainstream culture. By adopting beliefs, behavior, and culture, the group has adopted the American lifestyle of consuming a huge quantity of calories and low physical activities hence the high incidences of obesity (Alibeji & Stewart, 2017). Besides physical inactivity and diet, other factors causing healthcare disparities for the group include lower education and socioeconomic levels. Due to traditional values, Hispanics put the needs of the family before their own medical needs. Furthermore, they prefer traditional medicine over professional medicine due to certain misconceptions, such as insulin causes blindness. Traditional medicine includes the use of herbs and folk healing.
In cultural consideration for the American Indians patients, the high diabetes rate among the population can be linked to environmental and behavior factors, which play a major role compared to genetics. The high obesity rate can be linked to shifting away from traditional food to more caloric consumption (Alibeji & Stewart, 2017). The consumption habit is also influenced by the limited finances, the absence of adequate transportation, and access to grocery stores. Such factors have resulted in the group shifting to a modern diet, considering it is cheap and readily available.
I had a chance to work at a different Hospital where people belonging to different backgrounds came. It is fascinating to observe that people in different circumstances grow differently. They have the ability to look at the situation from various different angles and in different scenarios. It was a great experience to observe people from different populations and cultures (118 from the interview). This helpful experience can enable me to deal with different challenges that come in the life of a medical practitioner while dealing with avoid array of people. But there is a need to discuss cultural management of the disease where the issue addressed is cultural considerations in diabetes management for various ethnic groups (Garro, 1995). Comment by Adam Johnson: You should include a conclusion apragraph that reminds the reader of the themes and bring together you overall paper topic
Alibeji, I., & Stewart, A. (2017). Cultural Consideration in Diabetes Management [Abstract]. Cultural Considerations in Diabetes Management, 41-53. Retrieved March 26, 2018, from http://www.ncpa.co/issues/APNOV16-CE.pdf
Concha, J. B., Mezuk, B., & Duran, B. (2015). Culture-centered approaches: the relevance of assessing emotional health for Latinos with type 2 diabetes. BMJ Open Diabetes Research and Care, 3(1), e000064.
Gardner, J. (2017). Patient-centred medicine and the broad clinical gaze: Measuring outcomes in paediatric deep brain stimulation. BioSocieties, 12(2), 239-256.
Garro, L. C. (1995). Individual or societal responsibility? Explanations of diabetes in an Anishinaabe (Ojibway) community. Social Science & Medicine, 40(1), 37-46.
Kleinman, A., & Hanna, B. (2008). Catastrophe, caregiving and today's biomedicine. Biosocieties, 3(3), 287-301.