This positivist approach to medical studies is the historical research methodology of Western medicine. Western medicine has been used as an instrument of Imperialism, spreading the domination of a monopolistic form of health inquiry and the propagation of images of the European and the non-European (the Other).
The manner, in which, most diseases are studied draws on a strict positivist approach that fails to recognize the imperialistic framework that guides research. Western medicine believes that the key to changing health outcomes is to pinpoint the biological etiology of a disease. This method of research is useful for many infectious diseases. However, chronic diseases are multifactorial in nature and call on a multidisciplinary approach of investigation.
Imperialism with its patriarchical foundation cultivated Western medicine to value men as the standard human and women as the other. King (2002) argues that an ideology of Western medicine is the “emerging diseases worldview” that contrasts healthy (Western) and non-healthy (non-Western). This binary ideology supports boundaries between genders, races, classes, and nation states. Western medicine has historically operated with this imperialistic gaze and health delivery and health outcomes have, therefore, suffered for the individuals that are non-Western/marginalized/female in relation to the individuals that are Western/privileged/male.
In the United States, for example, African American mothers suffer poor maternal morbidity and mortality in general. In the Atlantic Slave Trade, Africans were forcefully brought to America between the seventeenth and nineteenth century. This commodification of humans stems from the imperialistic strategy of garnering economic gain from the other (non-European). The Atlantic Slave Trade created African Diaspora, a culture influenced by mass displacement, discontinuity with their native homeland, their culture, and their community. African Americans today face the struggle of coping with this legacy of imperialistic intrusion on their identity and history.
Western medicine continues to focus on pathophysiological processes of diseases and ignores contextual factors of patients' lives. Economic, social, historical, environmental, and psychological factors of patients' lives are de-emphasized. How has this history of displacement and discontinuity affected African Americans today? How has Western medicine, a historical tool of imperialism, affected health outcomes of African Americans today? These are questions that continue to go unanswered.
Western medicine continues to be an instrument of imperialism, propagating a form of health inquiry that sustains the historical order of healthy (Western/European/white/privileged) and non-healthy (non-Western, non-European/brown/marginalized). Health disparities persist nationally and globally due to the systematic persistence of disregarding broader contextual factors and power relationships of patients' lives. The embodiment of disease is more than a biological process. Simplifying disease to be independent of the power relations that sustain hierarchical divisions in race, class, and gender, helps Western medicine continue the use of imperialistic frameworks for health inquiry. Consequently, the marginalized will suffer poorer morbidity and mortality outcomes.
References
King, N.B. (2002). Security, disease, commerce: Ideologies of postcolonial global health. Social Studies of Science, 32, 763-789.
Wednesday, December 24, 2008
Tuesday, December 23, 2008
Corporatization of Health Care: A Quiet Linguistic Strategy
As an anti-capitalist, I am rightly sickened by Western medicine’s move from the terminology of “patient” centered care to “client” centered care. The concepts are both the same; care individually tailored to the patient/client’s needs. However, this is where semantics hold much weight. The change in terminology brings an array of ideals and connotations, and a support of the hegemonic power structure of capitalism, where the use of the word “client” reduces human beings to a means of gaining profit.
A client is a customer; someone who pays for goods or services. A patient is person who requires medical care. Persons, who require medical care, need medical care to prevent morbidity and mortality, regardless of their financial ability. A client can pay for the “goods or services” (health care), regardless if they actually need it to prevent morbidity and mortality. The use of “client” slyly inserts the importance of the monetary exchange between the health care seeker and the health care giver. “Patient” is a much too nebulous term to continue to use in Western medicine’s movement towards full corporatization of Western health care.
This movement is taking place quietly, creeping into our future health care professionals’ classrooms, in the hospitals we treat people, and most unfortunately, in the way some of us view health care as a privilege and not a right. It is through insipid inconspicuous tactics, like changing terminology, we are unwittingly influenced. Health care textbooks have been updated with newer editions that have been careful to use “client” instead of the outdated “patient”. As health care professionals, we begin to call the health care seekers our “clients”. We internalize that health care is only for those that can pay. The vows we took to do no harm and to help others have been discreetly replaced with the values of money and fiscal integrity. Before we know it, we believe that health care is a privilege for only those that can pay. We begin to attach human worth to economic value. In the end, it is those that cannot pay that need our help most of all.
This subtle linguistic change is a way to transform our thinking. We must be cognizant of the influence capitalism has on our health, our way of life, and our way of thinking. Remember: just because an idea is the most predominant and popular does not mean this idea is just. Human worth should never be reduced to monetary value. Commodity fetishism in the relations between the sick and the healers is offensive. Ultimately, the sick are objectified. The actual humanness of the patient in question are replaced with diagnoses, ICD-9 codes, and health insurance policies. The relations between human beings are transformed into economic exchanges.
This is not a world we want to live in.
Disconnect between humans, reduction of human beings into profit generators, and the demise of health care professionals into soulless money making profiteers are what we should fight against. We cannot let corporatization control how we practice medicine and how we care about our patients.
A client is a customer; someone who pays for goods or services. A patient is person who requires medical care. Persons, who require medical care, need medical care to prevent morbidity and mortality, regardless of their financial ability. A client can pay for the “goods or services” (health care), regardless if they actually need it to prevent morbidity and mortality. The use of “client” slyly inserts the importance of the monetary exchange between the health care seeker and the health care giver. “Patient” is a much too nebulous term to continue to use in Western medicine’s movement towards full corporatization of Western health care.
This movement is taking place quietly, creeping into our future health care professionals’ classrooms, in the hospitals we treat people, and most unfortunately, in the way some of us view health care as a privilege and not a right. It is through insipid inconspicuous tactics, like changing terminology, we are unwittingly influenced. Health care textbooks have been updated with newer editions that have been careful to use “client” instead of the outdated “patient”. As health care professionals, we begin to call the health care seekers our “clients”. We internalize that health care is only for those that can pay. The vows we took to do no harm and to help others have been discreetly replaced with the values of money and fiscal integrity. Before we know it, we believe that health care is a privilege for only those that can pay. We begin to attach human worth to economic value. In the end, it is those that cannot pay that need our help most of all.
This subtle linguistic change is a way to transform our thinking. We must be cognizant of the influence capitalism has on our health, our way of life, and our way of thinking. Remember: just because an idea is the most predominant and popular does not mean this idea is just. Human worth should never be reduced to monetary value. Commodity fetishism in the relations between the sick and the healers is offensive. Ultimately, the sick are objectified. The actual humanness of the patient in question are replaced with diagnoses, ICD-9 codes, and health insurance policies. The relations between human beings are transformed into economic exchanges.
This is not a world we want to live in.
Disconnect between humans, reduction of human beings into profit generators, and the demise of health care professionals into soulless money making profiteers are what we should fight against. We cannot let corporatization control how we practice medicine and how we care about our patients.
Subscribe to:
Comments (Atom)