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Philosophy of Culture Philosophy of Culture

Focus on Medicine as Culture Focus on Medicine as Culture
Definition Definition
Culture Culture ( (Latin Latin: : cultura cultura, lit. "cultivation") is a , lit. "cultivation") is a
term that has many different inter term that has many different inter- -related related
meanings. However, the word "culture" is most meanings. However, the word "culture" is most
commonly used in three basic senses: commonly used in three basic senses:
1. 1.Excellence of taste in the Excellence of taste in the fine arts fine arts and and humanities humanities, ,
also known as also known as high culture high culture. .
2. 2.An integrated pattern of human knowledge, belief, An integrated pattern of human knowledge, belief,
and behavior that depends upon the capacity for and behavior that depends upon the capacity for
symbolic thought and social learning. symbolic thought and social learning.
3. 3.The set of shared attitudes, values, goals, and The set of shared attitudes, values, goals, and
practices that characterizes an institution, practices that characterizes an institution,
organization, or group. organization, or group.
Definition Definition
The The etymology etymology of the modern term "culture" has a of the modern term "culture" has a
classical origin. In English, the word "culture" is based classical origin. In English, the word "culture" is based
on a term used by on a term used by Cicero Cicero, in his , in his Tusculan Disputations Tusculan Disputations, ,
wrote of a cultivation of the soul or wrote of a cultivation of the soul or "cultura animi" "cultura animi", ,
thereby using an agricultural metaphor to describe the thereby using an agricultural metaphor to describe the
development of a philosophical soul, which was development of a philosophical soul, which was
understood understood teleologically teleologically as the one natural highest as the one natural highest
possible ideal for human development. possible ideal for human development.
Samuel Pufendorf Samuel Pufendorf took over this metaphor in a modern took over this metaphor in a modern
context, meaning something similar, but no longer context, meaning something similar, but no longer
assuming that philosophy is man's natural perfection. His assuming that philosophy is man's natural perfection. His
use, and that of many writers after him "refers to all the use, and that of many writers after him "refers to all the
ways in which human beings overcome their original ways in which human beings overcome their original
barbarism, and through artifice, become fully human". barbarism, and through artifice, become fully human".
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Definition Definition
The German philosopher The German philosopher
Immanuel Kant Immanuel Kant (1724 (1724 1804) 1804)
formulated an individualist formulated an individualist
definition of "enlightenment" definition of "enlightenment"
similar to the concept of similar to the concept of bildung bildung: :
"Enlightenment is man's "Enlightenment is man's
emergence from his self emergence from his self- -incurred incurred
immaturity. immaturity. He argued that this He argued that this
immaturity comes not from a lack immaturity comes not from a lack
of understanding, but from a lack of understanding, but from a lack
of courage to think independently. of courage to think independently.
Against this intellectual cowardice, Against this intellectual cowardice,
Kant urged: Kant urged: Sapere aude Sapere aude, "Dare to , "Dare to
be wise!" be wise!"
Definition Definition
In reaction to Kant, German scholars such In reaction to Kant, German scholars such
as as Johann Gottfried Herder Johann Gottfried Herder (1744 (1744 1803) 1803)
argued that human creativity, which argued that human creativity, which
necessarily takes unpredictable and highly necessarily takes unpredictable and highly
diverse forms, is as important as human diverse forms, is as important as human
rationality. Moreover, Herder proposed a rationality. Moreover, Herder proposed a
collective form of collective form of bildung bildung: "For Herder, : "For Herder,
Bildung was the totality of experiences that Bildung was the totality of experiences that
provide a coherent identity, and sense of provide a coherent identity, and sense of
common destiny, to a people." common destiny, to a people."
Definition Definition
In 1795, the great linguist and philosopher In 1795, the great linguist and philosopher
Wilhelm von Humboldt Wilhelm von Humboldt (1767 (1767 1835) called for 1835) called for
an anthropology that would synthesize Kant's an anthropology that would synthesize Kant's
and Herder's interests. and Herder's interests.
It would be necessary for this purpose, It would be necessary for this purpose,
Humboldt thought, to accord a positive value to Humboldt thought, to accord a positive value to
human sensuality and give it a freer and more human sensuality and give it a freer and more
creative rein. Consequently, he rejected the creative rein. Consequently, he rejected the
traditional dualistic view of human nature with traditional dualistic view of human nature with
its mind/body dichotomy and the Cartesian its mind/body dichotomy and the Cartesian
notion of the human spirit as a kind of ghost in notion of the human spirit as a kind of ghost in
the machine. the machine.
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Definition Definition
Instead, he maintained, mind and body form a Instead, he maintained, mind and body form a
vital unity and what we call spirit ( vital unity and what we call spirit (Geist Geist) for him ) for him
was nothing but was nothing but the finest ramification of the finest ramification of
sensuality. sensuality. The path to self The path to self- -determination that determination that
Kant had demanded in his moral philosophy Kant had demanded in his moral philosophy
must therefore proceed through the cultivation must therefore proceed through the cultivation
of man's sensuality ( of man's sensuality (Sinnlichkeit Sinnlichkeit). ).
Hence the realm of aesthetics is granted a key Hence the realm of aesthetics is granted a key
function in any attempt to overcome the function in any attempt to overcome the
inherited mind/body dichotomy, in which inherited mind/body dichotomy, in which
Humboldt saw a major obstacle in the path of Humboldt saw a major obstacle in the path of
achieving individual self achieving individual self- -determination. determination.
Definition Definition
During the During the Romantic era Romantic era, scholars in , scholars in Germany Germany, especially , especially
those concerned with those concerned with nationalist nationalist movements movements such as such as
the nationalist struggle to create a "Germany" out of the nationalist struggle to create a "Germany" out of
diverse principalities, and the nationalist struggles by diverse principalities, and the nationalist struggles by
ethnic minorities against the ethnic minorities against the Austro Austro- -Hungarian Empire Hungarian Empire
developed a more inclusive notion of culture as developed a more inclusive notion of culture as
" "worldview worldview." According to this school of thought, each ." According to this school of thought, each
ethnic group has a distinct worldview that is ethnic group has a distinct worldview that is
incommensurable with the worldviews of other groups. incommensurable with the worldviews of other groups.
Although more inclusive than earlier views, this approach Although more inclusive than earlier views, this approach
to culture still allowed for distinctions between "civilized" to culture still allowed for distinctions between "civilized"
and "primitive" or "tribal" cultures. and "primitive" or "tribal" cultures.
Definition Definition
In 1860, In 1860, Adolf Bastian Adolf Bastian (1826 (1826 1905) argued for 1905) argued for
"the psychic unity of mankind". He proposed that a "the psychic unity of mankind". He proposed that a
scientific comparison of all human societies would scientific comparison of all human societies would
reveal that distinct worldviews consisted of the reveal that distinct worldviews consisted of the
same basic elements. same basic elements.
According to Bastian, all human societies share a According to Bastian, all human societies share a
set of "elementary ideas" ( set of "elementary ideas" (Elementargedanken Elementargedanken); );
different cultures, or different "folk ideas" different cultures, or different "folk ideas"
( (V V lkergedanken lkergedanken), are local modifications of the ), are local modifications of the
elementary ideas. This view paved the way for the elementary ideas. This view paved the way for the
modern understanding of culture. modern understanding of culture.
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Definition Definition
In the nineteenth century, humanists such as In the nineteenth century, humanists such as
English English poet and essayist poet and essayist Matthew Arnold Matthew Arnold
(1822 (1822 1888) used the word "culture" to refer to 1888) used the word "culture" to refer to
an ideal of individual human refinement, of "the an ideal of individual human refinement, of "the
best that has been thought and said in the best that has been thought and said in the
world. world. This concept of culture is comparable to This concept of culture is comparable to
the the German German concept of concept of bildung bildung: "...culture being : "...culture being
a pursuit of our total a pursuit of our total perfection perfection by means of by means of
getting to know, on all the matters which most getting to know, on all the matters which most
concern us, the best which has been thought concern us, the best which has been thought
and said in the world." and said in the world."
In practice, In practice, culture culture referred to an referred to an lite lite ideal and was ideal and was
associated with such activities as associated with such activities as art art, , classical music classical music, ,
ect. As these forms were associated with urban life, ect. As these forms were associated with urban life,
"culture" was identified with "civilization" (from lat. "culture" was identified with "civilization" (from lat.
civitas civitas, city). , city).
Another facet of the Another facet of the Romantic Romantic movement was an movement was an
interest in interest in folklore folklore, which led to identifying a "culture" , which led to identifying a "culture"
among non among non- -elites. This distinction is often characterized elites. This distinction is often characterized
as that between " as that between "high culture high culture", namely that of the ", namely that of the ruling ruling
social group social group, and " , and "low culture low culture." In other words, the idea ." In other words, the idea
of "culture" that developed in Europe during the 18th of "culture" that developed in Europe during the 18th
and early 19th centuries reflected inequalities within and early 19th centuries reflected inequalities within
European societies. European societies.
After reviewing the research on primate After reviewing the research on primate
culture, culture, W.C. McGrew W.C. McGrew concluded, "[a] concluded, "[a]
discipline requires subjects, and most discipline requires subjects, and most
species of nonhuman primates are species of nonhuman primates are
endangered by their human cousins. endangered by their human cousins.
Ultimately, whatever its merit, cultural Ultimately, whatever its merit, cultural
primatology must be committed to cultural primatology must be committed to cultural
survival [i.e. to the survival of primate survival [i.e. to the survival of primate
cultures]." cultures]."
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Definition Definition
Culture for McGrew is not a kind of knowledge. He Culture for McGrew is not a kind of knowledge. He
suggests that suggests that we view culture as a process we view culture as a process. .
He lists six steps in the process: He lists six steps in the process:
1. 1. A new pattern of behavior is invented, or an existing one is A new pattern of behavior is invented, or an existing one is
modified. modified.
2. 2. The innovator transmits this pattern to another. The innovator transmits this pattern to another.
3. 3. The form of the pattern is consistent within and across The form of the pattern is consistent within and across
performers, perhaps even in terms of recognizable stylistic performers, perhaps even in terms of recognizable stylistic
features. features.
4. 4. The one who acquires the pattern retains the ability to perform The one who acquires the pattern retains the ability to perform
it long after having acquired it. it long after having acquired it.
5. 5. The pattern spreads across social units in a population. These The pattern spreads across social units in a population. These
social units may be families, clans, troops, or bands. social units may be families, clans, troops, or bands.
6. 6. The pattern endures across generations. The pattern endures across generations.
Definition Definition
Perbandingan Perbandingan pengertian pengertian kebudayaan kebudayaan
tradisional tradisional dan dan postmodern. postmodern.
Click Click di di sini sini
Medicine as Cultures Medicine as Cultures
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Thelma Hyman is 90 years Thelma Hyman is 90 years
old, and she expects to old, and she expects to
be called Mrs. Hyman be called Mrs. Hyman
when she visits the when she visits the
doctor's office. But when doctor's office. But when
the black woman the black woman
recently visited the office recently visited the office
of a white physician, he of a white physician, he
called her Thelma. called her Thelma.
"I'm not sure I'm going "I'm not sure I'm going
back to him," says the back to him," says the
resident of Washington, resident of Washington,
D.C. "It's very important. D.C. "It's very important.
Everyone has their own Everyone has their own
feelings about how you feelings about how you
need to address them." need to address them."
Thelma Hyman, 90, of
Washington, D.C., who recently
was disappointed when a
physician referred to her by her
first name. Researchers are
studying cultural gaffes such as
this to see if they are affecting
health care disparities.
In 2005, New Jersey became the first state to In 2005, New Jersey became the first state to
require cultural require cultural- -competence education for competence education for
physicians to get licenses. California requires physicians to get licenses. California requires
continuing medical education for doctors to continuing medical education for doctors to
include cultural and linguistic competency include cultural and linguistic competency
training. training.
The federal government is financing studies The federal government is financing studies
examining whether the training can help health examining whether the training can help health
care workers get diverse groups to comply care workers get diverse groups to comply
better with doctors' orders. better with doctors' orders.
But no study has proven cultural competency But no study has proven cultural competency
training works, either by improving doctor training works, either by improving doctor- -
patient relationships, increasing patient patient relationships, increasing patient
compliance or reducing disparities. compliance or reducing disparities.
An example: An example:
doctors with Native American patients to "ask doctors with Native American patients to "ask
if patients may seek a healer or medicine if patients may seek a healer or medicine
man." It also recommends that doctors with man." It also recommends that doctors with
Latino patients break the ice by asking them Latino patients break the ice by asking them
their country of origin. their country of origin.
Indonesia: Indonesia: It is not allowed to go to the It is not allowed to go to the
doctor before one has finished doctor before one has finished Sasak Sasak belians belians. .
It is not allowed to mix them. It is not allowed to mix them.
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Culture Culture refers to integrated patterns of refers to integrated patterns of
human behavior that include the human behavior that include the
language, thoughts, communications, language, thoughts, communications,
actions, customs, beliefs, values, and actions, customs, beliefs, values, and
institutions of racial, ethnic, religious, or institutions of racial, ethnic, religious, or
social groups. social groups.
the professional culture of medicine can the professional culture of medicine can
be viewed as the language, thought be viewed as the language, thought
processes, styles of communication, processes, styles of communication,
customs, and beliefs that often customs, and beliefs that often
characterize the profession of medicine. characterize the profession of medicine.
This may be a difficult concept for This may be a difficult concept for
students to grasp initially because they students to grasp initially because they
may not view medicine as a culture or may not view medicine as a culture or
may view it as described by Taylor as the may view it as described by Taylor as the
culture of no culture. Culture or civilization culture of no culture. Culture or civilization
according to Edward Burnet according to Edward Burnet Tylor Tylor (2 (2
October 1832 October 1832 2 January 1917) : 2 January 1917) :
complex whole which includes knowledge, complex whole which includes knowledge,
belief, art, morals, law, custom, and any belief, art, morals, law, custom, and any
other capabilities and habits acquired by other capabilities and habits acquired by
man as a member of society. man as a member of society.
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Students may find difficulty in viewing medicine as a Students may find difficulty in viewing medicine as a
culture because the culture of medicine is not a topic culture because the culture of medicine is not a topic
that is formally discussed in medical school education. that is formally discussed in medical school education.
The culture of medicine is most often learned through The culture of medicine is most often learned through
the hidden curriculum and through role the hidden curriculum and through role- -modeling. modeling.
Although it is not a part of the formal curriculum, the Although it is not a part of the formal curriculum, the
hidden curriculum often dictates certain customs, rituals, hidden curriculum often dictates certain customs, rituals,
and rules of conduct thereby, defining the cultural milieu and rules of conduct thereby, defining the cultural milieu
of medicine. Incorporating topics that are usually part of of medicine. Incorporating topics that are usually part of
a hidden curriculum into a more formal discussion on a hidden curriculum into a more formal discussion on
cultural competence may help to overcome some of the cultural competence may help to overcome some of the
challenges we identified above and may also provide a challenges we identified above and may also provide a
framework for a formal discussion of the culture of the framework for a formal discussion of the culture of the
medical profession. medical profession.
Traditionally, when discussing medicine as a culture, the Traditionally, when discussing medicine as a culture, the
focus tends to be on reinforcing the virtues of medicine, focus tends to be on reinforcing the virtues of medicine,
such as honesty, empathy, altruism, honor, and respect. such as honesty, empathy, altruism, honor, and respect.
Although these attributes are the core of lectures on Although these attributes are the core of lectures on
professionalism in doctoring classes, they may be professionalism in doctoring classes, they may be
difficult for students who are just embarking on medical difficult for students who are just embarking on medical
training to grasp. Applying the professional culture of training to grasp. Applying the professional culture of
medicine as a framework for teaching about culture can medicine as a framework for teaching about culture can
highlight elements within the culture of medicine that highlight elements within the culture of medicine that
are more obvious and tangible to medical students who are more obvious and tangible to medical students who
are in the early stages of their education. Examples of are in the early stages of their education. Examples of
these elements include the white coat, a shared stylized these elements include the white coat, a shared stylized
dress code among physicians; dress code among physicians; doctor talk doctor talk, a shared , a shared
language or unique pattern of communication among language or unique pattern of communication among
physicians; and the physician explanatory model, a physicians; and the physician explanatory model, a
shared system of beliefs regarding health shared system of beliefs regarding health
The white coat is a symbol of the medical The white coat is a symbol of the medical
profession and other health professions that can profession and other health professions that can
be used as a tool in teaching about culture. be used as a tool in teaching about culture.
Traditionally, it symbolized sterility, science, and Traditionally, it symbolized sterility, science, and
healing, and it has now become a time healing, and it has now become a time- -honored honored
tradition among physicians. tradition among physicians.
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Studies have shown that wearing a white Studies have shown that wearing a white
coat is associated with patients' trust and coat is associated with patients' trust and
confidence in their physician as well as confidence in their physician as well as
their willingness to disclose personal their willingness to disclose personal
matters to their physicians. matters to their physicians.
One study found that doctors who wore One study found that doctors who wore
white coats were described by their white coats were described by their
patients as being more hygienic, patients as being more hygienic,
professional, authoritative, and scientific. professional, authoritative, and scientific.
The way in which physicians express The way in which physicians express
themselves verbally, themselves verbally, doctor talk doctor talk, is , is
another element of the culture of medicine another element of the culture of medicine
that is rarely taught explicitly. The lexicon that is rarely taught explicitly. The lexicon
of physicians is characterized by statistical of physicians is characterized by statistical
facts, presented in terms of probability, facts, presented in terms of probability,
gradations of severity, and the use of gradations of severity, and the use of
acronyms and medical terminology that is acronyms and medical terminology that is
often unfamiliar to the patient. often unfamiliar to the patient.
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The use of doctor talk can also impact the The use of doctor talk can also impact the
provider provider- -patient interaction. A number of studies patient interaction. A number of studies
have shown that medical terminologies that are have shown that medical terminologies that are
used by health care providers are often used by health care providers are often
misunderstood by patients. Pointing out the misunderstood by patients. Pointing out the
sometimes indiscriminate use of medical sometimes indiscriminate use of medical
terminology may help to reinforce the terminology may help to reinforce the
importance of linguistic competence and importance of linguistic competence and
communication skills to students. Linguistic communication skills to students. Linguistic
competency ensures that health information is competency ensures that health information is
communicated either verbally or in writing in a communicated either verbally or in writing in a
way that is understood by the patient. way that is understood by the patient.
Topics Topics
1. 1. Theoretical perspective on medicine and Theoretical perspective on medicine and
society. society.
2. 2. The body in medicine. The body in medicine.
3. 3. Representations of medicine, illness and Representations of medicine, illness and
disease in elite and popular culture. disease in elite and popular culture.
4. 4. The lay perspective on illness and disease. The lay perspective on illness and disease.
5. 5. Power relations and the medical encounter. Power relations and the medical encounter.
6. 6. Feminism and medicine Feminism and medicine