Published 2022-03-04
Keywords
- Doctor-patient relationship, clinical act, narrative, reflective ethnography.
How to Cite
Abstract
In this work I analyze the way in which medical sociology and anthropology have studied the doctor-patient relationship; as a result of the said study, I propose another analytical route which, taking into account the social actor and the narrative as a form of thought, sensitivity, discourse and cultural praxis, approaches this relationship as a clinical act that reveals contexts of action and interaction in which verbal and non-verbal exchanges take place. Thus, the clinical act is a substantially narrative social fact, given that exchanges between different social actors are generated by producing complex narratives with plots that reveal them as narrators of a situation in tension.
From a reflective and relational ethnography perspective, in a tertiary care center located in Mexico City, I present a description and analysis that reveals narrative plots that show how medical interaction interrupts, blurs and silences the patient’s voice for the sake of his biomedical translation.
Downloads
References
- Atkinson, Paul. 1995 Medical talk and medical work: The liturgy of the clinic. Sage. Londres. 1997 Narrative turn or blind alley? Qualitative Health Research, 7: 325-344.
- Atkinson, Paul y David Silverman. 1997 Kundera’s ‘Immortality’: The Interview Society and the Invention of Self. Qualitative Inquiry, 33: 304-325.
- Berkenkotter Carol. 2008 Patient tales. Case histories and the use of narratives in psychiatry. University of South Carolina Press. Columbia, South Carolina.
- Bruner Jerome S.. 1986 Actual minds, possible worlds. Harvard University Press. Cambridge, MA.
- Acts of meaning. Harvard University Press. Cambridge, MA.
- Clark Jack A. y Elliot G. Mishler. 1992 Attending to patients’ stories: reframing the clinical task. Sociology of Health & Illness, 14 (3): 344-372.
- DelVecchio Good, Mary-Jo y Byron J. Good. 2000 Clinical narratives and the study of contemporary doctor-patient relationships, en Social Studies in Health & Medicine, G. L. Albrecht, R. Fitzpatrick y S. C. Scrimshaw (eds). Sage Publications. Londres: 243-258.
- Eisenberg, Leon. 1977 Disease and illness: Distinctions between professional and popular ideas of sickness. Culture, Medicine and Psychiatry, 1 (1): 9-23.
- Fabrega, Horacio y D. B. Silver. 1973 Illness and shamanistic curing in Zinacantan: An ethnomedical analysis. Stanford University Press. California.
- Frank, Arthur W.. 1995 The wounded storyteller: Body, illness, and ethics. University of Chicago Press. Chicago. 2000 The Standpoint of Storyteller. Qualitative Health Research, 10 (3), May: 354-365.
- Freidson, Eliot. 1970 La Profesión Médica. Un Estudio de Sociología del Conocimiento Aplicado. Ed. Peninsula. Barcelona.
- Goffman Erving. 1983 The interaction order: American Sociological Review, 48 (1): 1-17.
- Good, Byron. 1994 Medicine, rationality, and experience. Cambridge University Press. Cambridge.
- Hahn, Robert y A. Kleinman. 1983 Belief as pathogen, belief as medicine: “Voodoo death” and the “placebo phenomenon” in Anthropological perspective. Medical Anthropology Quarterly, 144 (3): 16-19.
- Hamui, Liz y Josefina Ramírez. s/f Etnografía clínica y narrativas. Dimensión Antropológica. Volumen 81: 1-25. En prensa.
- Helman, Cecil G. 1981 Disease versus illness in general practice. The Journal of the Royal College of General Practitioners, 31 (230): 548-552.
- Kirmayer, Laurence. 2001 Broken narratives: clinical encounters and the poetics of illness experience, en Narrative and the cultural construction of illness and healing, C. Mattingly y L. Garro (eds). University of California Press. Berkeley: 153-180.
- Beyond the ‘new cross-cultural psychiatry’: cultural biology, discursive psychology and the ironies of globalization. transcult psychiatry, 431: 126-144.
- Kleinman, Arthur. 1980 Patients and healers in the context of culture: An exploration of the borderland between Anthropology, Medicine, and Psychiatry. University of California Press. Berkeley. 1988 The illness narratives: suffering, healing, and the human condition. Basic Books. Nueva York. 1999 Experience and its Moral modes: culture, human conditions, and disorder, en The Tanner Lectures on Human Values, G. B. Peterson (ed), vol 20. University of Utah Press. Salt Lake City: 357-420.
- Kleinman, Arthur y Byron Good. 1985 Culture and Depression. University of California Press. California.
- Kleinman, Arthur y Joan Kleinman. 1991 Suffering and Its Professional Transformation: Towards an Ethnography of Interpersonal Experience. Culture, Medicine, and Psychiatry, 153: 275-301.
- Kleinman Arthur, Leon Eisenberg, Byron Good. 2006 Culture, illness, and care: clinical lessons from Anthropologic and crosscultural research. Focus the journal of lifelong learning in psychiatry. Winter, IV (1-140-149).
- Lindenbaum Shirley y Margaret M. Lock. 1993 Knowledge, Power and Practice: The Anthropology of Medicine and Everyday Life. University of California Press. Berkeley.
- Martínez-Hernáez Ángel. 2018 Síntomas y pequeños mundos. Un ensayo antropológico sobre el saber psiquiátrico y las aflicciones humanas. Barcelona Anthropos Editorial, UAM-I. México.
- Martínez-Hernáez Àngel, Lina Masana y Susan M. DiGiacomo. 2013 Evidencias y narrativas en la atención sanitaria. Una perspectiva antropológica. Publicacions URV Tarragona, Porto Alegre Rio Grande do Sul-Brasil.
- Mattingly, Cheril. 1998 Healing dramas and clinical plots: The narrative structure of experience. Cambridge University Press. Cambridge.
- Mechanic, David. 1976 The growth of bureaucratic medicine: An inquiry into the dynamics of patient behavior and the organization of medical care. John Wiley and Sons. New York.
- Menéndez, Eduardo. 1983 Hacia una práctica médica alternativa. Hegemonía y autoatención gestión en salud. Casa Chata, CIESAS. México. 1990 Antropología médica. Orientaciones, desigualdades y transacciones. Cuadernos de la Casa Chata, Cuaderno 179. México.
- Mishler, Elliot. 1984 The Discourse of Medicine: Dialectics of Medical Interviews. ablex. Norwood, Nueva Jersey.
- Parsons, Talcot. 1951 The social system. Routledge and Kegan Paul. London.
- Ramírez, Josefina. 2016a Algunas consideraciones sobre la narrativa como metodología idónea para el estudio del proceso salud/enfermedad/atención. Revista CONAMED, 21 (2): 66-70. 2016b Las emociones como categoría analítica en antropología. Un reto epistemológico, metodológico y personal, en Cartografías emocionales. Las tramas de la teoría y la praxis, Oliva López y Rocío Enríquez (coords.). Facultad de Estudios Superiores Iztacala UNAM-ITESO. México: 97-126. s/fa Etnografía del ritual clínico como espacio fronterizo. Dimensión Antropológica. Volumen 81: 1-23. En prensa. s/fb Una reflexión epistemológica para la construcción del cuerpo sentipensante: la búsqueda del cuerpo perdido. Corpo Grafías. Estudios críticos de y desde los cuerpos 8 (8): 1-26. En prensa.
- Singer, Merrill. 1987 Cure, care and control: an ectopic encounter with biomedical obstetrics, en In Cure Studies in Medical Anthropology, Baer H. (ed.). Gordon & Breach. Nueva York: 249-65. 1989 The Coming of Age of Critical Medical Anthropology. Social Science and Medicine, 2811: 1193-1203.
- Taussig Michel. 1980 Reification and the consciousness of the patient. Sot. Sci. Med., 14B: 3-14.
- Waitzkin, Howard. 1989 A critical theory of medical discourse: ideology, social control, and the processing of social context in medical encounters. Journal of health and social behaviour, 302: 220-239.
- Wind Guittle. 2008 Negotiated interactive observation: Doing fieldwork in hospital settings. Anthropology & Medicine, 15 (2): 79-89.
- Young, Allan. 1980 The discourse on stress and the reproduction of conventional knowledge. Sot. Sci. Med., 14B: 133-146. 1982 The Anthropology of Illness and Sickness. Ann. Review of Anthropology, 11: 257-285.