Eisenbruch M, Handelman L
Department of Child and Family Psychiatry, Royal Children's Hospital, Parkville, Australia.
Soc Sci Med. 1990;31(12):1295-9. doi: 10.1016/0277-9536(90)90068-4.
Although Western medicine helps people understand disease and death in scientific terms, patients often explain their illnesses very differently. The explanations held by patients and their families from 'foreign' cultures can be bewildering to the clinician. In treating immigrant patients, particularly those with terminal illness, it is essential to understand their own explanations. Clinically applied medical anthropology considers how the patient's culture shapes his understanding of disease. In an effort to apply an anthropological approach to the pediatric setting, a cultural consultation service was developed at the Royal Children's Hospital in Melbourne. This service involved a team which included a psychiatrist (with anthropological training), an anthropologist, and several Southeast Asian community members. One patient for whom the service consulted was an adolescent Cambodian boy with glioblastoma multiforme, stage IV. This case is analyzed in the light of the culturally determined problems in management and the culturally embedded meaning of the illness. The patient's belief in ancestral and house spirits as well as his belief in the Theravada Buddhist doctrine of karma is examined. The case demonstrates how belief in such religious phenomena does not necessarily preclude compliance with Western health care.
尽管西医帮助人们从科学角度理解疾病和死亡，但患者对自身疾病的解释往往大不相同。来自“外来”文化的患者及其家属所持的解释可能会让临床医生感到困惑。在治疗移民患者，尤其是那些患有绝症的患者时，了解他们自己的解释至关重要。临床应用医学人类学关注患者的文化如何塑造其对疾病的理解。为了将人类学方法应用于儿科环境，墨尔本皇家儿童医院设立了一项文化咨询服务。该服务团队包括一名接受过人类学培训的精神科医生、一名人类学家以及几名东南亚社区成员。该服务所咨询的一名患者是一名患有多形性胶质母细胞瘤四期的柬埔寨青少年男孩。本文根据管理中由文化决定的问题以及疾病中所蕴含的文化意义对该病例进行分析。探讨了患者对祖先和家神的信仰以及他对小乘佛教因果报应教义的信仰。该病例表明，对这类宗教现象的信仰不一定会妨碍患者接受西方医疗护理。
