Cassileth B R
Cancer Control Program, University of Pennsylvania Cancer Center, Philadelphia 19104.
Cancer. 1989 Apr 1;63(7):1247-50. doi: 10.1002/1097-0142(19890401)63:7<1247::aid-cncr2820630703>3.0.co;2-3.
Questionable or "unorthodox" treatments are not selected in a vacuum; their degree of popularity and the particular types used are functions of their social and cultural context. The liquid preparations that were popular earlier in this century reflected fascination with bottled medicinals, consistent with the growing era of pharmaceutical medicine. Today's questionable remedies are similarly consistent with their social and cultural context. "Metabolic" therapies emphasizing diet, self care, vitamins, and internal cleansing, along with "immune-enhancing" regimens, represent today's reigning "alternatives." Such approaches reflect underlying social trends and values, such as belief in assuming personal responsibility for one's health, the importance of self care and physical fitness, patients' rights movements, dietary emphases encouraged by conventional and alternative medicine alike, the holistic medicine movement, and general disaffection with organized medicine. Just as questionable therapies are born of the values and beliefs of their culture, so these treatments and their use affect the social environment in which they exist. The relationship is reciprocal and cyclic, with social trends encouraging particular forms of questionable regimens and these regimens, in turn, reinforcing prevailing social beliefs. Public beliefs about cancer were reflected in responses to our studies of unorthodox cancer therapies and of psychosocial correlates of survival. Responses revealed widely held values and beliefs about cancer, cancer treatment, and medicine generally. These themes are described.
有问题的或“非正统”的治疗方法并非在真空中被选择;它们的流行程度和所使用的具体类型是其社会和文化背景的产物。本世纪早些时候流行的液体制剂反映了对瓶装药物的迷恋,这与制药医学不断发展的时代相一致。如今有问题的疗法同样与其社会和文化背景相符。强调饮食、自我护理、维生素和内部清洁的“代谢”疗法,以及“增强免疫力”的养生法,代表了当今占主导地位的“替代疗法”。这些方法反映了潜在的社会趋势和价值观,比如相信个人对自身健康负责、自我护理和身体健康的重要性、患者权利运动、传统医学和替代医学都鼓励的饮食重点、整体医学运动,以及对有组织的医学的普遍不满。正如有问题的疗法源自其文化的价值观和信仰一样,这些疗法及其使用也会影响它们所处的社会环境。这种关系是相互的和循环的,社会趋势鼓励特定形式的有问题的养生法,而这些养生法反过来又强化了普遍的社会信仰。公众对癌症的看法反映在我们对非正统癌症疗法以及生存的社会心理相关因素的研究的回应中。回应揭示了关于癌症、癌症治疗和一般医学的广泛持有的价值观和信仰。这里描述了这些主题。