Laursen Sara Seerup, Dehlholm-Lambertsen Birgitte, Stenager Egon, Johannessen Helle
Department of Regional Health Research, Faculty of Health Sciences, University of Southern Denmark , Odense , Denmark.
Familiecentret, Hospital of Southern Jutland , Aabenraa , Jutland.
Anthropol Med. 2019 Aug;26(2):228-243. doi: 10.1080/13648470.2017.1361651. Epub 2017 Dec 6.
This paper explores the moral implications of treatment of young people with functional somatic symptoms. Based on an ethnographic field study at a Danish pain clinic for youngsters (age 8 to 18), the paper seeks to unearth the cultural, moral values that clinical practice steers by and upholds, and the implications this has for the assessment and management of ill body-selves. Through an exposition of the general practice of the clinic and an investigation of two specific cases of youngsters, it is found that the assessment of symptoms and selves and the goals of treatment are informed by cultural ideals of 'the good self' and 'the good life' in which and - both pertaining to the notion of individual responsibility - figure as prevalent virtues. The study underpins the findings of other researchers who have found that ideals of individual autonomy and responsibility for own life and health permeate the Western health care system and the discourses of ill individuals. The contribution of this article is to portray in ethnographic detail how such a cultural ethics manifests in practice and what implications this have for the treatment of young people with functional symptoms at a specific location and in specific cases. The two cases illustrate that the underlying norms and values can give rise to very different moral assessments of symptoms and selves within the same diagnostic category.
本文探讨了对患有功能性躯体症状的年轻人进行治疗所涉及的道德问题。基于对丹麦一家针对青少年(8至18岁)的疼痛诊所的人种学实地研究,本文旨在揭示临床实践所遵循和秉持的文化、道德价值观,以及这对病态身体自我的评估和管理所产生的影响。通过阐述该诊所的常规诊疗做法并调查两个青少年的具体病例,研究发现,症状和自我的评估以及治疗目标受到“良好自我”和“美好生活”等文化理想的影响,其中与个人责任概念相关的 和 被视为普遍的美德。该研究支持了其他研究人员的发现,即个人自主以及对自己生活和健康负责的理想贯穿于西方医疗保健系统以及患病个体的话语之中。本文的贡献在于以人种学的详细程度描绘了这种文化伦理在实践中的表现形式,以及这在特定地点和特定病例中对患有功能性症状的年轻人的治疗有何影响。这两个病例表明,潜在的规范和价值观可能导致在同一诊断类别中对症状和自我产生截然不同的道德评估。