Abstract

PIP: Medical ethics have usually been ignored in comparative studies of medical systems; they are almost exclusively Western and based on the technocratic culture of practitioners of cosmopolitan medicine. Important values of heterogeneous and homogeneous cultural systems may appropriately be studied in a medical context. Cross-cultural medical anthropological studies have not dealt extensively with medical ethics, and have not systematically examined the values involved in decision-making by healers, although the choices made by patients have been emphasized. Studies of decision-making in the context of healing can be useful in investigations of the operation of value systems and of conflicts and changes in such systems. Western examples of ethical conflicts and bases of choice in regulation of the profession, individual vs. social obligation, obligation of the practitioner to take action, allocation of scarce resources, and the patient's right to information suggest general problems that exist in most medical systems regardless of the level of technological development or the concepts of disease prevention and cure. Ethical conflicts in medical care allow study of value ranking in decision-making. Questionnaires have been the most common method for studying ethical questions in Western medical settings, and such questionnaires could be adapted for use cross-culturally. Medical ethics in non-Western settings may also be investigated by looking at "trouble cases," by participant observation, and by intensive interviewing.