In all these aspects, and many others, scientific medicine and understandings and experiences of ill health and disease in western societies are inevitably and always underpinned by sociocultural meanings in ways that we don't always recognise.
Anthropologists and sociologists use the concept of the "lifeworld" to describe the everyday sociocultural context in which meaning is generated. In the case of lay people, this term refers to the understandings, concepts and beliefs they bring to the medical encounter. These are shaped not only by their encounters with doctors and other health-care professionals but also by such factors as personal experiences, interactions with others, information derived from the mass media and the internet, and membership of social class, gender or generational groups as well as racial or ethnic groups.
Same, same but different
Even within the western world, there are significant national differences in how scientific medicine is understood and practised. These differences can be particularly evident in controversies over medical innovation, such as human embryonic stem cell research.
Major differences between western countries are also apparent in health-care spending and statistics of drug prescriptions and medical techniques. A comparative study showed that the French tend to be less obsessed with germs and hygiene but are more focused on the health of their livers - and their doctors treat them accordingly.
Americans, on the other hand, are generally germ-aversive and favour "fighting" disease aggressively. Their doctors have a highly-technical "no-holds-barred" approach to testing for and treating disease. And US health-care costs are the highest in the world partly as a result of this.
Germans are influenced by a lingering Romanticism that considers "heart insufficiency" as a cause of illness, and are therefore high consumers of heart drugs.
For their part the British are stoic supporters of their nationalised medical system, the National Health Service (NHS). It may not offer many luxuries but at least provides care for all. Britons tend to be concerned about their bowel habits and the importance of "soldiering on" in the face of illness.
And Australians? A detailed study has yet to be undertaken of our health beliefs and practices. It would be fascinating to do such research taking into account the increasing cultural diversity within the Australian population.
As these comparisons show, culture-bound syndromes are not confined to non-western cultures. And we shouldn't assume that just because a medical system has science as its knowledge base that it is morally neutral or somehow immune to the influences of culture.
Just as the lifeworlds of patients need to be acknowledged, it's equally important to recognise that doctors and other health-care professionals bring their own cultural beliefs to the medical encounter. This is generated not only by their scientific training but also by other aspects of their own lifeworlds.
