Artikel

Rationaliteitsoverwegingen bij het gebruik van geneesmiddelen: de rol van culturele factoren

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Abstract

Rationality considerations about the use of medicines. The role of cultural factors - The suboptimal use of medicines is attributed to a lack of rationality. It is thereby assumed that there exists a standard that - given a certain state of science - is unproblematic and universally valid. However, there is evidence from anthropological investigations that the latter is not the case. Countries not only differ substantially in their use of medicines, they also have different views concerning the question of what is the qualitative and quantitative optimum. These differences are caused, among other things, by what we call implicit cultural assumptions (ICA’s), i.e. the culture-specific worldview and values, and by ideas about health, illness, nature, etc. As a consequence, deviations from the international standard of appropriate medicine use can not be reduced to irrational factors only. It is therefore suggested that the traditional view of the existence of one universally unquestioned standard is an oversimplification. If we want to make medicine use more efficient, it seems more appropriate to start from the actually existing normative pluralism. The above approach can be used to partly explain the important variation in the use of antibiotics in Europe. Of course, a great deal of that variation is due to incontestably irrational factors, e.g. lack of knowledge, biased information, etc., but a substantial part can be attributed to ICA’s. One example of an ICA that is likely to affect the demand for and prescription of antibiotics is the trust in nature versus the idea that we can/should control nature. The former leads to the inclination to intervene as little as possible, the latter to a preference ’to do something’. The culture-specific degree of individualism, short term thinking and epistemological issues like the adherence to a monocausal etiology, are only a few of the many other examples of cultural traits that are of influence. ICA’s can not be judged as rational or irrational in themselves. However, in the context of concrete situations, like the overuse of antibiotics, some of the ICA’s can be shown to influence negatively not only the use of antibiotics but also the judgement of its use, and so the concept of rationality. As a consequence, it is important to investigate how the various ICA’s affect the belief about the appropriate¬ ness of antibiotics. Because ICA’s are by definition implicit, they only come to light by means of comparative studies. Once we have established which ICA’s are dominant in a given country and how they are related to the use of antibiotics, the way is open to a higher degree of rationality.

How to Cite:

Deschepper, R., (1997) “Rationaliteitsoverwegingen bij het gebruik van geneesmiddelen: de rol van culturele factoren”, Tijdschrift voor Sociale Wetenschappen 42(1), 34–49. doi: https://doi.org/10.21825/tvsw.95258