Volume 73 Number 6 October 2006	back to contents

1Chair and Esther and Sidney Rabb Professor in the Department of Anthropology at Harvard University and Professor of Psychiatry and Medical Anthropology at Harvard Medical School, and 2Ph.D. candidate in medical anthropology in the Department of Anthropology at Harvard University.

Address all correspondence to Arthur Kleinman, M.D., Professor of Anthropology, William James Hall, Room 330, CBRSS, Harvard University, 33 Kirkland Street, Cambridge, MA 02138; email: kleinman@wjh.harvard.edu or pbenson@fas.harvard.edu

This work was adapted from an Alexander Richman Commemorative Lecture for Humanism and Ethics in Medicine at the Department of Medicine, Mount Sinai School of Medicine, New York, NY on September 28, 2004, and updated as of March 2006.

Abstract

No one can doubt any longer that culture is crucial to medicine. The evidence for health disparities across ethnic and racial groups as well as for cultural influences on health care practices is too impressive to overlook. Yet the concept of culture and how it is employed in medicine today is quite different from the way culture is now regarded in anthropology, the discipline that originated and popularized the concept. Rather than understand culture as a “timeless” ethnic stereotype applied to patients—which is a common but dangerous practice—physicians need to understand how culture influences doctors as much as patients. And physicians need to understand that culture is not only about differences in dress, etiquette and diet, but also and most profoundly, about what really matters to people. That is, culture is about the changing moral experiences of patients, families, and practitioners, and how those moral experiences powerfully affect the doctor-patient relationship. This article suggests that there is a moral crisis in today's medicine that reflects global cultural transitions. This crisis must be addressed if practitioners are to provide care at the highest moral and human level.

Key Words

Culture, moral experience, medicalization, anthropology, doctor-patient relationship.

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