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Differences Between Non-Biomedical Forms of Knowing and Biomedical Forms of Knowing

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https://ysjournal.com/differences-between-non-biomedical-forms-of-knowing-and-biomedical-forms-of-knowing/Biomedical evidence informs Western ways of knowing in medicine and research. In other words, it is how we know when someone is sick (e.g., a person’s body temperature above 100.4 degrees Farhenheit informs us that they have a fever1), when two variables are positively correlated (e.g., a Pearson’s coefficient of close to 1.0 informs us that a relationship may exist between two variables2), and when treatment is successful (e.g., a significant improvement in a patient’s lab results inform us that they got better). Biomedical forms of knowing (i.e., how a concept related to biomedicine is understood) are based on biomedical evidence and Western ways of learning. For example, doctors learn about medicine by going to medical school, dissecting cadavers, and studying textbooks. Non-biomedical forms of knowing (i.e., how a concept not related to biomedicine is understood) can be based on cultural traditions, family teaching, and intuition. It is important to understand that biomedical forms of knowing are not the only guides to healing practices and that the absence of biomedical forms of knowing does not delegitimize another culture’s medicine. In other words, non-biomedical forms of knowing may be just as valid as biomedical forms of knowing. This is an important idea in clinical settings because healthcare workers may interact with patients of diverse cultural backgrounds and should be culturally competent, which means able to care for people with different languages and cultures.3 Due to the fact that awareness of varying experiences of different ethnic populations improves the efficacy of helping professionals,4 understanding the value of traditional medicines may help clinical providers treat their patients. Knowing how traditional medicine can affect behaviour and cognition, which can be similar in the way that culture can affect behaviour and cognition,5,6 may help clinical providers develop the most suitable care for individual patients.

Hot-cold classification, Chinese views of the body, and bonesetting are non-biomedical forms of knowing. Hot-cold classification categorizes food and medicine on a spectrum from “hot” to “cold” mainly based on their effects to inform food consumption and illness treatment.7 Chinese traditional views of the body are based on ideas that the body is porous and that its internal environment is constantly interacting with the external environment.8 Bonesetting is a practice in which providers use their hands to physically manipulate patients and treat bone injuries.9 Even though these non-biomedical forms of knowing are not standardized or regulated, they are still valid healing practices important to their cultures and thus should be respected by healthcare professionals. This is important to maintain cultural competence and care for patients.

Provider treatment is variable within non-biomedical forms of knowing, but healthcare professionals should still respect traditional medicines. Hot-cold classifications are modified slightly as characterization methods are passed on and continually constructed with personal influences from new observations and experiences.7 Bonesetting develops individually from the unique injury that started their profession, hands-on training from different patients, and tacit knowledge that informs their clinical practice.10,9 These non-biomedical healing practices are not standardized, which contrasts with biomedical ways of knowing that typically produce similar treatment recommendations even if a patient goes to different providers. For example, if a child has a fever, the western response would be to give the child nonsteroidal anti-inflammatory drugs (NSAIDs) or acetylsalicylic acid (ASA). The response from hot-cold classification may include NSAIDs and ASA, but they can also include different foods with “cold” properties, depending on the one that the user would think is best. If someone had a fractured ulna, the biomedical response would be to give an x-ray, perform surgery, and install a cast. The bonesetting response would vary; one may use manipulation, creams, and wrapping techniques different from what another from the same community would use. Even though traditional healing practices are different from modern medicine, healthcare professionals should implement cultural competence and acknowledge those practices respectfully when treating patients whose cultures value them.

Non-biomedical forms of knowing are not regulated, but they should be respected as they inform valuable healing practices. Unlike biomedical forms of knowing, bonesetting, hot-cold classification, and Chinese views of the body focus mainly on symptoms rather than signs. They do not utilize tests (e.g., x-rays, labs, surveys) that would provide data to guide treatment, record in charts, or report to a regulatory institution. They are still important because the absence of signs allows for everyone to be treated. This is different from biomedicine, which defines diseases based on sets of signs and may produce medical orphans (i.e., people with symptoms that do not fit within any disease label).11 As non-biomedical forms of knowing allow for treatment of everyone with symptoms, they are especially valuable to their cultures. Even though they are not regulated, they should be respected by healthcare professionals for the maintenance of cultural competence.

Non-biomedical forms of knowing contrast with biomedical forms of knowing by lacking standardization and regulation. It is important to understand that they are not better or worse than non-biomedical forms of knowing. They are simply different ways of informing different styles of medicine. These notions are important to hold in clinical settings because patient populations are diverse and cultural competence helps with treatment and patient care.

Bibliography

[1] Potter, Patricia, Anne Perry, Patricia Stockert, and Amy Hall. Fundamentals of Nursing, 8th Edition. Missouri: Mosby, 2012.

[2] Saconi, Bruno. “Correlation and Regression.” Lecture presented at NURS230, Philadelphia, PA, September 2019.

[3] Seeleman, Conny, Jeanine Suurmond, and Karien Stronks. “Cultural competence: a conceptual framework for teaching and learning.” Medical education 43, no. 3 (2009): 229-237.

[4] Chan, Sam. “Families with Asian Roots.” Developing Cross-Cultural Competence: A Guide for Working with Young Children and Their Families. Baltimore: Paul H. Brookes, 1992.

[5] Kathryn Murphy. “The importance of cultural competence.” Nurs. Incredibly Easy 9, no. 2 (2011): 5.

[6] Fang, Shi-Ruei S., and Linda Wark. “Developing cross-cultural competence with traditional Chinese Americans in family therapy: Background information and the initial therapeutic contact.” Contemporary Family Therapy 20, no. 1 (1998): 59-77.

[7] Messer, Ellen. “Hot-cold classification: theoretical and practical implications of a Mexican study.” Social Science & Medicine. Part B: Medical Anthropology 15, no. 2 (1981): 133-145.

[8] Kuriyama, Shigehisa. “The Imagination of the Body and the History of Embodied Experience: The Case of Chinese Views of the Viscera.” Kyoto: International Research Center for Japanese Studies (2001): 17-29.

[9] Hinojosa, Servando Z. “”The hands know”: Bodily engagement and medical impasse in highland Maya bonesetting.” Medical Anthropology Quarterly 16, no. 1 (2002): 22-40.

[10] Mukharji, Profit Bijari. “Manual Medicine.” Lecture presented at HSOC145, Philadelphia, PA, October 2019.

[11] Aronowitz, Robert A. “When do symptoms become a disease?.” Annals of internal medicine 134, no. 9_Part_2 (2001): 803-808.

About the author

Clare-Mangubats-Profile-PictureClare Jocelyn Mangubat is a nursing student at the University of Pennsylvania. She is currently involved in a research study as a Study Assessor, a pilot study as a Co-Investigator, a research journal as an Associate Editor, and a psychology clinical program as a Senior Group Leader. She plans on getting her Master’s in Nursing to be a Psychiatric-Mental Health Nurse Practitioner.