Emerging Currents in Health and Medicine - A Socio-Cultural Critique of Their Discourses and Practices -

Abstract

We have witnessed several kinds of new discourses and practices in health and medicine since the 1970s, such as popular concerns with alternative or complementary medicine, inordinate attention to the promotion of 'healthy' living, rapid resurrection of traditional medicine and ecological management of health. Four structural and situational factors are discussed to underlie these new trends：(i) as 'crisis' in health care of the 1970s was translated into health care reform of the 1980s backed up by neo-liberal political philosophy, the state responsibility for nation's health is being transferred to the individual ；(ii) it resulted from the limits of biomedical paradigm in dealing with chronic diseases；(iii) medico-scientific knowledge of disease is transformed into the subjective discourses and technologies of health in postmodern society ； and (iv) it is deeply associated with the considerable increase in environmental risk perception of health and disease. There are some inherent countervailing forces in these new discourses and practices. First, while they derive from lifestyle-oriented behavioral change, medicalization of life and death is still consolidated in the new trends. Second, inasmuch as new tides are reliant upon science, they. are likely to be remote from techne that means not the practical application of theoretical knowing but a special form of practical knowing. Third, as new discourses and activities accomplished＇in the name of health＇increasingly occupy important strategies in forming the self-identity, they serve as moral apparatus which involves prescriptions about how we should live our lives and conduct our bodies, both individually and collectively. Therefore, two points are suggested to consider seriously whether these streams will succeed in improving the‘healthy’living of all the people. Instead of limiting tile perspective to medicine, healing and health care, a new matrix that interweave welfare, ecology and labor along with them is timely needed for enhancing the health for all. In addition, as the World Health Report fm strongly shows, inequality in health heavily depends upon socio-economic development of a society, and it is not the richest countries that have the best health status, but those that have the smallest income differences between rich and poor.