The Dimensions of Medical Rationality: A Problematic for the Psychosocial Study of Medicine

Abstract

Social anthropologists work to understand why people behave as they choose to behave and why types of behavior (e.g., medical behavior) are often remarkably different from society to society. Much of their thinking on this subject has been shaped by a set of premises that originated in the utilitarianism of Hobbes and Locke and is reflected today in the anthropologists’ discourse on the nature of rational man and the universality of ration-ally determined behavior (e.g., Barth 1966; Frankenberg, 1967; Prattis, 1973; Sahlins, 1976; Wilson, 1970). The first of the premises contends that in every society man is capable of calculating his interests. He is inclined to choose rationally among what he believes are his alternatives, and to set priorities on his different wants, placing self-preservation over the pursuit of physical pleasure, for example. Second, although rational choice presupposes coherent beliefs about the world, there are important differences between how populations perceive and appraise objects and events. These differences are determined by the particular cultures and experiences of the populations. Third, material (technoenvironmental) circumstances limit the kinds of alternatives from which people are able to choose. Finally, even after we take into account a population’s particular perceptions and circumstances, we are sometimes left with a residuum of behaviors that do not appear to be the product of calculation.