MEDICAL CHOICE RESEARCH METHODOLOGY IN LINDA GARRO’S COGNITIVE MEDICAL ANTHROPOLOGY

Abstract

Medical choice is a quite natural subject for medical anthropology as the latter has discovered and described the phenomenon of medical pluralism. The article elaborates on the medical pluralism studying methods proposed by modern cognitive medical anthropology via one of its most outstanding representatives, Linda Garro. This sphere of medical anthropology focuses on the individual choice of health systems or practices. Linda Garro’s books and articles include both results of empirical studies of medical choice and a profound reflection on its cognition principles. The article analyses the collection of works «The Ethnography of Health Care Decisions» (Social Science & Medicine, Volume 16, Issue 16, 1982) where Garro acted as collector, editor and author, and her book «Medical Choice in a Mexican Village» (1994) co-authored with Young. In the book Garro and Young introduce such notions as the «study of medical choice», «decision-making approach», «model treatment decision making» and explain the medical decision making in a Mexican community Pichátaro based on the anthropologists’ empirical studies.

The article pays particular attention to the analysis of Garro’s methodologic work «On the Rationality of Decision-Making Studies» (1998) which explains the basic principles of cognitive medical anthropology, its subject matter and goals and contains detailed arguments of cognitive medical anthropologists’ opponents with responses to them. The study focuses on such problems as the freedom of choice and how it is influenced by the social background, the correlation of action and belief, the difference between normative and descriptive approaches to rationality, inter-influence of culture and personal experience in decision making, methods used by anthropologists to reduce «post hoc rationalization». One of Garro’s key ideas is linked with the concept of «divergent rationality» which allows variability in decision making, different ways of applying culturally available schemes by people in case of illness. Linda Garro uses it to support the methodological options provided by medical choice model in case of chronic conditions which were the subject of Garro’s research in a Canadian community. The article also talks about narrativist concept of illness and treatment which, according to Garro, is a logical follow-up of the medical choice topic.

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