Self-Medication and Society by Sylvie Fainzang

Author:Sylvie Fainzang [Fainzang, Sylvie]
Language: eng
Format: epub
Tags: Social Science, General, Sociology
ISBN: 9781315447148
Google: QDFuDQAAQBAJ
Publisher: Routledge
Published: 2016-11-03T04:30:44+00:00

4Knowledge and competence

One of the terms of the debate that rages about self-medication is the competence (Hunter, 2010) of the users, or rather what the health professionals believe to be their incompetence, which mirrors the distrust subjects sometimes feel towards their doctor. Here, I do not seek to takes sides in this debate. Within the remit of such a study, an anthropologist’s role is not to support those who loudly proclaim the existence of a ‘lay’ knowledge that rivals a professional or ‘expert’ knowledge,1 rendering users capable of self-medicating, nor is it to support those who contest this knowledge or who at least reject the competence it would provide in treating oneself through self-medication. Because it is indeed this issue of knowledge that is raised alongside that of competence. Studies into the meaning assigned to the practice of self-medication tend to avoid reflecting on the relationship to knowledge it implies. The authors of the CSA/CECOP (2007) study identified three groups of patients: those for whom self-medication means ‘treating oneself without going to see a doctor’, those for whom it is ‘seeing a pharmacist to treat oneself without seeing a doctor’, and those who think it is ‘choosing medicines oneself with which to treat oneself’. Yet, these three categories do not hold the same status as regards the relationship with medical power, and especially not in terms of the knowledge it is based on, since the first phrase emphasises lay knowledge as opposed to professional knowledge, the second emphasises pharmacist knowledge as opposed to that of the doctor, while the third only emphasises the user’s role as a ‘consumer’. The posture of the user towards knowledge remains unexplored even though these categories can overlap as regards this issue.

We have seen that self-medication is the object of some reservations, notably from the doctors, because they consider it to be often dangerous for the very reason that it is based on insufficient knowledge. They invoke the risk involved either of a ‘delay in diagnosis’ or of an incorrect medicinal use. Inversely, recourse to self-medication for the subjects is an expression of their claim to competence, based on their knowledge. I will examine how the diverse forms of knowledge mobilised in self-medication are constituted in order to define the stakes involved in the assertion or denial of this competence. When broaching the matter of user knowledge, it is customary to oppose so-called lay knowledge with professional or expert knowledge. Freidson (1984) proposed the concept of a lay system of reference to account for what leads individuals to share information about their health problems and the agents capable of treating them to guide their choices of care-providers or health services. However we should note that a lay system of reference for Freidson is equivalent to a hierarchical process of searching for information that begins with the least informed and experienced and finishes with those who have the most information and experience, before arriving at the medical care system itself (Aïach and Cèbe, 1991: 12), whereas,

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