“Preventive care carries a quasi-moralistic message that people and societies are responsible for their health and must shoulder certain disciplines in order to avoid disease” (Brody and Englehardt 299). The idea of preventive medicine makes an individual in charge of his/her own health by preventing disease or illness before it ever occurs. Preventive care encourages a sense of responsibility in people by letting them take direct control of their own health. It promotes the idea that, avoiding bad things from happening is better than fixing the bad things after it happens. If bad things still occur, it, indirectly, holds an individual and society accountable for letting it happen at the first place. However, as Brody & Englehardt say that since preventive care is not clearly medical, (prevention happens before medical intervention) it does not fall within the jurisdiction of influential scientific organizations. Moreover, scientific organizations emphasis more on statistics which makes it easy for them to report their findings and hence more resources are allocated to their programs.
According to Brody and Englehardt, many countries allocate money for fixing health problems as they occur rather than allocating it towards increasing resources so that these health problems can be avoided. These countries’ healthcare system focuses on reactive medicine in which the symptoms are treated as they occur rather than working to prevent them from getting happening in the first place. Both culture and medicine in these countries have formed a relationship which is acceptable for the majority of their population. It is difficult for these countries to ever come out of this cycle because it is much easier for them to report quantifiable findings for the cure of the sick. On the other hand, it could be not only difficult, but nearly impossible to quantify actions which may or may not prevent an illness. For this reason, even though, the benefits of preventive medicine are clear, they are not definitely measureable which makes it a less popular approach.
I believe that the global differences in medical practice, that Brody and Englehardt talk about, will continue to differ, until a joint consent is made to align them. Some of these countries are among the poorer nations where the governments constantly face a vicious cycle of disease and poverty. These places are in a need of the competencies and incentives so that their strategy can be shifted from reactive methodology to proactive mode of care. Furthermore, an approach a country takes towards preventive health care is greatly influenced by their culture where each believes in their own practice method as being the best. For example, in the U.S, risk reducing mastectomies are patients’ choice and can be carried out for carriers of the BRCA mutation gene to prevent the risk of developing breast cancer. However, France only favors mastectomy if the risk factor is greater than 60% and that only if a woman is at least thirty years old (Payer 183). This is largely due to their perception of preventive mastectomy as a tragedy and not a celebration of an improved life. It is therefore important to identify a bio cultural approach of healthcare, one that defines health in both biological and cultural methods, explaining how disease and societies are integrated. This way of understanding takes both societal, traditional views and perception of disease, and the way the diseases and illnesses are best cured using traditional and or biomedical healing. By understanding this bio cultural approach, we can appreciate the benefits each have to offer and possibly use these benefits to better our and other health systems around the world. With all said, what Brody and Englehardt refers to cannot be denied that, every individual and every society still needs to consider health in a moral sense and adopt self-control behaviors in order to avoid future health problems.
Work Cited
Brody, Baruch A. Bioethics: readings & cases. Englewoods Cliffs, N.J.: Prentice-Hall, 1987. Print.
Payer, Lynn. Medicine & culture: varieties of treatment in the United States, England, West Germany, and France. New York: H. Holt, 1988. Print.
Preventive medicine is definitely novel in the fact that it provides people with information regarding behaviors and health outcomes and therefore places the decision in their hands as to what behaviors they will partake in from that point. It does place a lot of responsibility on the people to take care of themselves. Which honestly, many people probably won’t like. Because it requires them to make a choice and decide what matters to them more. And because they can then no longer blame ignorance, society, etc. for the majority of their health problems.
It’s true that our healthcare system was built around treating diseases when they appeared and had no mechanisms for stopping disease before it happens. Preventive Health and Preventive medicine are very new in that regard. This makes it very difficult for this important feature to be worked into the system. Especially since, as you pointed out, it’s not even clear if it can even be called ‘medical’.
Your discussion about visible outcomes and countable results is also really on point. It’s very true that in order to convince people, receive funding and even validity, people want and have to have statistics. Medical testing definitely helps in this regard, but preventive medicine is vulnerable because it takes a long time, and requires lots of longitudinal studies and willing participants, to document change. And it’s difficult to find support when there are people and diseases that need to be treated now and you’re asking for money, support and patience for something that can and will take generations to see the effect of.
I definitely agree with your argument that preventative medicine needs to be worked into the health care system. Evidently it is very difficult to make this happen, due to the fact that it is unquantifiable and bio cultural as stated. Since there is minimal uniformity between what certain countries view as acceptable and what other do, it is hard to have a universal preventative medical system. I think working through countries’ differences to create this preventative care system would be ideal, because accurate prevention could potentially save large sums of money in treatment. Although prevention would require some form of funding; provided the benefits are higher than the costs, this should occur. For now, a world-wide universal health care system seems unapproachable, so the US individually should focus on promoting preventative care through commercials, book, articles, and other forms of media to scare people about the potential diseases out there. With media encouraging preventative health care, many people will conform and start preventing instead of waiting until the beginning of a real illness.
The reason why most governments allocate funds for fixing current problems rather than allocating funds for preventing these problems depends on the knowledge of the people. As you have stated, current problems are tangible, and therefore, draw more attention. The best way is to ensure that people are educated about what can be done now to prevent illness later. For example, childhood obesity has declined within the last couple of years as people were realizing that obesity leads to health problems in the long run. Schools began including nutritional meals and fitness programs for children as a preventative measure for obesity.(http://www.washingtonpost.com/national/health-science/new-cdc-data-shows-43-percent-drop-in-obesity-rates-among-children-2-to-5/2014/02/25/b5b3a3fa-9e65-11e3-9ba6-800d1192d08b_story.html). The reason for the push to decrease childhood obesity is to ensure that they do not mature into obese adults because obesity has been proven to be linked with other diseases such as heart disease (http://www.nhlbi.nih.gov/health/health-topics/topics/obe/risks.html). Today, a lot of money is allocated to treatments for heart and cardiovascular disease. If we prevented obesity from increasing in the US sooner, then we wouldn’t have to spend so much on cardiovascular disease treatments now. Fighting childhood obesity and obesity in general is still in its early stages, so only time will tell if the public is willing to support preventative measures such as this one.
Like everyone else, I agree that Preventive Medicine needs to replace Reactive Medicine. Unfortunately, human nature and society’s position is to ignore problems that cannot be quantified or seen. Therefore, people are not willing to care of their health since the consequences are not immediately seen if they ignore the warnings of their doctors.
Furthermore, the biocultural effects on medicine are amazing. Particularly how two first world countries with advanced medical care have different medical care recommendations. The societal cultural effects of how we are raised greatly impacts our future decisions and views on the world. What we view as the logical and correct course of action is viewed as illogical and wrong in other countries. I think health and medicine is specific to every country because food and ideology differs in every country. The medical community and officials need to understand and respect this when creating medical recommendations.
The main issue with getting countries to provide preventative medicine instead of treating health problems after they occur stems from the fact that by targeting a specific issue, one can easily see the effects. If the country spends its financial resources on preventative medicine and ignores all of the other health problems, it’s citizens will start to demand what is happening to their money because they are unable to see physical results to the preventative medicine. I agree with your comment that ‘need of the competencies and incentives’ so that ‘strategies can be shifted from reactive methodology to proactive’. By providing preventative medicine, the health of people would be superior than ever before.
I am in full support of the use of preventative medicine. The little effort and money put into prevention can make a world of difference in the future, saving huge amounts of money that would be used on a cure. I think it is a good thing to make people accountable for the decisions they make and put the patient in charge of their own health in terms of prevention. I also agree that the problem with instituting preventative medicine is that countries want to be able to quantify their actions and see direct results. This is much more the case with reactive rather than preventative medicine. This is like the case we discussed in class about reducing the cholesterol of many people with preventative measures vs. funding the heart transplant of one person. The heart transplant is much more likely to receive more attention because the results are quantifiable and short term.
We know that we should be “responsible” and “shoulder certain disciplines in order to avoid disease,” but preventative healthcare is not easy in poor countries. Take Mexico for example. Mexico is a very poor country with few opportunities and poor health. If you have never heard of Oportunidades, check it out here: http://www.oportunidades.gob.mx/Portal/wb/Web/oportunidades_a_human_development_program. This was an amazing program that provided conditional cash transfers and healthcare interventions to Mexican citizens. Who wouldn’t take cash as an incentive to get healthier? It’s a win-win for both parties, since Mexico lowers overall health costs and citizens get healthier. There has been so much data released for the resulting benefits for BMI, development and growth in children, and other causes of mortality. The Oportunidades program was so successful that the Mexican government event extended the program from rural areas to more urban area to find more success. This is the kind of investment for the future that we should see more of, instead of “focusing on reactive medicine,” like you said.