"Witness-Based Medicine" in Psychosomatic Medicine : Qualitative Research in Cultural Anthropology (2^<nd> report)

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  • Suzuki Katsumi
    Department of Health and Environment, Graduate School of Social Sciences and Humanities, Chiba University
  • Tsujiuchi Takuya
    Department of Health and Environment, Graduate School of Social Sciences and Humanities, Chiba University:Department of Health Science and Social Welfare, School of Human Sciences, Waseda University
  • Tsujiuchi Yuko
    Department of Psychosomatic Medicine, Graduate School of Medicine, The University of Tokyo
  • Kumano Hiroaki
    Department of Psychosomatic Medicine, Graduate School of Medicine, The University of Tokyo
  • Kuboki Tomifusa
    Department of Psychosomatic Medicine, Graduate School of Medicine, The University of Tokyo

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Other Title
  • 心身医療における"証言に基づく医療" : 文化人類学による質的研究 (第2報)
  • シンシン イリョウ ニ オケル ショウゲン ニ モトヅク イリョウ ブンカ ジンルイガク ニ ヨル シツテキ ケンキュウ ダイ2ホウ

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Abstract

Objectives : We argue for a key concept in "Narrative-Based Medicine" through detailed analysis of interactions in illness narratives. The purpose of this research is to illustrate that practical knowledge based on a patient's lived experience of illness has significant meanings and functions for medical treatments that advocate a holistic medical care. Subjects and method : Subjects of this research are 5 patients placed in the 3^<rd> stage of Four-stage model (1^<st> report). This research adopted the qualitative research method from an anthropological point of view, because it was necessary to mention the influence of a researcher upon subjects. An anthropological research for narrative analysis can deal with interactions among patients, a doctor and a researcher as academic agenda. Results : We examined illness narratives for clarification of a key concept in "Narrative-Based Medicine". It was clarified that illness narratives as "witness" were proving the truth of their illness experience. We found there are 3 aspects on dynamics of witness (Fig. 1); (1) illness narratives as witness of subjects in the 3^<rd> stage, (2) a medical doctor as a witness person for their illness narratives, (3) a researcher or a family member as a second witness person. We found that each interaction among these 3 aspects could be considered indispensable conditions in order to conduct medical treatments based on the dynamics of witness. Significance of illness narratives as witness lies in that subjects will be able to live together with chronic illness through interactions among these 3 aspects. Conclusion : In analysis of illness narratives in this research, it was clarified that the dynamics of witness in the above mentioned 3 aspects could generate medical phenomenon that encouraged patients to live together with chronic illness. We regarded the dynamics of witness as one of the key concepts of "Narrative-Based Medicine". Hence we named this medical phenomenon "Witness-Based Medicine".

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