Value Dilemmas and Reciprocally Evoked Transactions of Patient and Curer

This paper is a preliminary report on a part of a larger project which focuses on the role of values in the passage of the ailing individual through the ‘rooms' and ‘corridors’ of specialized medical and social healing in office practice and institutional settings. Only some of the complex ways of valuing which influence the behavior of patients and medical practitioners in the healing context are to be examined here.

Being sick, in and of itself, is not a valued state of affairs in any society. Moreover, illness does not necessarily imply failure to meet normal obligations, that is, being socially deviant in the usual sense of the word. Rather, being ill means that something has to be done about it—that man tries to decrease his direct calls on the defenses of nature against disease. Thus, illness represents an internal biological problem solving process, as well as a form of individual and cultural focal search behavior directed ultimately to maximizing the yield of nature to man while minimizing the yield of man to nature.

It is not surprising that diverging values about illness in general, specific diagnostic entities7,47,45 and treatment methods36 are the rule, rather than the exception in society. The value systems of the private medical practitioner do not necessarily correspond to the valuative criteria and expectations concerning illness and treatment which the individual patient might have. Some convergence of views between professional and lay people only seems to take place if the patient remains in treatment for a considerable time.44,31