Правила принятия терапевтических решений хроническими больными
Therapeutic Decision-Making Rules by Chronic Patients

Summary/Abstract: The article presents the results of a study of the patients’ medical choice in a situation of chronic illness. The empirical analysis is based on 25 in-depth interviews and focus group interviews with patients with chronic medical conditions. The study was conducted within the framework of cognitive medical anthropology developed by Linda Garro. Of particular interest is the analysis of the relationship between cultural knowledge and personal experience, the role of interiorized and non-interiorized cultural patterns in the patients’ medical choice. This article describes the rules of making two therapeutic decisions for chronic patients: the choice of medical system (conventional and/or nonconventional medicine) and the choice between self-treatment and professional medical care. The study shows which cultural beliefs are the basis for mono-choice in favor of biomedicine or nonconventional medicine, as well as for a combined choice of different medical systems. Special attention is paid to strategies for combining conventional and nonconventional medicine (based on divergent rationality). One of the most common strategies is the use of unconventional medical practices and folk remedies as exclusively complementary to the main treatment. Another strategy is to use biomedical technologies only for specific diseases (usually, diseases that are identified as life threatening). In a situation of deciding between self-treatment and professional medical treatment, in addition to cultural knowledge about diseases and treatments, other circumstances, such as personal experience of treatment, institutional (non)trust, or availability of alternatives, become increasingly important.

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