Paper short abstract:

Confronted with an ageing population as well as the availability of ever better but more expensive treatments, chronic diseases have become a financial burden. Under these circumstances, the European Institutions have opened the debate to innovation from qualitative research in social science, participation unthinkable even five years ago.

Paper long abstract:

Methodological challenges can be encountered when (participantly) observing chronic diseases, but medical anthropology as well as the institutional ethnography (Abeles, 1995) both offer very strong toolboxes for tackling healthcare issues.

In the case of chronic diseases, the strength of ethnography is related to perceptions of everyday life and normality; trying to understand who patients trust and where they seek help when disease it not that thing that strikes and goes but stays for a lifetime; after the initial stages where technical knowledge is crucial, what makes a difference will seldom be the medical staff or technology; it may be similar people in similar situations; it may be alternative medicine of all kinds; it may be religion or other forms of spirituality; it may be none of the above. Nevertheless, anthropology is the only discipline that can legitimately deconstruct the predominant biomedical approach.

Anthropological methods are by default holistic, therefore they include the point of view of all the actors involved: supra-state, state and legislation, deriving institutions, civil society (patient organisations), industry, media, etc. In a debate which shifted from too much "doctor-" to too much "patient-"centered, such a holistic approach is crucial.

Cognitive anthropology is a major strength in the debate: how knowledge is produced, reproduced and transmitted. Cognitive anthropology can help with involving patients in the health literacy processes.

The issues raised in this abstract will be illustrated with ethnography on three categories of chronic diseases.