Public archaeological interpretation on the campus of St. Mary's College of Maryland.

Overview

This research examines medical decision-making involving the possibility of sexual dysfunction as a side effect of treatment of prostate problems in older black and white American men. The context for this analysis is the recent movement towards "shared decision-making" between doctors and patients. The shared decision-making movement grows out of the importance of informed consent, and doctors' ethical obligation, frequently not well carried out, to include patients in treatment decisions. In this ...
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Overview

This research examines medical decision-making involving the possibility of sexual dysfunction as a side effect of treatment of prostate problems in older black and white American men. The context for this analysis is the recent movement towards "shared decision-making" between doctors and patients. The shared decision-making movement grows out of the importance of informed consent, and doctors' ethical obligation, frequently not well carried out, to include patients in treatment decisions. In this dissertation, I analyze how men across social class and race respond to the invitation to share in decision-making---to "talk back" to the doctor. Additionally, this research focuses specifically on men's questions, as they look at a video "decision aid" designed to encourage shared decision-making in the treatment of non-cancerous prostate problems. I apply the tools of medical anthropology to critically analyze the assumption of the patient-centered care movement that simply informing men of the pros and cons of treatments will empower them. The task of this dissertation research is to tease out whether men understand and accept the shared decision-making message or whether issues of race, class, masculinity, and experience in the world may undercut messages of empowerment and rational choice. A key finding is that men view BPH treatment as a high stakes decision. Additional findings suggest that men are conservative in their ordering of treatment preferences. They choose watchful waiting first, over medications and surgery. This research is important because it is one of the first to report an analysis of sexual concerns among an educationally and racially diverse sample of men. Men are quite hesitant to choose treatments that may negatively impact their sexuality. The study findings also highlight the importance to men of legitimizing watchful waiting as a viable treatment option. However, in routine health care practice, watchful waiting may not be routinely presented as a treatment option. To the extent that men's preferences and health care provider approaches to counseling men are mismatched, a contributing factor to men's health disparities is not effectively addressed. It may be important to create a new type of "decision-making clinical visit" for important, but non-urgent decisions that involve potentially irreversible patient outcomes. For anthropology, it will be important to understand that men's health and male sexuality are a couplet. But, first, we have to get on the men's health train. If we are to be culture scientists, it would be to our detriment to neglect a ripe field of study, and especially, those anthropologists that subscribe to "studying gender." Men want to maintain a sexual self, and age, race, or education does not dampen this desire. Future research would entail asking men of different ages and racial backgrounds specific questions about health and sexuality, and how the interplay of these two features are important, if indeed they are, to other clinical decisions. Also, examining actual patient-doctor encounters in the clinical setting would provide an insightful gaze into the balances of power and how the shared decision-making process works, perhaps permitting us to engage in a discourse that moves beyond men's "doing gender" to explain men's poor health outcomes.
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Product Details

  • ISBN-13: 9781243556431
  • Publisher: BiblioLabsII
  • Publication date: 9/3/2011
  • Pages: 264
  • Product dimensions: 7.44 (w) x 9.69 (h) x 0.55 (d)

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