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Investigación y Educación en Enfermería

Print version ISSN 0120-5307

Invest. educ. enferm vol.33 no.2 Medellín May/Aug. 2015

http://dx.doi.org/10.17533/udea.iee.v33n2a20 

ENSAYO / ESSAY / ENSAIO

 

DOI: 10.17533/udea.iee.v33n2a20

 

 

Historic perspectives from anthropology. Reflections proposed to Transcultural Nursing

 

Perspectivas históricas desde la antropología. Reflexiones propuestas a la Enfermería Transcultural

 

Perspectivas históricas desde a antropologia. Reflexões propostas à Enfermagem Transcultural

 

 

Cecilia Rohrbach Viadas1

 

1RN and Anthropologist, Ph.D. Professor, Universidad Autónoma de la Ciudad de México, México. email: cecilia_rohrbach@hotmail.com.

 

Receipt date: November 10, 2014. Approval date: April 30, 2015.

 

Article linked to research: none.

Subventions: none.

Conflicts of interest: none.

How to cite this article: Rohrbach C. Historic perspectives from anthropology. Reflections proposed to Transcultural Nursing. Invest Educ Enferm. 2015; 33(2): 374-379.

DOI: 10.17533/udea.iee.v33n2a20

 


ABSTRACT

History brings together meanings related to earlier periods, being aware of the past as a panorama to reread the present. Madeleine Leininger presented in 1970 an implicit and respectful message to the Nursing Profession when introducing Nursing and Anthropology. Two Worlds to Blend. Implicitly: Nursing you disregard culture. This article shows the absence of the history of anthropology and of nursing within Transcultural Nursing and it includes how education has influenced theoretic, methodological, and comparative approaches giving researchers the responsibility to decide their fundamentals. Berthoud (2001) has inspired the anthropological and historic perspectives of the author, thus universalism, relativism, and comparison are presented.

Key words: anthropology; nursing; transcultural nursing.


RESUMEN

La historia trae significados relacionados con periodos anteriores, reconociendo que el pasado es un panorama para releer el presente. En 1970, Madeleine Leininger propuso un mensaje implícito a la enfermería al introducir: "Nursing and Anthropologie. Two Worlds to Blend". Implícitamente: Enfermería: habéis descuidado la cultura. En este artículo también se hace referencia a la ausencia de la historia de la antropología y de enfermería dentro de la Enfermería Transcultural. El artículo incluye la influencia de la educación sobre los enfoques teóricos, metodológicos y comparativos dando responsabilidad a los investigadores de decidir sus fundamentos. La perspectiva antropológica e histórica de la autora se inspira en Berthoud (2007), presentando el universalismo, el relativismo y la comparación.

Palabras clave: antropología; enfermería; enfermería transcultural.


RESUMO

A história traz significados relacionados com períodos anteriores, reconhecendo que o passado é um panorama para reler o presente. Madeleine Leininger propõe em 1970 uma mensagem implícita à enfermagem ao introduzir: "Nursing and Anthropologie. Two Worlds to Blend". Implicitamente: Enfermagem: descuidastes a cultura. Neste artigo também se fala sobre a ausência da história da antropologia e de enfermagem dentro da Enfermagem Transcultural. O artigo inclui a influência da educação sobre os enfoques teóricos, metodológicos e comparativos dando responsabilidade aos pesquisadores de decidir seus fundamentos. A perspectiva antropológica e histórica da autora se inspira em Berthoud (2007), apresentando o universalismo, o relativismo e a comparação.

Palavras chave: antropología; enfermagem; enfermagem transcultural.


 

With regard to universalism and relativism

A critical reflection far from closing a debate begins on the contrary by opening it. (Preiswerk Y)

Universalism develops in Europe during the period named "The Enlightenment", nurturing a significant philosophy during the XVII and XVIII centuries influencing Science, Society, Religion, as well as everyday life. Whereas Relativism develops around 1900-1920, opposing evolutionism, the considered theoretical framework of European anthropology at that time.

The Enlightenment was formed by numerous European philosophers thinking again religious convictions, traditions, art, literature, science with a mainstream of individuals participating to such intellectual movement. Science and its compulsory requirements were acknowledged for Natural Sciences with no difference between mathematics and law, or astronomy and sociology, Dr. Leininger referred as "received view". This is the reason why recognition is searched from authors involved in Humanities. The Enlightenment (also known as Age of Reason) developed in a number of European countries (Germany, France, England, Scotland, Spain, and Russia, among others), and two brief descriptions may simplify this historical period: 1) The Enlightenment was an intellectual challenge to authority on nearly every level: i) Philosophers proposed reason to cultivate individualistic thinking and judgment preferably to tradition, they also suggested ideas detached from church tutoring guiding towards rational thinking. The consciousness of this reflection inspires the unity of humanity as a fundamental inheritance transmitted from the philosophers of the Enlightenment and recognized by anthropologists, along with freedom and equality. The principles and norms surrounding this period, shape the basis of modernity where science is an essential element as well. Modernity appears both as adequate and incomparable because monarchies are discarded, and tradition is losing its meaning. Anthropologists support somehow the evolutionist theory built up in earlier years; ii) as well as throughout the seventeenth and eighteen centuries, and what is more even later; iii) a second definition of the Enlightenment may contribute to its understanding: 2) "A European intellectual moment of the late seventeenth and eighteenth centuries emphasizing reason and individualism, eluding tradition. It was heavily influenced by seventeenth century philosophers such as Descartes, Locke, and Newton, and prominent figures like Kant, Goethe, Voltaire, Rousseau, and Adam Smith".1 The Enlightenment encourages knowledge and its understanding bearing in mind that such comprehension is reached by humans and not by God as believed up to that time.

Universalism or Rationalism opposed by Relativism and bringing reviewers to the evolutionist theory. Relativism also known as Cultural Relativism was launched by Franz Boas (1858-1942). This author was a famous German-American anthropologist equally known as the Founder of American Anthropology. Franz Boas launched Relativism around 1900-1920 challenging evolutionism, the vogue theory around 1850-1900 centered on progress and evolution. What could be opposed? Boas contested evolutionism since there was no definite proof supporting the origin of humanity while advancing his main relativistic premise: "Cultures are unique and must be interpreted within their own cultural context 4".Such proposition, commonly shared by Relativistic anthropologists may be considered as a direction finder in American Anthropology. Boas sustained that "cultural relativism involves specific epistemological and methodological prerogatives. Whether or not these claims necessitate a specific ethical stance is a matter of debate.5 However, an ethical stance arises if an anthropologist comes across studies describing cultural practices opposed to her/his own values, one example is "sexual mutilations", as observed in some African villages. The description of these practices6 becomes conflicting when confronting the theoretic premise of relativism previously cited.7 Those practices are not to be judged if the relativistic premise is to be respected. This living proof shows the ethical conflict within Relativism. Franz Boas taught, applied, and transmitted his vast knowledge and field experience to his disciples, most of them turned out to be famous soon after their studies: Margaret Mead, Alfred Kroeber, Ruth Benedict, Robert Lowie, Melville Herskovits, and many others. Boas premise bears in mind cultural unity if the researcher respects the observed cultural context.

A regard towards the understanding of humanities

Consciousness is itself the structure built upon this tenuous bridge between the two eternities of the unknown, and history is the record of what has taken place therein. Memory, in short, reveals the world as a process, and so makes its data historical. (Shotwell JT)

The understanding of Humanities and their acknowledgment as Sciences becomes present at this moment in order to remain faithful to the historic orientation of this article. Around 1890-1920, only Natural Sciences were judged to be sciences, as previously specified. Throughout the Enlightenment and even later, philosophers' texts enhanced rationality, and logic, within the scientific realm. However, an existing challenge concerning the requirements and thus the significance of science needed to be considered. Was it applicable to appeal for the same fundamentals, the same criteria for all sciences? Science at the end of the nineteenth century constructed theories when explaining the phenomena under study and generating laws, when demonstrating statistical studies based on rigorous methods.

This perspective demanded solid arguments if Natural Scientists were to be convinced of Humanities value. On the other hand, the philosophical, logical, and ethical background gathered during the Enlightenment advanced those investigators who were authorities in Humanities and developed different theories and methodologies. An author who spent his life studying, analyzing, and publishing his critical reflections on this subject was Wilhelm Dilthey8 (1833-1911), a German Historian, Psychologist, Sociologist, and Hermeneutic Philosopher. Wilhelm Dilthey had a predecessor in hermeneutics, Friedrich Schleiermacher (1768-1834) a German theologian, and philosopher, considered the founder of modern hermeneutics. Along with Schleiermacher's previous thinking and texts in hermeneutics, Dilthey was able to differentiate Humanities from Natural Sciences. Around the end of the nineteenth century, Dilthey had to expose solid confirmations for challenging personalities evidencing an appropriate theoretic and methodological foundation for Humanities. For Dilthey, human experience comprehends two boundaries: one, forthcoming from the natural world, requiring objectivity; and the later related to our inner experience. Dilthey strongly rejected the unique model of Natural Sciences (Naturwissenschaften), and proposed a distinct model for the Human sciences (Geisteswissenschaften). For this author the rationale for Natural Sciences explains phenomena in terms of cause to effect, or else on going from general to particular, a deductive thinking. Dilthey contemplates comprehension within Human Sciences as perceiving the measure at first, and the whole later. He named this comprehensive theory "Verstehen" in view of its applicability to all sciences. The method is to observe first, to understand after, and to interpret later. This would be a representative approach of Humanities, while Natural Sciences require explanations in order to elaborate laws. These two approaches may be combined, as Max Weber, the famous German Sociologist, suggested. Dilthey confirmed: history, philosophy, sociology, psychology, communication studies, law, and linguistics, as Humanities, as sciences requiring dissimilar methods to investigate reliable problematic themes and formulate research projects.

The challenge of Natural Sciences was thus to arrive at law-based explanations, on the other hand the fundamental commitment of the Humanities was the understanding of human and historical life, since history requires identifying present constructions of our own experience together with being competent and experienced in objectively interpreting what others convey.9 Dilthey has heavily influenced the phenomenologist movement in Europe and in America, some of these authors are Paul Ricouer, and Hans Georg Gadamer. Dilthey reflections on history and hermeneutics influenced also other philosophers of the twentieth century, like Heidegger and Ortega, demonstrating how analysis motivates and inspires the understanding of Humanities. On the whole these elements contributed to Anthropology's acknowledgement as a science and confirmed by a happening: Edward Burnett Tylor, an English researcher, was agreed Professor of Anthropology in 1896 at Oxford University becoming the first representative of this discipline in the world.

Comparing universalism and relativism

Comparative problems emerge when comparison is applied, when the researcher selects the premises to apply. Comparison is a complex process demanding anthropological and methodological knowledge to understand the studied cultures. There are numerous theories (evolutionism, diffusionism, functionalism, and structuralism) where comparison is practiced. The evolutionist theory is to be first examined for its influence during the examined periods. Jean Poirier, anthropologist and editor of the Pleiades French Encyclopedia, describes the ambiance of the evolutionist theory (1850-1920): "there was a passion side in the rational aspect; one feels the attraction concerning the conviction of progress; it is part of the scientism heritage, who would like to shelter man into the logic of evolution".10

Evolutionism contemplates modern society as holding a superior status and therefore as a guide for the called "developing societies".11 This is an ethnocentric position although it rings the bell that the unity of humankind remains the major legacy from European philosophers; a fundamental patrimony today"12 because "no comparative reflection at any scales whatsoever is possible, without recognizing, in one way or another, the unity of the human genre".12 Let us remember as well, that the expression "Unity of Humanity" needs to be elaborated and afterwards put on paper. When one thinks of the Unity of Humanity coming from the Bible, the Christian origin confirmed views Indians and Spaniards and Indians placed at the same level. However, to come to such decision took several years. There one may remember the human tendency to be ethnocentric and to remain attentive12 and to have in mind a clear conception of comparison: "Comparison within its universality is thus, the translation of a cultural domain into another one", and through the detour of the understanding of the other, it finally allows a different regard on us.

What about Relativism? The main relativistic premise concerning uniqueness of each culture limits comparison to its own context generating incompatibility to compare. To make it clear, in spite of this incompatibility, relativists engage comparison, not being acquainted with incompatibilities as shown".13 How could a hierarchy of values be established if all cultures are unique? In this logic there are contrasting postures concerning objectivity among relativists. Melford E. Spiro, an American researcher, opposes cultural relativism and contradicts other relativists as follows: "Even conceding that nontrivial generalization and no vacuous theories are discoverable, epistemological relativism rejects the conception of anthropology as a 'scientific' discipline not so much on pragmatic as on principled grounds. The proper aim of anthropology, it contends, is not explanation, but interpretation —the elucidation of symbolic 'meanings'— that requires that it be conceived and practiced not as a scientific but as a hermeneutic discipline".14 (quotation marks in text). It is a major change proposed by Spiro who conceives epistemological relativism as the meaning given to cultural contexts, however, anthropology is more than hermeneutics and much more than purely culture. Hodgen gives a relevant paragraph about the comparative approach: "However, to note and enumerate similarities and differences in manners and customs is one thing; to grasp their historical or scientific meaning is another".5

History and reflections for transcultural nursing

Dr. Leininger initial project proposed blending nursing and anthropology: Nursing and Anthropology. Two Worlds to Blend. If the title was attractive its development declined. The absence of history of anthropology, as well as of history of nursing with no data concerning such absence may possibly help to elucidate and understand this deficiency. A historic approach improves the process of theory building because the studied bibliography develops knowledge and arguments from other authors, allowing an ethical analysis of own positions and values, facilitating orientations and implementing choices with solid arguments. Cultural Relativism premise adopted by Leininger raises another question: "Cultural relativism has become a popular concept in anthropology and Transcultural Nursing. It refers to the position that, cultures are unique, and must be evaluated, according to their own values".15 (my underlining). This relativistic premise if confronted with the history of anthropology could have been adopted with nursing arguments; however, there is a slight difference between Boas and Leininger premises. Franz Boas' cultural relativism mentions "interpret", while Leininger indicates "evaluate" without explanation. It is not the premise that changes; but the term "evaluation". Is caring evaluating cultures? Is the aim of caring to change cultures? Evaluation must necessarily be examined and if retained, justified.

Methodologically, cultural relativism means that while the anthropologist is in the field, he or she temporarily suspends ("brackets") own esthetic and moral judgements. The aim is to obtain a certain degree of "understanding" or "empathy" with the foreign norms and tastes. Morally and politically, cultural relativism means that other cultures are respected and should be treated "as good as" one's own".16 What is it that is borrowed from Cultural Relativism in Transcultural Nursing, is it the main premise? It is through debates that reflection makes us become conscious of our errors thinking of an ethical and human research.

Bringing special thoughts for Transcultural Nursing

Madeleine Leininger understanding of the Culture Care Theory stipulates: "The purpose of the Culture Care Theory is to discover human care diversities (differences) and universalities (similarities) in order to generate new knowledge to guide nursing care practice."15 Universalities and "similarities" are unable to be differentiated. How may a researcher decide of a similar or universal pattern when the same word differentiates such patterns? Madeleine Leininger has been frequently recognized as the pioneer of culture care within nursing, in spite of the fact that texts have been repetitively published, rather than confirmed. Transcultural Nursing has been preserved from critical thinking by expert nurses both in anthropology and transcultural nursing. It is not my intention to advance a thorough analysis of a field that released richness for nursing.

My modest purpose focuses on the lack of history as previously mentioned, followed by suggestions about cultural relativism application within Transcultural Nursing. Dr. Leininger blending Nursing and Anthropology project may have benefited from historic knowledge to demonstrate its pertinence and afterwards its complementarity, and integration. History does not seem to attract nurses, as a famous Historian and French nurse, Marie-Françoise Collière."1" confirmed it in a Nursing and History Congress in Switzerland: "I was searching to elucidate the difficulties faced by health professionals in the field. I positively remarked just how the lack of historic knowledge damages nursing". Is knowledge between America and Europe so distant?

Knowledge about Universalism and Relativism gives an ample basis to understand how science was assembled, what changes were possible, necessary to enter what I may call a "scientific ethos". It is not the "received view" that we must oppose because of its "paternalism"; it is the reasoning of its principles, of its mistakes, and its richness that may be useful for investigating theories and methodologies. The question is not to accept or refuse knowledge, methods, theories coming from other disciplines, or from other continents, it is to encounter and share the way of thinking.

Genuine historical knowledge requires mobility of character, a profound understanding of human existence - not detachment and objectivity. (Nietzsche F)

 

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