Psychiatric judgments across cultural contexts : relativist, clinical-ethnographic, and universalist-scientific perspectives

Abstract

Psychiatrists encounter persons from diverse cultures who profess experiences (e.g., communicating with spirits) that evoke intuitions of abnormality. This view might not be shared with the person or her/his cultural peers, raising questions concerning the justification of such intuitions. This article explores three positions relevant to the process of justification. The relativist position transfers powers of judgment to the subject’s peers yet neglects individual values and operates with a discredited holistic view of culture. The clinical- ethnographic position remedies this by suspending judgment subject to understanding the individual in a sociocultural context yet finds objections with the universalist-scientific position: objective standards exist and could justify intuitions of abnormality cross-culturally. This article argues that the claim to objectivity is value-laden, reflecting instead a brand of normality and relationship to reality further upheld through epistemological utility and valued technological progress. In conclusion, it is suggested that the clinical-ethnographic position takes personal values and context seriously, both of which are crucial for responsible clinical practice.