Bricolage médical. Savoirs et pratiques des oncologues cambodgiens

Abstract

This article analyzes the ways in which oncologists practice medicine in Cambodia. It focuses on everyday practices and describes the processes of biomedical adaptation and appropriation, in other words, to describe how physicians adapt their knowledge and skill, by appropriating the tools and resources at their disposal, in order to treat their patients. I illustrate how Cambodian physicians rely on “evidence-based medicine” (medicine based on randomized clinical trials) to legitimize the validity of their practices. They refer to science—to a “scientific truth” understood as positivist knowledge—by mobilizing statistics from Western medical studies when they must convince patients and their families to undergo treatment. However, these doctors face a certain number of local constraints that lead them to adapt standard treatments. They adjust on a case-by-case basis to “not kill the patient” as they say. Of course, they are confronted with uncertainties related to the deleterious effects of medications and the evolution of the disease. But they must also consider the financial resources of patients. Doctors and users are thus confronted with therapeutic dilemmas that encourage the former to be flexible in their practices. Medicine is based here on a transformation of knowledge resulting from the complex forms of accommodation of medical practice, it is produced by health professionals confronted with empirical realities that are out of step with formal and theoretical knowledge.

Keywords

• anthropologie médicale
• Cambodge
• médecine
• médecin
• cancer
• cancérologie