Divergent Views and Experiences Regarding 'Completed Life' and Euthanasia in the Netherlands.

A small proportion of older people in the Netherlands want to end their lives because they feel their lives to be 'completed' and no longer worth living. Currently, there is heated debate over whether or not these people should have the right to euthanasia. Drawing on previous research, we conduct a heuristic analysis of views and experiences of three different 'parties' involved in this debate, namely, the older people, their relatives and friends and medical professionals.

'Look under the sheets!' Fighting with the senses in relation to defecation and bodily care in hospitals and care institutions.

This essay focuses on sensory aspects of care in situations surrounding defecation in hospitals and other care institutions. Sensory activity does not merely encompass pleasant experiences that enhance healing and well-being. Anthropologists-and other disciplines as well-have paid little attention to unpleasant and disgusting experiences that our senses meet and that may rather increase pain and suffering in the context of care.

Autonomy and dying: Notes about decision-making and "completed life" euthanasia in the Netherlands.

Euthanasia in the Netherlands is based on the notion that the person seeking assistance to die is able to make an autonomous decision. The objective of this study is to explore this notion, in particular, in the case of "tiredness of life." The article is mainly based on two qualitative researches and two selected case histories that provide an in-depth insight into the complex process of (not) reaching a clear decision.

Not-knowing and the proliferation of assumptions: local explanations of Cutaneous Leishmaniasis in Suriname.

Why do patients and others confronted with cutaneous leishmaniasis (CL) - a parasitic skin disease - in the hinterland of Suriname, South America, provide a dazzling variety of aetiological explanations for one single illness? And how do these explanations reflect local knowledge of and interest in the origin of illness? In this article, we explore these questions using the concept of 'not-knowing', as introduced by Murray Last in 1981. One of Last's conclusions is that 'don't knows' or 'don't cares' reflect people's disinterest in medicine. The aim of this article, however, is to draw attention to another aspect of not-knowing: it may lead to a proliferation of explanatory assumptions, unhindered by precise knowledge.

Factors That Influence Enrolment and Retention in Ghana' National Health Insurance Scheme.

Background: The government of Ghana introduced the National Health Insurance Scheme (NHIS) in 2004 with the goal of achieving universal coverage within 5 years. Evidence, however, shows that expanding NHIS coverage and especially retaining members have remained a challenge. A multilevel perspective was employed as a conceptual framework and methodological tool to examine why enrolment and retention in the NHIS remains low.

How migrants keep Italian families Italian: and the private care of older people.

Purpose: The purpose of this paper is to describe how migration affects the care of older people in Italy.

Design/methodology/approach: The paper is based on anthropological fieldwork by one of the authors. This consisted of in-depth interviews with 20 "" (migrant caregivers), with relatives of older people and with social workers in the city of Verona, Italy.

Why are the poor less covered in Ghana's national health insurance? A critical analysis of policy and practice.

Background: The National Health Insurance Scheme (NHIS) was introduced in Ghana to ensure equity in healthcare access. Presently, some low and middle income countries including Ghana are using social health insurance schemes to reduce inequity in access to healthcare. In Ghana, the NHIS was introduced to address the problem of inequity in healthcare access in a period that was characterised by user-fee regimes.

Nuancing stigma through ethnography: the case of cutaneous leishmaniasis in Suriname.

Health-related stigma and its dramatic consequences for those stigmatized have long been a crucial concern for public health authorities globally. However, before concluding that stigma spoils the lives of people with a particular disease or disability and is a major obstacle to obtaining/providing adequate health care, it is necessary to first determine whether there is actual stigmatization related to the condition concerned. The purpose of this article is to nuance the concept of stigma through a detailed ethnographic exploration of the experiences and views of patients and others affected by the parasitic skin disease cutaneous leishmaniasis (CL) in Suriname, South America.

Wisdom and counselling: A note on advising people with HIV/AIDS in Ghana.

This article raises the question of whether the practice of HIV/AIDS counselling in Ghana can be linked to the wisdom that older people are said to have and use when they give advice to younger family members. Older people believe they have wisdom and life experience that young people should listen to; counsellors hold an opposite view about their work, insisting that it is they who listen to people with HIV/AIDS to help them make their own decisions. In actual practice, however, HIV/AIDS counsellors predominantly give information and advice, for at least three reasons.

How women in Bangladesh confront the stigma of childlessness: agency, resilience, and resistance.

In a context where motherhood is an integral part of a woman's stereotype, being childless is a devastating experience. We explore how these so-called deviant women manage this situation. The objective of this article is to contribute to the debate regarding infertile women's agency, resilience, and resistance.

Community concepts of poverty: an application to premium exemptions in Ghana's National Health Insurance Scheme.

Background: Poverty is multi dimensional. Beyond the quantitative and tangible issues related to inadequate income it also has equally important social, more intangible and difficult if not impossible to quantify dimensions. In 2009, we explored these social and relativist dimension of poverty in five communities in the South of Ghana with differing socio economic characteristics to inform the development and implementation of policies and programs to identify and target the poor for premium exemptions under Ghana's National Health Insurance Scheme.

Talking in triads: communication with Turkish and Moroccan immigrants in the palliative phase of cancer.

Aims And Objectives: To gain insight into the factors that influence communication between health professionals and Turkish and Moroccan immigrants in the palliative phase of cancer.

Background: In palliative care, communication is crucial. The question, however, is whether Dutch healthcare providers, on the one hand, and Turkish and Moroccan patients and their family members, on the other, agree on what is constituted by good communication.

Repackaging exemptions under National Health Insurance in Ghana: how can access to care for the poor be improved?

For the past 10 years the Ghana Government has been trying to replace the old user fee system with an overall health insurance scheme, but one problem of the old system continues to bedevil the new policy: exemption of the poor. This paper presents data from empirical fieldwork and also puts forward an opinion. It discusses how past experiences of user fee exemptions for the poor can inform exemptions under the new 'National Health Insurance Scheme' (NHIS) as a means to ensuring equity in health care.

Alien origins: xenophilia and the rise of medical anthropology in the Netherlands.

The beginnings of medical anthropology in the Netherlands have a 'xenophile' character in two respects. First, those who started to call themselves medical anthropologists in the 1970s and 1980s were influenced and inspired not so much by anthropological colleagues, but by medical doctors working in tropical countries who had shown an interest in the role of culture during their medical work. Secondly, what was seen as medical anthropology in those early days almost always took place in 'foreign' countries and cultures.

Understanding and improving communication and decision-making in palliative care for Turkish and Moroccan immigrants: a multiperspective study.

Objective: The aim of this study is to explore how communication and decision-making in palliative care among Turkish and Moroccan patients is influenced by different styles of care management between Turkish and Moroccan families and Dutch professional care providers. Problems as well as solutions for these problems are highlighted.

Design: A qualitative design was used, totally interviewing 83 people (6 patients, 30 relatives and 47 care providers) covering 33 cases of incurable cancer patients receiving palliative care.

'Palliative care': a contradiction in terms? A qualitative study of cancer patients with a Turkish or Moroccan background, their relatives and care providers.

Background: Palliative cancer care aims to improve quality of life and ultimately quality of dying, while prolonging life is not an objective anymore when death nears. The question is, however, whether these perspectives on palliative care are congruent with the perspectives of immigrant families with a Turkish or Moroccan background.

Methods: A qualitative design was used as we were looking for the personal views of 'very ill' cancer patients with a Turkish or Moroccan background, their family members and their Dutch care providers.

Fracture treatment by bonesetters in central Ghana: patients explain their choices and experiences.

Objective: To understand factors influencing patients' decisions to choose either fracture treatment by a bonesetter or in the hospital and to explore patients' experiences with bonesetter treatment.

Method: In-depth interviews with 46 patients with a radiological proven fracture in a district hospital in central Ghana.

Results: Traditional healers, such as bonesetters, play a substantial role in the Ghanaian healthcare system.

Social and cultural efficacies of medicines: complications for antiretroviral therapy.

Using ethnographic examples of medicine use, prescription, distribution and production, the authors argue that social and cultural effects of pharmaceuticals should be taken into account. Non-medical effects deeply influence the medical outcome of medicine use. Complications around the advent of anti-AIDS medicines in poor countries are taken as a point in case.

'Sacraments' in the Hospital: Exploring the Magic and Religion of Recovery.

This article proposes to look at the ritual dimension of hospital work, a chain of words and acts, which fill patients with hope for a 'future life'. Conventional boundaries between magic, science and religion are reconsidered. The author argues that biomedicine, far from being a cultural no-man's land, represents the basic values of culture.