Abstract

This paper considers some findings from an ethnographic study of psychiatric patients in hospital care in East Malaysia. The subject of treatment is considered with regard to professional attitudes towards patient 'compliance' and the demonstration of resistance by users within a multicultural context in which traditional healing continues to be a popular alternative to biomedicine. 'Resistance' here is used in its literal meaning, rather than as an abstract, theoretical construct. The narratives of Malaysian patients in relation to resisting treatment in this study form some direct comparisons with, for example, the quotes from service users on the topic of medication, 'control and coercion' in the UK. (Rogers, A., et al. (1993) Experiencing psychiatry: Users' views of services. London: MacMillan Press/MIND Publications.) Resistance to treatment then is interpreted by staff as the outcome of sickness behaviour, which frequently results in coercive strategies. The undisputed power of the medical profession in Malaysia has contributed to the lack of an evolved 'service-user' perspective in which few patient rights are recognised, especially non-treatment. These responses remain embedded in a paternalistic and custodial attitude that does not acknowledge issues of spirituality or alternative healing practices that are important to hospitalised patients. Modernisation of services have not led to a parallel development with regard to patient participation or in terms of appropriate cultural responses. It is concluded that until this takes place professionals will continue to ignore the personal meaning users attach to treatment resistance.