Deconstructing fatalism: ethnographic perspectives on women's decision making about cancer prevention and treatment

Med Anthropol Q. 2011 Jun;25(2):164-82. doi: 10.1111/j.1548-1387.2010.01136.x.


Researchers have long held that fatalism (the belief in a lack of personal power or control over destiny or fate) constitutes a major barrier to participation in positive health behaviors and, subsequently, adversely affects health outcomes. In this article, we present two in-depth, ethnographic studies of rural women's health decisions surrounding cancer treatments to illustrate the complexity and contestability of the long-established fatalism construct. Narrative analyses suggest that for these women, numerous and complex factors--including inadequate access to health services, a legacy of self-reliance, insufficient privacy, combined with a culturally acceptable idiom of fatalism--foster the use of, but not necessarily a rigid conviction in, the notion of fatalism.

MeSH terms

  • Adult
  • Aged
  • Anthropology, Cultural
  • Appalachian Region
  • Attitude to Health / ethnology*
  • Decision Making*
  • Female
  • Humans
  • Hysterectomy / psychology
  • Middle Aged
  • Neoplasms / ethnology*
  • Neoplasms / prevention & control
  • Neoplasms / psychology*
  • Neoplasms / therapy
  • Personal Autonomy
  • United States
  • Vaginal Smears / psychology