Morbus Mediterraneus: A Cultural Alibi for an Unequal Pain Burden

According to a widespread trope in German medical literature, patients from the Mediterranean basin are hypersensitive to pain, exaggerating its severity to win familial sympathy and avoid responsibilities; moreover, they are alleged to be disproportionately susceptible to somatoform conditions and chronic pain. Underwritten by a philosophical anthropology positioning culture as a structuring cause of nearly all aspects of cognition, culture is made the first-order explanation for pain inequities, relegating structural factors to a background of minor causes. The institutionalization of these stereotypes prepares the ground for systematic testimonial injustice. To redress these injustices, one must dislodge the received view of culture and its clinical significance. I argue, conceptually and empirically, that clinical and experimental pain disparities have political and material, rather than cultural, causes. I offer an alternative understanding of culture that does not obfuscate the structural causes of pain inequities and is supportive of epistemic humility and equity-oriented care.