This collection of 49 readings with extensive background description exposes students to the breadth of theoretical perspectives and issues in the field of medical anthropology. The text provides specific examples and case studies of research as it is applied to a range of health settings: from cross-cultural clinical encounters to cultural analysis of new biomedical technologies to the implementation of programs in global health settings.

In the heady days of 2011–2012, when Barack Obama was in his first term and the Patient Protection and Affordable Care Act heralded a golden future, medical anthropologists and activists had reason to be excited. Their country was about to take—so they believed—the greatest single step in the right direction since LBJ’s “Great Society” welfare spending program. It was in this climate that Inhorn and Wentzell’s collection of essays was published, and the optimism of the times shines through many (...) of the essays.The harsh reality is that at the end of 2012 Obama was re-elected, and after a painful deadlock the health insurance legislation known as “Obamacare” was pushed through. What followed has not turned out quite the way anyone expected and has driven an initial and unprecedented tidal wave of disapproval of the Obama presidency. Reading Medical Anthropology at the Intersections is therefore a sobering lesson in how a week can be a very long time in politics and a year a positive etern. (shrink)

(2001). The Challenge of Genetic Engineering to Medical Anthropology and Ethics. Human Reproduction & Genetic Ethics: Vol. 7, No. 1, pp. 21-25.

In China's healthcare sector, a popular and socio-culturally distinctive phenomenon known as guanxi jiuyi, whereby patients draw on their guanxi with physicians when seeking healthcare, is thriving. Integrating anthropological investigation with normative inquiry, this paper examines medical guanxi through the lens of patient–physician trust and mistrust. The first-hand empirical data acquired – on the lived experiences and perspectives of both patients and physicians – is based on six months' fieldwork carried out in a county hospital in Guangdong, southern China, (...) which included in-depth interviews with 20 patients and 20 medical professionals. Patients who emphasized the positive effects of guanxi on patient–physician trust believed that it facilitates access to experienced medical specialists, enhances clinical communication, and reduces the financial and medical risks of over diagnosis and overtreatment by physicians. At the same time, these findings reveal patients' strong sense of mistrust, not only towards individual health professionals but also to the medical profession and China's commercialized healthcare industry. While some health professionals in the study responded favourably to medical guanxi, most were opposed to it on the grounds that it undermines professional standards and equitable healthcare. We found that the practice of medical guanxi is not morally justifiable, chiefly because it reinforces the present high levels of patient–physician mistrust and erodes trust between patients and the medical profession as a whole. In China, both the medical profession and the state need to promote patient–physician trust based on medical professionalism and institutional norms, rather than on guanxi or individual relationships. (shrink)

Recent approaches in the medical and social sciences have begun to lay stress on “plasticity” as a key feature of human physiological experiences. Plasticity helps to account for significant differences within and between populations, particularly in relation to variations in basic physiological processes, such as brain development, and, in the context of this article, daily sleep needs. This article proposes a novel basis for the redevelopment of institutions in accordance with growing awareness of human variation in physiological needs, and (...) articulates a theory of multibiologism. This approach seeks to expand the range of “normal” physiological experiences to respond to human plasticity, but also to move beyond critiques of medical practice that see medicine as simply responding to capitalist demands through the medicalization of “natural” processes. Instead, by focusing on how the institutions of U.S. everyday life—work, family, and school—structure the lives of individuals and produce certain forms of sleep as pathological, this article proposes that minor alterations in institutions could result in less pathologization for individuals and communities. Multibiologism provides a foundation for shared priorities in the social sciences, in bioethics, and in medical practice, and may lay the groundwork for emergent collaborations in institutional reform. (shrink)

This paper takes a phenomenological hermeneutic orientation to explicate and explore the notion of the grey zone of health and illness and seeks to develop the concept through an examination of the case of alcohol consumption. The grey zone is an interpretive area referring to the irremediable zone of ambiguity that haunts even the most apparently resolute discourse. This idea points to an ontological indeterminacy, in the face of which decisions have to be made with regard to the health of (...) a person (e.g., an alcoholic), a system (e.g., the health system), or a society. The fundamental character of this notion will be developed in relation to the discourse on health and the limitations of different disciplinary practices. The case of alcohol consumption will be used to tease out the grey zone embedded in the different kinds of knowledge made available through the disciplinary traditions of medical science, with its emphasis on somatic well-being, and anthropology, with its focus on communal well-being. This tension or grey zone embedded in different knowledge outcomes will be shown to have a discursive parallel with the dialogue between the Athenian, the Spartan, and the Cretan in Plato’s Laws. Making use of the dialogical approach as described by Gadamer, the Athenian’s particular resolution of the tension will be explored as a case study to demonstrate the necessarily particular analysis involved in a grey zone resolution. (shrink)

In 1866, six Inuits were taken to the United States for the purpose of serving as specimens to American scientists at the Natural History Museum. Shortly after their arrival in New York, four of them had died. One of the survivors returned to the Arctic, while the sixth, Minik, now alone, fought to make possible the return of the remains of his dead companions to their village. Since the latter were being exhibited, as was then often the case (and happens (...) even today in many museums), in order to offer visitors examples of the Inuk people, Minik protested in vain. In 1909 he returned to Greenland when the scientists denied that the remains of his friends still existed. Several years later, still pursuing the issue, he went back to the United States to take up the fight against the bureaucracy for the repatriation of the bodies. He died in the United States in 1918. It was only in 1993 that he won out and that the remains of the four were returned to the Arctic homeland. (shrink)

Introduction. A man of today inevitably acquires the status of a patient in the context of preventive medicine, even when he is healthy. But at the same time, he or she becomes an object of influence both from medicine itself and from numerous social institutions and commercial structures, in addition to health institutions, which proclaimed their mission to ensure human well-being. The purpose of the study is to comprehend the philosophical and anthropological aspects of the patient’s phenomenon and clarify basic (...) foundations of transforming a patient’s consciousness in the context of progressive life medicalization. Methods. The methodological basis of the research comprises sociocultural, hermeneutic, existentialphilosophical and phenomenological approaches. The research is based on M. Heidegger’s anthropological ontology, E. Giddens’ existential ontology; M. Foucault’s concept of life medicalization; P.D. Tishchenko’s concept of transforming bio-power in modern culture. Scientific novelty of the research. The author has developed a hypothesis for the principles of forming individual and mass patient consciousness, which determines a modern person’s way of being in the context of life medicalization. Results. Suffering from the fear of the existence finiteness becomes the existential foundation of the modern patient’s consciousness, while the existential and rational foundations of the patient consciousness of the modern enlightened individual are mutually mediated. The link in their mutual mediation is believing in the possibility of achieving the ideal health, formed in modern socio-cultural conditions. In the situation of total life medicalization, in which health is understood as a prosperous existence, a special way of human being is formed on the basis of the individual patient’s consciousness. The “effect” of the life medicalization is the emergence of a mass patient consciousness - the fear of losing health forms the ideology of a medicalized society in which every individual becomes a patient. Conclusions. The progress of biomedicine is able to determine the crisis of human identity. In this regard, it is important to clarify the philosophical concepts of health and illness in the context of the modern sociocultural situation, which allows to determine the possible ideal of health within the framework of medical interventions that are safe for the human essence and capable of providing “ontological safety” when healing an individual. (shrink)

"This is an extremely interesting and innovative collection with unusual empirical richness, with ethical and epistemological discussions cutting across ...

However much the three great traditions of medicine - Galenic, Chinese and Ayurvedic - differed from each other, they had one thing in common: scholarship. The foundational knowledge of each could only be acquired by careful study under teachers relying on ancient texts. Such medical knowledge is special, operating as it does in the realm of the most fundamental human experiences - health, disease, suffering, birth and death - and the credibility of healers is of crucial importance. Because of (...) this, scholarly medical knowledge offers a rich field for the study of different cultural practices in the legitimation of knowledge generally. The contributors to this volume are all specialists in the history or anthropology of these traditions, and their essays range from historical investigations to studies of present-day practices. (shrink)

If personhood is the quality or condition of being an individual person, brainhood could name the quality or condition of being a brain. This ontological quality would define the `cerebral subject' that has, at least in industrialized and highly medicalized societies, gained numerous social inscriptions since the mid-20th century. This article explores the historical development of brainhood. It suggests that the brain is necessarily the location of the `modern self', and that, consequently, the cerebral subject is the anthropological figure inherent (...) to modernity (at least insofar as modernity gives supreme value to the individual as autonomous agent of choice and initiative). It further argues that the ideology of brainhood impelled neuroscientific investigation much more than it resulted from it, and sketches how an expanding constellation of neurocultural discourses and practices embodies and sustains that ideology. (shrink)

Since the 1970s, anthropologists have moved into diverse workplaces, including private and public settings, that raise new issues for anthropology as a discipline as well as for the discourse on science more generally. In the context of increasing globalization, the articulation of new ethical dilemmas around such issues as technology, indigenous knowledge and rights, government regulation and bioethics among others, can and do inform and shape scientific public policy. The authors in this volume work in traditional research centres and (...) universities, as well as in private and public sectors, and across specialties from medical anthropology and social medicine to archaeology and cyberspace. They explore the dimensions of an ethical anthropology in today's world, and the unique contribution of anthropology to the sciences. (shrink)

This text explores the border between medical and social problems, the boundary between health and social change. The book studies the body as the mediator between individual and collective experience, finding that many health problems, for example the trauma of violence or depression in the course of chronic pain, are less individual medical problems than interpersonal experiences of social suffering. It argues for an ethnographic approach to moral practice in medicine, one that embraces the infrapolitical context of illness, (...) responses to it, the social institutions relating to it and the way it is configured in medical ethics. (shrink)

Empiricism has many different faces. As the contributions to this volume demonstrate, in the 17th and 18th century demonstrate medical and philosophical empiricism is less about an "essence" and more a series of specifically modern "acts" or "gestures.".

Ethical medical decision-making for a child is generally navigated with various standards and models that have been developed to address its complexities. A case is presented of the parents’ refusal of a surgical procedure for their child considered by medical providers as essential and potentially lifesaving, along with the ethical debate of whether the parents’ decision was in the child’s best interest and whether their refusal reached a threshold to report and seek state intervention. Utilizing the best interest (...) standard and additional ethical decision-making tools, the ethicists helped the medical team accept the parents’ decision as reasonable, thus avoiding involvement with Child Protective Services. It is my goal to clarify the parents’ decision as reasonable and as honoring their child’s best interests and inherent dignity through the lens of Catholic anthropological and moral principles. These strengthen the ethical and moral arguments for the parents’ decision and the opposition to state intervention. (shrink)

The tradition of anthropological medicine in philosophy of medicine is analyzed in relation to the earlier interest in epistemological issues in medicine around the turn of the century as well as to the current interest in medical ethics. It is argued that there is a continuity between epistemological, anthropological and ethical approaches in philosophy of medicine. Three basic ideas of anthropologically-oriented medicine are discussed: the rejection of Cartesian dualism, the notion of medicine as science of the human person, and (...) the necessity of a comprehensive understanding of disease. Next, it is discussed why the anthropological movement has been superseded by the increasing interest in medical ethics. It is concluded that the present-day moral issues cannot be interpreted and resolved without clarification of the underlying anthropological images. (shrink)

The past two decades have seen the extensive privatisation and marketisation of health care in an ever reaching number of developing countries. Within this milieu, medical tourism is being promoted as a rational economic development strategy for some developing nations, and a makeshift solution to the escalating waiting lists and exorbitant costs of health care in developed nations. This paper explores the need to problematize medical tourism in order to move beyond one dimensional neoliberal discourses that have, to (...) date, dominated the arena. In this problematization, the paper discusses a range of understandings and uses of the term ‘medical tourism’ and situates it within the context of the neoliberal economic development of health care internationally. Drawing on theory from critical medical anthropology and health and human rights perspectives, the paper critically analyzes the assumed independence between the medical tourism industry and local populations facing critical health issues, where social, cultural and economic inequities are widening in terms of access, cost and quality of health care. Finally, medical tourism is examined in the local context of India, critiquing the increasingly indistinct roles played by government and private sectors, whilst linking these shifts to global market forces. (shrink)

Definition of the problem: Referring to the current critique of bioethics from the point of view of medical anthropology in North America, implications for moral philosophy and health care ethics are questioned. Arguments: The intrinsic and extrinsic flaws of common biomedical ethics as theory-driven ethics of principles and norms are also demonstrated in the German discussion of medical ethics (by reference to ’ethos’ and ’responsibility’) and ethical theory (especially phenomenology or hermeneutics). Objections to the Western bias of (...) Bioethics from the perspective of cross-cultural research are not only a radical critique of biomedicine but a challenge to philosophy and ethics becoming ’intercultural’. Conclusions: Cultural and social studies of life, context and ethos could be helpful in developing the ethical sensitivity, intercultural perception and motivations of health care personnel. In return, the field workers’ self-reflection of their normative preconditions will become an issue. (shrink)

Although the use of new health technologies in healthcare and medicine is generally seen as beneficial, there has been little analysis of the impact of such technologies on people's lives and understandings of health and illness. This book explores how new technologies not only provide hope for cure and well-being, but also introduce new ethical dilemmas and raise questions about the "natural" body. Focusing on the ways new health technologies intervene into our lives and affect our ideas about normalcy, the (...) body and identity, New Health Technologies explores: how new health technologies are understood by lay people and patients how the outcomes of these technologies are communicated in various clinical settings how these technologies can alter our notions of health and illness and create "new illness." Written by authors with differing backgrounds in phenomenology, social psychology, social anthropology, communication studies and the nursing sciences, this book is essential reading for students andacademics of medical sociology, health and allied studies, and anyone with an interest in new health technologies. (shrink)

This chapter contains sections titled: The Status of Humans in Maimonides' Ontology Matter, Privation, and Evil Accounting for Multiplicity of Persons The Constitution of Soul and Body Immortality of the Soul: Personal or General? Conclusion further reading.

Agenda 21 of United Nations demands better situation of ecology, economy, health, etc. in all countries. An evaluation of scientific contributions in international congresses of fundamental anthropological sciences (philosophy, psychology, psychosomatics, physiology, genito-urology, radio-oncology, etc.) demonstratesevidence of large discrepancies in the participation not only of developing and industrial countries, but also between the last ones themselves. Low degree of research and education leads to low degree of economy, health, ecology, etc. [Lit.: Neu, Michailov et al.: Physiology in Agenda 21. Proc. (...) Int. Un. Physiol. Sci. San Francisco, Faseb J. 19/5, A1355, 2005; Agenda 21 in Psychol. 28th Int. Congr. Psychol. Beijing, 1028.62/3028.96, 2004]. CONCEPTION: The science is leading in the social and economic development of humanity, but the misuse of science causes disastrous repercussions (ecological and self-destruction). New models for scientific education, beginning with philosophy, followed by philosophical, pedagogical, medical, theological anthropology, and research are necessary tosupport Agenda 21 and prevent misuse of science. According to proposals on foundation of experimental schools (Immanuel Kant) and international universities (Bertrand Russell) the International Academy of Science/ICSD supports these ideas and initiated the creation of first (interdisciplinary) International Faculties forAnthropology as paradigm for humanization, higher effectiveness and pluralistic internationalization of science, leading to better education ("Erziehung und Ausbildung") and research in all countries, i.e. decrease of the gap between industrial and developing countries. CONCLUSION: Foundation of international institutes for general (philosophy, pedagogy, medicine) as well as for special anthropology (theology, informatics-logic-mathematics, culture, biology, (bio-) physics/chemistry) in context of an integralanthropology via networks of national ones from selected countries of Africa, America, Asia, Australia, Europe can permit the necessary implication of philosophy in education of anthropological sciences as well as research and education (post graduate) by common international research and educational programmes, lecturers, students, etc. in one country. This project needs political and financial support by UNO, European Union, governments, banks, industries to support the education of a homo sanus, humanus et spiritualis for the future humanity. (shrink)

This paper presents an analysis of the applicability of a principalist approach for a global, or cross-cultural, bioethics. We focus especially on the principle of individual autonomy, a core value in ethical discourse. We echo some long-standing criticisms of other anthropologists, sociologists, and many medical ethicists that the individualistic approach to autonomy is a Euro-American value and cannot be ethically applied in all settings. As a remedy, we suggest an adaptation of Kleinman's Explanatory Model approach to questions of decisionmaking. (...) We argue that the analysis and resolution of ethical dilemmas might also benefit from forms of pedagogy that integrate anthropological and other social science perspectives, and the incorporation of ethnographic techniques in ethical practice. (shrink)

Naked Science is about contested domains and includes different science cultures: physics, molecular biology, primatology, immunology, ecology, medical environmental, mathematical and navigational domains. While the volume rests on the assumption that science is not autonomous, the book is distinguished by its global perspective. Examining knowledge systems within a planetary frame forces thinking about boundaries that silence or affect knowledge-building. Consideration of ethnoscience and technoscience research within a common framework is overdue for raising questions about deeply held beliefs and assumptions (...) we all carry about scientific knowledge. We need a perspective on how to regard different science traditions because public controversies should not be about a glorified science or a despicable science. Contributors are: Ward Goodenough, Eloisa and Brent Berlin, Colin Scott, Jean Lave, Emily Martin, Troy Duster, Hugh Gusterson, Charles Schwartz, Joan Fujimura, Sharon Traweek, Estellie Smith, Ellen Bielawaski, David Jacobon, Charles Ziegler, Pamela Asquith. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Philosophy, Psychiatry, & Psychology 10.1 (2003) 25-27 [Access article in PDF] Gender, Body, Meaning:Anthropological Perspectives on Self-Injury and Borderline Personality Disorder Carolyn Sargent THE CENTRAL THEMES OF "Commodity Body/Sign: Borderline Personality Disorder and the Signification of Self-Injurious Behavior" reflect issues that cut across the disciplines represented by this journal and have received increasing attention from anthropologists. Medical anthropologists, as well as psychological anthropologists and others interested in symbolic (...) analysis of the body, have addressed such topics as the culture of biomedicine and the cultural shaping of psychiatric classification, the multiple meanings of body modifications, power relations in therapeutic interactions between doctor and patient, and cultural variation in understandings of normality and abnormality.Curiously, there is little anthropological literature that directly focuses on either borderline personality disorder (BPD) or self-injurious acts per se. Indeed anthropological research on psychiatric diagnosis, classification, and treatment, as well as ethnopsychiatry, include scant reference to personality disorders. One exception is Nuckolls' 1992 article, "Toward a Cultural History of the Personality Disorders," which raises pertinent questions for one of Potter's introductory statements—that the majority of those diagnosed with BPD are women. Nuckolls directly addresses gender ideology and gender roles in the United States in his comparison of antisocial personality and histrionic personality diagnoses. In his paper, he argues that these personality disorders have cultural histories and are strongly congruent with prevailing gender stereotypes, such that men are many times more likely to be diagnosed as antisocial than women and women much more likely to be diagnosed as histrionic (Nuckolls 1992, 37). He also historicizes the emergence of certain behavioral styles that have been seen as characteristic of women and men, and the evolution of psychiatric diagnoses that classify extreme manifestations of these behavioral styles.The issue of why women, rather than men, are more frequently diagnosed with BPD is not elaborated in Potter's article, although she notes the importance of considering the intersection of gender and "identifying behaviors" associated with BPD. Cultural analyses of gender ideology in the [End Page 25] United States might suggest that the connection involves gendered expectations concerning emotionality and relational context but these articulations remain intriguing and underexplored. One might speculate that BPD/self-injury occurs in the context of particular gender ideologies, perhaps in class-based, industrialized societies where the body is highly commodified. It appears that the history of this constellation of symptoms and behaviors remains to be written.Cultural analysis of self-injury, a theme that runs through Potter's article, tends to be embedded in the anthropological literature on body ornamentation, initiation rituals, and "culture-bound" syndromes. Mascia-Lees and Sharpe (1992, 1) describe the body as "a site of adornment, manipulation, and mutilation," practices with roots reaching back as far as 30,000 years, and include as examples head deformation, scarification, foot binding, tooth filing, lip plates, nose rings, tattoos, subincision, and genital cutting.However, the concept of self-injury, as Potter notes, is problematic in the discipline of anthropology given the significance historically accorded to cultural relativism. Correspondingly, body "modification" is not "self-injury" as long as it is socially normative, for example, a facet of an initiation ordeal or body ornamentation (e.g., circumcision, scarification, piercing). Among the rare examples of acts that seem readily identifiable as "self-injury" are New Guinea practices of cutting off a finger to demonstrate mourning and Baatombu (West African) male finger amputation to show grief and anger over a wife's infidelity. Both are, however, considered culturally legitimate and not indicative of pathology.Potter's argument draws heavily on the notion of "body as text," derived largely from literary theory and feminist philosophy (Butler 1990; Jaggar and Bordo 1989). The perspective of "body as text" has influenced anthropological theory over the past two decades, particularly in the interpretive and postmodernist schools of thought. The body as a text of femininity is aptly characterized by Bordo, who argues that the continuum between female disorder and normal femininity is revealed by means of an analysis of symbolic meaning of gender in... (shrink)

The semantic confusion in Europe about the term “anthropology” has of late been considerable. On the one hand there is meant by it, and quite justifiably, human biology and medical anthropology. On the other hand, the work of some contemporary thinkers, under the name of “philosophical anthropology,” has recently gone beyond the narrower compass. This has been noticeable at both the German and the international European philosophical conventions since the last war. In addition to this, there (...) appeared the term “Kulturanthropologie,”—for the first time probably as the title of E. Rothacker's contribution to Systematische Philosophie, a collection of essays edited by Nicolai Hartmann and published in 1942. But “Kulturanthropologie,” in Rothacker's sense, is not a translation of “cultural anthropology,” which has in recent years grown to such eminence among scholarly fields in England and America. In the United States, “anthropology” designates a group of scholarly fields ranging on the one hand from biological anthropology to archaeology and the study of the beginnings of history on the other, often including history, linguistics, and other realms of research; it is neither one of the natural sciences nor of the humanities but one of the social sciences; and the actually new results of this young discipline, especially at Harvard, Yale, and the University of Chicago, are arrived at by means of team work by anthropologists, psychologists, and sociologists, which in Germany has not been the case so far. (shrink)