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UNIVERSITY OF EDINBURGH

Graduate School of Social & Political Science

Social Anthropology

ANTHROPOLOGY OF HEALTH AND ILLNESS (PGSP11423)

2017-2018, Sem.1

Mondays 2-4pm

Chrystal Macmillan Building, Seminar Rm. 5

Course Organiser:

Dr. Stefan Ecks (stefan.ecks@ed.ac.uk)

Guidance and Feedback Hours: Tuesdays 1-3pm

Course Secretary:

Morag Wilson (pgtaught.sps@ed.ac.uk)

0131 651 5066

AIMS AND OBJECTIVES

This course provides an advanced introduction to the anthropology of health, illness

and healing. Students will be introduced to key theories and current debates at the

interface of anthropology and medicine through a focus on cross-cultural approaches

to illness, medicine, and the body. We will explore how different ways of experiencing

and knowing the body, including varied concepts of gender and the life course, can

radically alter how people think about and engage with issues of health and healing.

This course explores biomedicine as one among several different ways of thinking

through and constituting personhood, illness and the body. It deals with the

challenges that arise when biomedical expertise meets other understandings of illness

and suffering; the multiple kinds of care provided in institutional, public, religious

and domestic settings; the relationship between curing and healing; and the ways in

which people grapple with affliction and uncertainty through narrative, through

relationships, and through action. Medical anthropology is not only narrowly

concerned with suffering and sickness but examines the significance of wellbeing,

health and medicine for all domains of social life. This course therefore explores the

centrality of health and healing to social, political, and historical processes in general.

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Learning Outcomes

At the end of the course, students should have a grasp of the major concerns in

medical anthropology, and should be able to understand the following issues:

how social understandings of the human body are formed and

transformed by healing knowledge and practices

why healing performances are having an effect on both individual patients

and social collectivities

how medications are a privileged entry point into medical anthropological

explorations

why broader frames of political, economic, and historical analysis are

immediately relevant for an understanding of body, illness, and healing

how "traditional healers" form their practices in a field of multiple healer-

patient relations and why "modernity" has not made non-biomedical forms

of healing disappear

why the distinction between objectively described "disease" and

subjectively perceived "illness" has both strengths and weaknesses

how notions of well-being are related to cultural understandings of

sickness

how medical anthropology uses different theoretical approaches, and how

they have changed

how medical anthropologists do ethnographic research

Teaching Plan

Week 1: INTRODUCING MEDICAL ANTHROPOLOGY

Week 2: KEY APPROACHES IN MEDICAL ANTHROPOLOGY

Week 3: THE BODY AND ITS PARTS

Week 4: "CULTURE" AND THE PROBLEM OF IRRATIONALITY

Week 5: QUESTIONING POWER

Week 6: MEDICALIZATION AND DEMEDICALIZATION

Week 7: HEALERS

Week 8: HEALING WITH (AND WITHOUT) SUBSTANCES

Week 9: LIFE AND DEATH

Week 10: TAKE CARE OF YOURSELF

Week 11: Assessment Feedback and Guidance

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Course Lectures and Readings

WEEK 1: INTRODUCING MEDICAL ANTHROPOLOGY

Medical anthropology has become the largest sub-discipline of social/cultural

anthropology. What is it all about, and why does it attract so much attention from

anthropologists and non-anthropologists alike? This lecture will introduce some

of the key issues in the field – what do we study and why? What can we learn

from researching what it means to be healthy, sick, or recovering in different

cultural contexts? Are there different ways to know the body? How can we look

cross-culturally at what it means to heal? What are the implications of social,

political and historical contexts for the health of individuals and larger societies?

Come prepared for an open discussion!

Key Readings

Inhorn, M. C. 2007. Medical Anthropology at the Intersections. Medical

Anthropology Quarterly 21(3): 249-255.

Lock, M. and Nguyen, V-K. ‘Introduction’ AND ‘Chapter 3: Anthropologies of

Medicine’ in An Anthropology of Biomedicine. Chichester: Wiley Blackwell.

Further Reading

Fadiman, Anne. 1998. The Spirit Catches You and You Fall Down: A Hmong Child,

Her American Doctors, and the Collision of Two Cultures. New York: Noonday Press.

Taylor, J. S. 2003. ‘The Story Catches You and You Fall Down: Tragedy,

Ethnography, and “Cultural Competence”’, Medical Anthropology Quarterly 17(2):

159-181

Hahn, R. 1995. Sickness and Healing: An Anthropological Perspective. New Haven:

Yale University Press.

Helman, C.G. (Ed.). 2000. Culture, Health and Illness: An Introduction for Health

Professionals. Oxford: Hodder Arnold. (pp. 1-11)

Nichter, M. & Lock, M. (Eds.). 2002. New Horizons in Medical Anthropology: Essays

in Honour of Charles Leslie. London: Routledge.

Hahn, R. A. and Inhorn, M. C. 2009. ‘Introduction.’ In Anthropology and Public

Health: Bridging Differences in Culture and Society Oxford: Oxford University Press

[available online through the library]

Napolitano, D. and Jones, C. 2006. Who needs ‘pukka’ anthropologists’? A study

of the perceptions of the use of anthropology in tropical public health research.

Tropical Medicine and International Health 11(8): 1264-1275.

Kleinman, K. and Kleinman, J. 2007. ‘Somatization: The Interconnections in

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Chinese Society among Culture, Depressive Experiences, and the Meanings of

Pain’ in M. Lock and J. Farquhar (eds), Beyond the Body Proper: Reading the

Anthropology of Material Life. Durham; London: Duke University Press

Hemmings, C. 2005. Rethinking medical anthropology: How anthropology is

failing medicine. Anthropology and Medicine 12(2): 91-103.

WEEK 2: KEY APPROACHES IN MEDICAL ANTHROPOLOGY

The lecture gives an overview of the field and introduces its most important

theoretical streams. The most entrenched distinction exists between

social/cultural approaches on the one hand, and biological approaches on the

other. Has this distinction become blurred over the past decade, and in which

directions is medical anthropology moving?

Key Readings

Petryna, A. 2015. Health: Anthropological Aspects. International Encyclopedia of the

Social & Behavioral Sciences 2nd Edition.

Kleinman, A. 1980. Patients and Healers in the Context of Culture: An Exploration of

the Borderland between Anthropology, Medicine, and Psychiatry. Berkeley: University

of California Press. (pp. 71-118)

Scheper-Hughes, Nancy. 1990. Three Propositions for a Critically Applied

Medical Anthropology. Social Science and Medicine 30(2): 189-197.

Further reading

Baer, H.A., M. Singer, and I. Susser. 1997. Medical Anthropology and the World

System: A Critical Perspective. Westport, CT: Bergin & Garvey.

Brown, P.J., M.C. Inhorn, and D.J. Smith. 1996. Disease, Ecology and Human

Behavior. In Medical Anthropology: Contemporary Theory and Method, C.F. Sargent &

M.J. Johnson (Eds.), pp. 183-218. London: Praeger.

Colson, A.C., & Selby, K.E. 1974. Medical Anthropology. Annual Review of

Anthropology 3: 245–262.

Csordas, T.J. 1994. Introduction: The Body as Representation and Being-in-the-

world. In Embodiment and Experience: The Existential Ground of Culture and Self, T. J.

Csordas (Ed.), pp. 1-26. Cambridge: Cambridge University Press,

DeWalt, K.M. 2007. Medical Anthropology. In International Encyclopedia of the

Social Sciences, 2nd Edition, pp. 130-132.

Farmer, P. 1999. Infections and Inequalities. Berkeley: University of California Press.

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Frankenberg, R. 2007. British Medical Anthropology: Past, Present and Future. In

Medical Anthropology: Regional Perspectives and Shared Concerns, Saillant, F. &

Genest, S. (Eds), pp. 183-211. Oxford: Blackwell.

Hahn, R. 1995. Sickness and Healing: An Anthropological Perspective. New Haven:

Yale University Press. (pp. 76-98)

Inhorn, M. C., & Wentzell, E. A. 2012. Medical anthropology at the intersections:

Histories, activisms, and futures. Durham: Duke University Press.

Kleinman, A. 1995. Writing at the Margin: Discourse Between Anthropology and

Medicine. Berkeley: University of California Press.

Lock, M. & Scheper-Hughes, N. 1996. A critical-interpretative approach in

medical anthropology: Rituals and routines of discipline and dissent. In Medical

anthropology: Contemporary theory and method, Revised edition, C.F. Sargent & T.M.

Johnson (Eds.), pp. 41-70. Westport, CT: Praeger.

Lupton, D., 2012. Medicine as culture: Illness, disease and the body. London: Sage.

(chpt. 1)

Merleau-Ponty, M. 2007. The Phenomenology of Perception (Extract). In Beyond

the Body Proper.

Mol, A. 2002. The Body multiple: Ontology in Medical Practice. Durham: Duke

University Press.

Moore, H. & T. Sanders 2005. Anthropology in Theory: Issues in Epistemology.

Oxford: Blackwell.

Rivers, W.H.R. 1924. Medicine, Magic and Religion. London: Kegan Paul.

Rubel, A.J. and M.R. Hass. 1996. Ethnomedicine. In Medical Anthropology:

Contemporary Theory and Method, C.F. Sargent & M.J. Johnson (Eds.), pp. 113-130.

London: Praeger.

Scheper-Hughes, Nancy. 2007. Nervoso. In Beyond the Body Proper.

Turner, V.W. 1967. The Forest of Symbols. Ithaka: Cornell University Press (chpt.

"Symbols in Ndembu Ritual" reprinted in Beyond the Body Proper)

WEEK 3: THE BODY AND ITS PARTS

"The body" has been a focal point in the social sciences (and far beyond) for the

past two decades. Depending on the conceptual approach, the body can be

written in many ways. Why does the body matter, and what is medical

anthropology’s perspective? Special emphasis will be given to debates about the

"body in parts" and self-care practices.

Key Readings

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Cohen, Lawrence. 1999. Where It Hurts: Indian Material for an Ethics of Organ

Transplantation. Daedelus 128(4):135-165.

Lock, M., 2015. Comprehending the body in the era of the epigenome. Current

Anthropology, 56(2), pp. 151-177.

Mauss, M. 2007. Techniques of the Body (Extract). In Beyond the Body Proper.

Further reading

Alter, J.S. 1996. Gandhi's Body, Gandhi's Truth: Nonviolence and the Biomoral

Imperative of Public Health. Journal of Asian Studies 55(2): 301-22.

Csordas, Thomas J. 1990. Embodiment as a Paradigm for Anthropology. Ethos

18(1): 5-47.

Csordas, T., 2011. Cultural phenomenology. In F. E. Mascia-Lees, ed, A Companion

to the Anthropology of the Body and Embodiment, pp.137-156. Oxford: John Wiley &

Sons.

Das, V. and Das, R.K., 2007. How the body speaks: illness and the lifeworld

among the urban poor. In J. Biehl, B. Good, A. Kleinman, eds., Subjectivity:

ethnographic investigations. Berkeley: University of California Press, pp. 66-97.

Ecks, S. 2009. Welcome Home, Descartes! Rethinking the Anthropology of the

Body. Perspectives in Biology & Medicine 52(1): 53-58.

Foucault, M. 1997. Ethics: Subjectivity and truth. Ed. Paul Rabinow. New York: The

New Press. (pp. 223-252)

Hogle, L.F. 2005. Enhancement Technologies and the Body. Annual Review of

Anthropology 34: 695-716.

Livingston, Julie. 2012. Improvising Medicine: An African Oncology Ward in an

Emerging Cancer Epidemic. Durham: Duke University Press.

Lock, M. 1993. Cultivating the Body: Anthropology and Epistemologies of Bodily

Practice and Knowledge. Annual Review of Anthropology 22: 133-155.

Lock, M. 2002. Twice Dead: Organ Transplants and the Reinvention of Death.

Berkeley: University of California Press, Pp. 23-56 & 315-340.

Lock, M. 2007. Human Body Parts as Therapeutic Tools: Contradictory

Discourses and Transformed Subjectivities. In Beyond the Body Proper.

Martin, Emily. 1993. Histories of Immune Systems. Culture, Medicine and

Psychiatry 17: 67-76.

Martin, E. 2006. The Pharmaceutical Person. BioSocieties 1:273-287.

Sharp, L. 2000. The Commodification of the Body and its Parts. Annual Review of

Anthropology 29: 287-328.

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Staples, James. 2003. Disguise, Revelation and Copyright: Disassembling the

South Indian Leper. Journal of the Royal Anthropological Institute (n.s.) 9: 295-315.

WEEK 4: "CULTURE" AND THE PROBLEM OF IRRATIONALITY

Many disciplines study illness and healing, from various angles. Among these

many disciplines, medical anthropologists are usually seen as the ones who can

figure out how "cultural" patterns of thinking can explain irrational behaviours,

such as "noncompliance" or "stigmatization. The common anthropological

rhetoric about patients is that they appear to hold all kinds of irrational and

superstitious beliefs about illness, but as soon as one explores their point of view

of "their culture," one could find that everything makes sense within a deeper

context. In many cases, this approach works surprisingly well, but there are many

moments when references to "culture" become disingenuous or even harmful.

How should anthropologists conceptualize apparently irrational beliefs among

patients?

For class discussion:

Ecks, S., 2016. The strange absence of things in the “culture” of the DSM-V.

Canadian Medical Association Journal, 188(2): 142-143.

Janes, C.R. 2006. Commentary: 'culture', cultural explanations, and causality.

International Journal of Epidemiology 35: 261-263.

Napier, A.D., Ancarno, C., Butler, B., Calabrese, J., Chater, A., Chatterjee, H.,

Guesnet, F., Horne, R., Jacyna, S., Jadhav, S. and Macdonald, A., 2014.

Culture and health. The Lancet, 384(9954): 1607-1639.

Further reading:

Allmark, P. & Tod, A. 2006. How should public health professionals engage with

lay epidemiology? Journal of Medical Ethics 32: 460-463.

Bastien, Joseph W. 1985. Qollahuaya-Andean body concepts: a topographical-

hydraulic model of physiology. American Anthropologist 87(3): 595-611.

Bi, P., Tong, S. & Parton, K.A. 2000. Family self-medication and antibiotics abuse

for children and juveniles in a Chinese city. Social Science & Medicine 50:

1445-1450.

Bierlich, B. 2000. Injections and the fear of death: an essay on the limits of

biomedicine among the Dagomba of northern Ghana. Social Science &

Medicine 50(5): 703-713.

Geissler, P.W. 2005. 'Kachinja are coming!': encounters around a medical research

project in a Kenyan village. Africa 75: 173-202.

Greenhalgh, Trisha. 1987. Drug prescription and self-medication in India: an

exploratory survey. Social Science & Medicine 25(3): 307-318.

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Hausmann, Muela S. et al. 2003. Recipe knowledge: a tool for understanding

some apparently irrational behaviour. Anthropology & Medicine 10(1): 87-

103.

Jadhav, Sushrut. 2007. Dhis and dhat: evidence of semen retention syndrome

amongst white Britons. Anthropology & Medicine 14(3): 229-239.

Kleinman, A., Eisenberg, L. & Good, B. 1978. Culture, illness, and care: clinical

lessons from anthropologic and cross-cultural research. Annals of Internal

Medicine 88: 251-258.

Leibing, Annette. 2010. Inverting compliance, increasing concerns: aging, mental

health, and caring for a trustful patient. Anthropology & Medicine 17(2): 145-

158.

Pylypa, J. 2007. Healing herbs and dangerous doctors: "fruit fever" and

community conflicts with biomedical care in northeast Thailand. Medical

Anthropology Quarterly 21(4): 349-368.

Whitmarsh, I. 2009. Medical schismogenics: compliance and 'culture' in

Caribbean biomedicine. Anthropological Quarterly 82(2): 447-475.

Yang, Lawrence Hsin et al. 2007. Culture and stigma: adding moral experience to

stigma theory. Social Science & Medicine 64(7): 1524-1535.

WEEK 5: QUESTIONING POWER

Power is an essential aspect of the human condition because the human body is so

vulnerable. We all can be overpowered by others, we can be stripped of all

possessions, all food, all human contacts all sense of orientation, all dignity.

Bodily vulnerability is the reason why all social relations are relations of power.

Michel Foucault has explored this systematically. His analysis of disciplinary

techniques has been hugely influential in medical anthropology since the 1980s.

In the past few years, Foucault's reception has shifted towards his concept of

"biopower". Targeting the body of the individual and of entire populations,

biopower aims to optimize and improve the body, health, sexuality, family life,

heredity, and hygiene. Biopower is so pervasive because its interventions are

always applied "in the best interest" of both the individual and of the population.

This lecture will embed biopower in Foucault's work and discuss its uses in

medical anthropology. We will look especially at the concept of "biological

citizenship".

Key Reading

Petryna, A. 2010. Biological Citizenship: The Science and Politics of Chenobyl-

Exposed Populations. In A Reader in Medical Anthropology. Theoretical

Trajectories, Emergent Realities, Byron J. Good, Michael M.J. Fischer, Sarah S.

Willen, and Mary-Jo DelVecchio Good (Eds). pp. 199-212. Chichester: Wiley-

Blackwell.

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Roberts, S.L. and Elbe, S., 2017. Catching the flu: Syndromic surveillance,

algorithmic governmentality and global health security. Security Dialogue,

48(1): 46-62.

Rose, N. & Novas, C. 2004. Biological Citizenship. In Global Assemblages:

Technology, Politics, and Ethics as Anthropological Problems, A. Ong & S. Collier

(Eds.). Oxford: Blackwell. Pp. 439-463.

Further Reading

Clarke, A. E., Shim, J. K., Mamo, L. Fosket, J. R. & Fishman, J. R. 2003.

Biomedicalization: Technoscientific Transformations of Health, Illness, and

U.S. Medicine. American Sociological Review 68(2): 161–194.

Farmer, P. 2004. An Anthropology of Structural Violence. In Current Anthropology

45(3): 305-325.

Fassin, D. 2007. The Politics of Life: Beyond the Anthropology of Health. In

Medical Anthropology: Regional Perspectives and Shared Concerns, Saillant, F. &

Genest, S. (Eds), pp. 252-266. Oxford: Blackwell.

Foucault, M. 1978 [1976] Right of Death and Power over Life. In The History of

Sexuality, vol. 1: An Introduction. New York: Pantheon Books.

Foucault, M. 2004. Naissance de la Biopolitique: Cours au Collège de France 1978-1979.

Paris: Gallimard/Seuil.

Lemke, T. 2001. The Birth of Bio-Politics: Michael Foucault’s Lectures at the

College de France on Neo-Liberal Governmentality. Economy and Society

30(i.2): 190-207. (download:

http://www.worldbank.org/research/inequality/pdf/lenke.pdf)

Nijhawan, M. 2005. Deportability, Medicine, and the Law. Anthropology &

Medicine 12(3): 271-285.

Proctor, R.N. 2000. The Nazi War on Cancer. Princeton, NJ: Princeton University

Press.

Rajan, K.S. 2005. Subjects of Speculation: Emergent Life Sciences and Market

Logics in the United States and India. American Anthropologist 107(1): 19–30.

Rose, N. 2007. The Politics of Life Itself: Biomedicine, Power, and Subjectivity in the

Twenty-First Century. Princeton, NJ: Princeton University Press.

Redfield, P. 2005. Doctors, Borders, and Life in Crisis. Cultural Anthropology 20(3):

328–361

Ticktin, Miriam. 2010. Where Ethics and Politics Meet. The Violence of

Humanitarianism in France. In A Reader in Medical Anthropology. Theoretical

Trajectories, Emergent Realities, Byron J. Good, Michael M.J. Fischer, Sarah S.

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Willen, and Mary-Jo DelVecchio Good (Eds). pp. 199-212. Chichester: Wiley-

Blackwell.

Wahlberg, A. 2006. Bio-politics and the Promotion of Traditional Herbal Medicine

in Vietnam. Health 10(2): 123–147.

WEEK 6: MEDICALIZATION AND DEMEDICALIZATION

"Medicalization"—the expansion of medical jurisdiction and treatment into areas

previously seen as "normal"—has long been critically discussed by

anthropologists and other social scientists. Debates around medicalization have

been given a renewed impetus by theories of "pharmaceuticalization," which

proposes that the expansion and intensification of drug-taking in new realms of

life should be looked at in a different way than medicalization. In turn,

demedicalization processes occur when medicine relinquishes the power to

define and regulate domains of life, or when that power is actively wrestled away

from it.

Key Reading

Cloatre, E. and Pickersgill, M., 2014. International law, public health, and the

meanings of pharmaceuticalization. New genetics and society, 33(4): 434-449.

Dumit, Joseph. Illnesses you have to fight to get: Facts as forces in uncertain,

emergent illnesses. Social Science & Medicine 62(3): 577-590.

Hacking, Ian. 2007. Kinds of People: Moving Targets. Proceedings-British Academy

151.

Further reading

Abraham, J. 2010. Pharmaceuticalization of Society in Context: Theoretical,

Empirical and Health Dimensions. Sociology 44(4): 603-622.

Applbaum, K. 2009. Getting to Yes: Corporate Power and the Creation of a

Psychopharmaceutical Blockbuster. Culture, Medicine and Psychiatry 33:

185-215.

Conrad, Peter. 2007. The Medicalization of Society: On the Transformation of Human

Conditions into Treatable Disorders. Baltimore: The Johns Hopkins

University Press.

Dumit, J. 2012. Drugs for Life. Durham, NC: Duke University Press.

Ecks, S. 2013. Eating Drugs: Psychopharmaceutical Pluralism in India. New York:

New York University Press. (esp. chpt. 4)

Edmonds, A. (2010). Pretty modern: Beauty, sex, and plastic surgery in Brazil.

Durham, NC: Duke University Press.

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Gertner, Alex. 2010. Science of Uncertainty: Making Cases for Drug Incorporation

in Brazil. Anthropological Quarterly 83(1): 97-122.

Greenslit, Nathan. 2006 Dep®ession and Consum$tion: Psychopharmaceuticals,

Branding, and New Identity Practices. Culture, Medicine, and Psychiatry

30(1): 29: 477-501.

Lane, Christopher. 2008. Shyness: How Normal Behavior Became a Sickness. New

Haven: Yale University Press.

Metzl, Jonathan M. 2007. If Direct-To-Consumer Advertisements Come to

Europe: Lessons from the USA. The Lancet 369: 704-706.

Metzl, Jonathan M. & Herzig, Rebecca M. 2007. Medicalisation in the 21st

Century: An Introduction. The Lancet 369: 696-97.

Metzl, J.M. & Kirkland, Anna Rutherford (Eds.) 2010. Against Health: How Health

Became the New Morality. New York: New York University Press.

Oldani, Michael. 2004. Thick Prescriptions. Medical Anthropology Quarterly 18(3):

325-356.

Rose, N. 2006. Disorders Without Borders? The Expanding Scope of Psychiatric

Practice. BioSocieties 1: 465-484.

Whitmarsh, Ian. 2008. Biomedical Ambivalence: Asthma Diagnosis, the

Pharmaceutical, and Other Contradictions in Barbados. American

Ethnologist 35(1): 49-63.

WEEK 7: HEALERS

Interactions between patients and healers in different cultural settings are a core

aspect of the ethnographic study of health and illness. This lecture will engage

students with the array of questions that such research can pose. What does it

mean to heal? Who can heal? Who defines what it means to be healthy or unwell?

What does it mean to be an expert? Who has control of the knowledge and

artefacts of healing? Where do such interactions take place – in public? In private?

How can we think about healing as performative?

Key Readings

Langwick, S. 2007. Devils, Parasites, and Fierce Needles: Healing and the Politics

of Translation in Southern Tanzania. Science, Technology & Human Values, 32:

88-117.

Lévi-Strauss, C. 1965. The sorcerer and his magic. In Structural anthropology 1.

Harmondsworth: Penguin.

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Further Reading

Csordas, T. 1988. ‘Elements of Charismatic Persuasion and Healing’, Medical

Anthropology Quarterly 2(2): 121-142

Davenport, B. A. 2000. ‘Witnessing and the Medical Gaze: How Medical Students

Learn to See at a Free Clinic for the Homeless’ Medical Anthropology

Quarterly 14(3): 310-327

Desjarlais, R. R. 1989. ‘Healing Through Images: The Magical Flight and Healing

Geography of Nepali Shamans’, Ethos 7(3): 289-307

Ecks, S. and Kupfer, C., 2015. “What is strange is that we don't have more

children coming to us”: A habitography of child psychiatrists and

scholastic pressure in Kolkata, India. Social Science & Medicine 143: 336-342.

Friedman-Peleg, K. and Goodman, Y. C. 2010. ‘From Posttrauma Intervention to

Immunization of the Social Body: Pragmatics and Politics of a Resilience

Program in Israel’s Periphery’, Culture, Medicine, and Psychiatry 34(3): 421-

442

Hampshire, K. R. and Owusu, S. A. 2013. ‘Grandfathers, Google, and Dreams:

Medical Pluralism, Globalization, and New Healing Encounters in Ghana’,

Medical Anthropology 32(3): 247-265

Harvey, G. 2002. Shamanism: A Reader London: Routledge.

Kleinman, A. 1980. Patients and Healers in the Context of Culture: An Exploration of

the Borderland between Anthropology, Medicine, and Psychiatry. Berkeley:

University of California Press

Keshet, Y. and Popper-Giveon, A. 2013. ‘Integrative Health Care in Israel and

Traditional Arab Herbal Medicine: When Health Care Interfaces with

Culture and Politics’ Medical Anthropology Quarterly 27(3): 368-384

Seligman, R. and Kirmayer, L.J. 2008. ‘Dissociative Experience and Cultural

Neuroscience: Narrative, Metaphor and Mechanism’, Culture, Medicine and

Psychiatry 32: 31-64

Tiilikainen, M. 2012. ‘It’s Just Like the Internet: Transnational Healing Practices

between Somaliland and the Somali Diaspora’ in H. Dilger, A. Kane, and S.

A. Langwick (eds), Medicine, Mobility, and Power in Global Africa. Indiana:

Indiana University Press.

WEEK 8: HEALING WITH (AND WITHOUT) SUBSTANCES

Healing encounters pose questions about differences between lay beliefs and

specialized knowledge, hierarchies of power, limits of understanding, and ways

of creating consensus. In medical anthropology, healing is commonly described

as an intricate performance in which all humans and objects have to play their

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parts for the outcome to be successful. Why is healing more than just giving

medicines, how is healing performative?

Key Readings

Hinton, D.E. and Kirmayer, L.J., 2017. The flexibility hypothesis of healing.

Culture, Medicine, and Psychiatry 41(1): 3-34.

Miller, F.G., Colloca, L. and Kaptchuk, T.J., 2009. The placebo effect: illness and

interpersonal healing. Perspectives in biology and medicine, 52(4), p.518.

Thompson, Jennifer Jo, Ritenbaugh, Cheryl, & Nichter, Mark. 2009. Reconsidering

the placebo response from a broad anthropological perspective. Culture,

Medicine and Psychiatry 33: 112-152.

Further Readings

Csordas, T.J. 2002. Body/Meaning/Healing. Houndmills: Palgrave Macmillan. (pp.

11-57)

Desjarlais, R.R. 1989. Healing Through Images: The Magical Flight and Healing

Geography of Nepali Shamans. Ethos 7(3): 289-307.

Desjarlais, R.R. 1992. Body and Emotion: The Aesthetics of Illness and Healing in the

Nepal Himalayas. Philadelphia: University of Pennsylvania Press.

Halliburton, M. 2003. The Importance of a Pleasant Process of Treatment: Lessons

on Healing From South India. Culture, Medicine and Psychiatry 27: 161–186.

Harvey, G. 2002. Shamanism: A Reader. London: Routledge.

Hoffman, G.A., Harrington, A. & Fields, H.L. 2005. Pain and the Placebo Effect:

What We Have Learned. Perspectives in Biology and Medicine 48(2): 248-265.

Kaptchuk, T.J., 2002. The placebo effect in alternative medicine: can the

performance of a healing ritual have clinical significance?. Annals of

Internal Medicine 136(11):817-825.

Kleinman, A., H. Guess, & J. Wilentz. 2002. An Overview. In The Science of the

Placebo: Toward an Interdisciplinary Research Agenda. H. Guess, A. Kleinman,

J. Kusek, & L. Engel, eds. London: BMJ Books.

Laderman, C. 1991. Taming the Wind of Desire: Psychology, Medicine, and Aesthetics

in Malay Shamanistic Performance. Berkeley: University of California Press.

Laderman, C. & Roseman, M. (Eds.) 1996. The Performance of Healing. London:

Routledge.

Moerman, D. 2002. Meaning, Medicine and the 'Placebo Effect'. Cambridge:

Cambridge University Press. (pp. 32-66)

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Sax, W. S. 2004. Healing Rituals: A Critical-Performative Approach. Anthropology

and Medicine 11(3): 293-306.

van der Geest, Sjaak, Reynolds Whyte, Susan & Hardon, Anita. 1996. The

Anthropology of Pharmaceuticals: A Biographical Approach. Annual Review of

Anthropology 25:153-178.

Waldram, J.B., 2013. Transformative and restorative processes: Revisiting the

question of efficacy of Indigenous healing. Medical anthropology, 32(3): 191-207.

WEEK 9: LIFE AND DEATH

Life and death are at the core of a vast range of anthropological studies, covering

the terrain of ritual, religion, gender, kinship, and exchange. Allowing and

prolonging life, while postponing and managing death are increasingly at the

forefront of biomedical technologies. This week, we will examine how medical

anthropologists have approached life and death, covering varying

understandings of both. How have medical technologies shaped biological,

ethical, moral, and legal categories of life and death? How do concepts of life and

death affect the use of medicine?

Key Readings

Gammeltoft, T.M. and Wahlberg, A., 2014. Selective reproductive technologies.

Annual Review of Anthropology 43: 201-216.

Lock, M. 1996. Death in Technological Time: Locating the End of Meaningful Life.

Medical Anthropological Quarterly 10(4): 575-600

Kaufman, S. R. and L. M. Morgan. 2005. The Anthropology of the Beginnings and

Ends of Life. Annual Review of Anthropology 34: 317-341

Further Readings

Franklin, S. 2014. Rethinking Reproductive Politics in Time, and Time in UK

Reproductive Politics: 1978-2008. Journal of the Royal Anthropological Institute

20:109-125.

Franklin, S. and M. Lock. 2003. Remaking Life and Death: Towards an Anthropology of

the Biosciences. Santa Fe, NM: SAR Press.

Hamdy, S. 2013. ‘Not Quite Dead: Why Egyptian Doctors Refuse the Diagnosis of

Death by Neurological Criteria’, Journal of Theoretical Medicine and Bioethics

34(2): 147-160

Helmreich, Stefan. 2012. Extraterrestrial relativism. Anthropological Quarterly

85(4): 1125-1139

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Kaufman, S.R., 2015. Ordinary Medicine: Extraordinary Treatments, Longer Lives, and

Where to Draw the Line (p. 314). Durham, NC: Duke University Press.

Lock, M. 2002. Twice Dead: Organ Transplants and the Reinvention of Death.

Berkeley: University of California Press

Meyers, T. 2007. A Turn Towards Dying: Presence, Signature, and the Social

Course of Chronic Illness in Urban America. Medical Anthropology 26(3): 205-

227.

Norwood, F. 2007. Nothing More to Do: Euthanasia, General Practice, and

End-of-Life Discourse in the Netherlands. Medical Anthropology 26(2):

139-174.

Philips, Sarah. 2011. Chernobyl forever. Somatosphere, April 25, 2011.

[download at http://somatosphere.net/test/2011/04/chernobyl-

forever.html]

Valentine, D., 2016. Atmosphere: Context, detachment, and the view from

above Earth. American Ethnologist, 43(3): 511-524.

Svendsen, M. N. 2015. Selective Reproduction: Social and Temporal

Imaginaries for Negotiating the Value of Life in Human Animal

Neonates. Medical Anthropology Quarterly 29(2): 178-195

Valentine, D., 2016. Atmosphere: Context, detachment, and the view from

above Earth. American Ethnologist, 43(3): 511-524.

Villadsen, K. and Wahlberg, A., 2015. The government of life: managing

populations, health and scarcity. Economy and Society, 44(1), pp.1-17.

WEEK 10: TAKE CARE OF YOURSELF

With so much bad medicine around, perhaps one should better resort to "self-

care"? Indeed, it is widely acknowledged that more than more than half of all

illness episodes are never treated with any drug, let alone come to the attention of

a medical professional. But self-care occupies an ambiguous position in

anthropological studies. Self-care is sometimes defined as all health practices

unmediated by medical commodities. Sometimes it is taken to mean irrational

and dangerous forms of self-medication with over-the-counter drugs. The bulk of

anthropological writings on "self-care" interpret them either as a strategy of

poverty or as a shift of responsibility from the public to the private individual

(keyword: "neoliberalism"). Michel Foucault's notion of self-care as a practice of

freedom has, to date, not been seriously taken up by anthropologists.

For class discussion:

Nichter, M. & Thompson, J.J. 2006. For my wellness, not just my illness: North

Americans' use of dietary supplements. Culture, Medicine and Psychiatry 30:

175-222.

Schull, N.D. 2006. Machines, medication, modulation: circuits of dependency and

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self-care in Las Vegas. Culture, Medicine and Psychiatry 30(2): 223-247

Weiner, T., 2011. The (un) managed self: paradoxical forms of agency in self-

management of bipolar disorder. Culture, Medicine, and Psychiatry, 35(4):

448-483.

Further reading:

Aujoulat, Isabelle et al. 2008. Reconsidering patient empowerment in chronic

illness: a critique of models of self-efficacy and bodily control. Social Science

& Medicine 66(5): 1228-1239.

Chen, Nancy N. 2003. Healing sects and anti-cult campaigns. The China Quarterly

174: 505-520.

Clarke, A. E. et al. 2003. Biomedicalization: technoscientific transformations of

health, illness, and U.S. medicine. American Sociological Review 68(2): 161-

194.

Ecks, Stefan. 2004. Bodily sovereignty as political sovereignty: 'self-care' in

Kolkata (India). Anthropology & Medicine 11(1): 75-89.

Farquhar, Judith & Zhang, Qicheng. 2005. Biopolitical Beijing: pleasure,

sovereignty, and self-cultivation in China’s capital. Current Anthropology

20(3): 303-327.

Foucault, Michel. 1982a. The subject and power. In Hubert L. Dreyfus and Paul

Rabinow, Michel Foucault: Beyond Structuralism and Hermeneutics. Chicago:

The University of Chicago Press.

Foucault, Michel. 1982b. On the Genealogy of ethics: an overview of work in

progress. In Hubert L. Dreyfus and Paul Rabinow, Michel Foucault: Beyond

Structuralism and Hermeneutics. Chicago: The University of Chicago Press.

Foucault, M. 1997. Ethics: Subjectivity and truth. Ed. Paul Rabinow. New York: The

New Press. (pages 223-252).

Geissler, P.W. et al. 2000. Children and medicines: self-treatment of common

illnesses among Luo schoolchildren in western Kenya. Social Science &

Medicine 50(12): 1771-1783.

Illich, Ivan. 1976. Limits to medicine. London: Marion Boyars.

McKinney, Kelly A. & Greenfield, Brian G. 2010. Self-compliance at 'Prozac

campus.' Anthropology & Medicine 17(2): 173-185.

Staples, J. 2004. Delineating disease: self-management of leprosy identities in

South India. Medical Anthropology 23: 69-88.

Vuckovic, N. 2000. Self-care among the uninsured: “You do what you can do.”

Health Affairs 19(4), 197-199.

WEEK 11: ASSESSMENT FEEDBACK AND GUIDANCE

There will be no lecture this week. Students are encouraged to make

appointments with Dr Stefan Ecks to discuss their assignments.

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ASSESSMENT

There are two essays for this course.

The first is an essay of between 800 and 1,000 words, submitted part way through

the course, worth 30% of the overall mark. Short essays must be submitted

electronically using ELMA by 12 noon on Wednesday 18 October 2017.

The second is an essay of between 3,000 and 3,500 words long, to be submitted

after the end of the course, worth 70% the final mark. Long essay titles will be

provided in class in week 6. Long essays must be submitted electronically using

ELMA by 12 noon on Monday 11 December 2017.

Feedback for coursework will be returned online via ELMA for the short essay on

Wednesday 08 November 2017 and the long essay on Wednesday 10 January

2018.

Short Essay

Essay topic: Medical anthropologists read the news

Select a health-related event that has been covered in the media (print, web,

radio, etc.) in the past one year and analyse it. Any given day, the front pages of

news outlets cover at least one health-related story. For example, on 18 August

2017, the BBC online news page featured 1) calls to cut calories in popular foods

to fight obesity epidemic, 2) female inmates in a US prison were offered shorter

sentences in exchange for a vasectomy or a long-acting birth control implant,

making them medical "guinea pigs", or 3) the UK counties where pensioners

report highest well-being. Take a story that grabs your attention and discuss it in

relation to a minimum of three relevant readings from our course to make sense

of the event. You should focus on the conceptual analysis of the event: how do

your readings in medical anthropology make you see these reports in a new

light? Media stories always have a certain bias in how they represent what has

happened but this essay is not an exercise in critical media studies. Instead, use

the news story as primary data. All sources, including the media stories, should

be clearly referenced. Usually an essay starts with a short summary of what the

case is all about before proceeding to the analysis.

Assessment Criteria for Essays

1. Development and coherence of arguments

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2. Demonstration of an advanced and critical understanding of relevant key

debates relating to medical anthropology as discussed on the course

3. Use of supporting evidence

4. Degree of reflexivity and critical thinking in relation to arguments and

evidence

5. Drawing together major arguments by way of conclusion in relation to the

assignment

6. Formal presentation of report: correct referencing and quoting; spelling,

grammar and style; layout and visual presentation.

Submission and Return of Coursework

For Assessment requirements you should consult the MSc Taught Student

Handbook -

http://www.sps.ed.ac.uk/gradschool/current_students/taught_msc_students

This is available on Learn.

Requirements included are:

Coursework submissions

Extension request

Penalties

External Examiner

The External Examiner for the course is Dr Arnar Árnason, Aberdeen University.