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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 ([email protected])
Guidance and Feedback Hours: Tuesdays 1-3pm
Course Secretary:
Morag Wilson ([email protected])
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.