12 257 Introduction to Medical Anthropology

12:257 Introduction to Medical Anthropology Fall 2017: Undergraduate Course Monday, Wednesday and Friday Slot 4 – CHO 022 Instructor: Dr. Emma Varley Associate Professor, Department of Anthropology CHO 207, Brandon University Email: [email protected] Office Hours: Friday 2:30 – 3:15pm or by appointment. I. Course Description and Objectives Medical anthropology involves up-close, person-centered, and ethically engaged examination of the complex cultural dynamics that underpin and give rise not only to health and wellbeing, illness and death, but also the medical systems on which we rely for treatment and cure. This introductory course will first discuss the history and development of medical anthropology as a sub-discipline of sociocultural anthropology. We will briefly explore the multiple directions that medical anthropology has taken since its inception, and the interdisciplinary approaches, concepts, and theories so central to contemporary anthropologists’ research, outreach, and activism. We will also discuss the field-based methods used by medical anthropologists – and ethnographers in particular – to investigate how cultural forces shape issues of health, illness, and medicine. The course will next focus on recent theoretical and ethnographic developments, such as the evolution of meaning-centered and critical medical anthropology approaches. Special attention will be paid to anthropologists’ efforts to explore how bodies, health and illness, and also medical services and systems are at the nexus of – and bear the effects of - intersecting neoliberal and capitalistic forces. In addressing the ways that social, political, and economic systems give rise to health (in)equity and (in)justice, we will gain insights to the socially important and applied ways that ethnography pulls into view otherwise obscured or invisible experiences, and the forms of suffering and signs of hope these entail. To this end, we will work together to review critical theories and ethnographic case studies of health and medicine in North America and around the world. Lectures, assigned readings and documentary films will be used to help students gain insights into the richness and complexity of health and medicine, in times of peace as well as instability and crisis. Through their active participation with lectures, in-class discussions and the timely completion of the required readings and assignments, students will: • • • • Become familiar with medical anthropology’s core concepts and theories, its methods, and applied disciplinary and interdisciplinary objectives, Identify the role played by colonial and postcolonial socio-economic and political dynamics – or, political etiologies - in producing health as well as illness, disease, and death at individual and societal levels; Draw on ethnographic case studies to discuss the ways that issues of health, illness, the body itself are shaped by local and global culture forces and contexts, Generate evidence-based anthropological evaluations and critiques of health, medicine and health systems, and medical humanitarianism, 1   • Understand the culturally responsive and sometimes ethically complex ways that medical anthropology methods and theory can be applied to professional and activist work on socially important and politically urgent issues in diverse culture contexts. II. Prerequisites 12 153 Introduction to Sociocultural Anthropology. III. Teaching Methods The course will incorporate both lecture and seminar approaches, the latter of which will involve assigned readings questions, and entail discussion among students and with the Instructor. Lectures and seminars will be supplemented by documentaries shown in-class. PDFs of the lecture PowerPoints will be posted to Moodle on a biweekly basis. Supplementary updates concerning medical anthropology research, events and related news will also be posted to the course Facebook Group Page: https://www.facebook.com/groups/1841747592508065/. Students who sign up for the Facebook page and regularly review posted content will receive a 2% bonus mark. Students actively contributing to the Group with postings, discussions, and responses – especially those that provide Canadian examples of the issues, debates, concepts, and theories detailed by the lecture topics and assigned readings – will receive a 4% bonus mark. VI. Course Evaluation and Assignments Students’ evaluation will be based on an in-class presentation, written assignments and the final exam. Students are required to use the course’s study guide, lecture notes and assigned readings in order to prepare for the course’s final exam. Your grade will be based on the following: 1. Classroom attendance and participation (5% + 5%) = 10% 2. Media research and in-class summaries of five relevant news articles = (5 x 3%) 15% (September 25; October 6, 13, 20, 27; November 3, 17, 24; December 1, 4) 3. One, three-page review of a suggested reading = 15% (September 29) 4. One, three-page response paper on an ethnographic film using pre-assigned questions and concepts = 15% (November 17) • “Extremis.” (2016, 24 minutes: Netflix Canada; medical procedures) • “My Beautiful Broken Brain.” (2016, 1 hour 24 minutes: Netflix Canada) • “The White Helmets.” (2016, 40 minutes: Netflix Canada; medical procedures, graphic violence) 5. One group-based (2 students) 10-minute presentation of an assigned reading for a select week = 15% (October 6, 20; November 24) 6. Research Essay (8-10 pages) = 30% (December 8) TOTAL = 100% 2   Letter Grade and Marks A+: 90.0 – 100% B: 74.0 – 76.9% C-: 60.0 – 63.9% A: 85.0– 89.9% B-: 70.0 – 73.9% D: 50.0 – 59.9% A-: 80.0 – 84.9% C+: 67.0 – 69.9% F: 0 – 49.9% B+: 77.0 – 79.9% C: 64.0 – 66.9% Unless previous and/or alternative arrangements are made with the course instructor, late assignments will be penalized 5% of the total assignment mark per day. Academic Integrity Students are specifically referred to the policy on academic integrity Section 4.2.2 of the General Calendar. Violations of this policy, including all forms of plagiarism, will not be tolerated. Your written assignments must represent original work, with your use of all resources properly cited (style requirements will be discussed in-class and posted on the course website). Human Rights Compliance Brandon University values diversity and inclusion, recognizing disability as an aspect of diversity. Our shared goal is to create learning environments that are accessible, equitable, and inclusive for all students. The Student Accessibility Services (SAS) office works with students who have permanent, chronic, or temporary disabilities. SAS will provide and/or arrange reasonable accommodations. If you have, or think you may have, a disability (e.g. mental health, attentional, learning, vision, hearing, physical, medical, or temporary), you are invited to contact Student Accessibility Services to arrange a confidential discussion at (204) 727-9759 or email [email protected]. If you are registered with SAS and have a letter requesting accommodations, you are encouraged to contact the instructor early in the term to discuss the accommodations outline in your letter. Additional information is available at the Student Accessibility Services website. V. Texts The course’s assigned readings consist of journal article and book chapter readings; these and the suggested readings will be made available to you on Moodle. The suggested readings (SR) are complementary to your assigned readings and the course lecture. You are encouraged to draw on the assigned and suggested readings, as well as the wider anthropological literature, to help support and enrich the arguments you make in your course assignments. Unless otherwise indicated by the Instructor, the assigned readings must be completed prior to lecture. Please be aware that class lectures are intended to build on, rather than directly repeat, the content of your weekly assigned readings. Students are therefore advised to take careful and comprehensive notes of all class lectures, or ensure that a responsible classmate takes them on your behalf in case of your absence. Your lecture notes, assigned readings, and the documentary films shown in-class are all ‘testable’ material, which means that they may appear in-whole or in-part as part of the midterm and final exam. 3   CLASS SCHEDULE Date Week One September 6, 8 Topic What Is Medical Anthropology: Part I Week Two What Is Medical September 11, Anthropology: Part II 13, 15 Readings and Assignments Baer, Hans A., Merrill Singer, and Ida Susser. (2003). “Medical Anthropology: Central Concepts and Development.” Medical Anthropology and the World System. Westport, CT: Praeger Publishers, pp. 3-29. Singer, Merrill and Hans Baer. (2007). “What Medical Anthropologists Do.” Introducing Medical Anthropology: A Discipline in Action. Plymouth, UK: Altamira Press, pp. 35-64. (SR) Finkler, Kaja, Cynthia Hunter, and Rick Iedema. (2008.) “What is going on? Ethnography in hospital spaces.” Journal of Contemporary Ethnography, 37 (2): 246-250. (SR) Long, Debbi, Cynthia L. Hunter, and Sjaak van der Geest. (2008). “When the field is a ward or a clinic: Hospital ethnography.” Anthropology & Medicine, 15 (2): 71-78. (SR) Savage. J. (2006). “Ethnographic Evidence: The Value of Applied Ethnography in Healthcare.” Journal of Research in Nursing, 11: 383-393. (SR) Smith-Morris, Carolyn et al. (2014). “Ethnography, Fidelity, and the Evidence that Anthropology Adds: Supplementing the Fidelity Process in a Clinical Trial of Supported Employment.” Medical Anthropology Quarterly, 28 (2): 141-161. Week Three Biomedical September 18, Hegemony: Medicalization and 20, 22 Pharmaceuticalization Browner, C.H. and Nancy Press. (1996). “The Production of Authoritative Knowledge in American Prenatal Care.” Medical Anthropology Quarterly, 10 (2): 141-156. Carpenter-Song, Elizabeth. (2009). “Children’s sense of self in relation to clinical processes: Portraits of pharmaceutical transformation.” Ethos, 37 (3): 257-281. (SR) Behague, Dominique A. (2009). “Psychiatry and Politics in Pelotas, Brazil: The Equivocal Quality of Conduct Disorder and Related Diagnoses.” Medical Anthropology Quarterly, 23 (4): 455-482. (SR) Greil, Arthur L. and Julia McQuillan. (2010). “’Trying Times’: Medicalization, Intent, and Ambiguity in the Definition of Infertility.” Medical Anthropology Quarterly, 24 (2): 137-156. 4   (SR) Lock, Margaret M. (2001). “The Tempering of Medical Anthropology: Troubling Natural Categories.” Medical Anthropology Quarterly, 15 (4): 478-492. Week Four Biopolitics and September 25, Biopower 27, 29 Greenhalgh, Susan. (2012). “Weighty subjects: The biopolitics of the U.S. war on fat.” American Ethnologist, 39 (3): 471-487. Marsland, Rebecca and Ruth Prince. (2012). “What is Life Worth? Exploring Biomedical Interventions, Survival, and the Politics of Life.” Medical Anthropology Quarterly, 26 (4): 453-469. (SR) Biehl, Joao. (2013). “The judicialization of biopolitics: Claiming the right to pharmaceuticals in Brazilian courts.” American Ethnologist, 40 (3): 419-436. (SR) Zeiderman, Austin. (2013). “Living Dangerously: Biopolitics and Urban Citizenship in Botoga, Colombia.” American Ethnologist, 40 (1): 71-87. Week Five October 2, 4, 6 The Social Construction of Health, Illness, and Disease Hoberman, John. (2012). “Medical consequences of racializing the human organism.” Black & Blue: The Origins and Consequences of Medical Racism. Berkeley: University of California Press, pp. 71-145. Assignment: Assigned Article Review Presentations, Groups 1 and 2 (October 6) (SR) Buchbinder, Mara. (2011). “Personhood diagnostics: Personal attributes and clinical explanations of pain.” Medical Anthropology Quarterly, 25 (4): 457-478. (SR) Chua, Jocelyn Lim. (2012). “The Register of ‘Complaint’: Psychiatric Diagnosis and the Discourse of Grievance in the South Indian Mental Health Encounter.” Medical Anthropology Quarterly, 26 (2): 221-240. (SR) Fein, Elizabeth. (2015). “’No One Has to Be Your Friend’: Asperger’s Syndrome and the Vicious Cycle of Social Disorder in Late Modern Identity Markets.” Ethos, 43 (1): 82-107. (SR) Grinker, Roy Richard and Kyungjin Cho. (2013). “Border Children: Interpreting Autism Spectrum Disorder in South Korea.” Ethos, 41 (1): 46-74. (SR) Whitmarsh, Ian. (2008). “Biomedical ambivalence: Asthma diagnosis, the pharmaceutical, and other contradictions in Barbados.” American Ethnologist, 35 (1): 5   49-63. Week Six Theories of Body and October 9, 11, Bodily Experience 13 October 9: Thanksgiving – No Class Csordas, Thomas. (1993). “Somatic Modes of Attention.” Cultural Anthropology, 8 (2): 135-156. Scheper-Hughes, Nancy and Margaret M. Lock. (1987). “The Mindful Body: A Prolegomenon to Future Work in Medical Anthropology.” Medical Anthropology Quarterly, 1 (1): 6-41. (SR) Shuttleworth, Russell P. and Devva Kasnitz. (2004). “Stigma, Community, Ethnography: Joan Ablon’s Contribution to the Anthropology of ImpairmentDisability.” Medical Anthropology Quarterly, 18 (2): 139161. Week Seven October 16, 18, 20 Social Determinants and Political Etiologies Everett, Margaret and Josef N. Wieland. (2013). “Diabetes among Oaxaca’s Transnational Population: An Emerging Syndemic.” Annals of Anthropological Practice, 36 (2): 295-311. Hamdy, Sherine F. (2008). “When the state and your kidneys fail: Political etiologies in an Egyptian dialysis ward.” American Ethnologist, 34 (4): 553-569. Documentary: “Remote Area Medical.” (2012, 1 hour 31 minutes) Assignment: Assigned Article Review Presentations, Groups 3 and 4 (October 20) (SR) Rock, Melanie. (2003). “Sweet blood and social suffering: Rethinking cause-effect relationships in diabetes, distress, and duress.” Medical Anthropology, 22 (2): 131174. Week Eight October 23, 25, 27 Precarity, Suffering, and Trauma Henry, Doug. (2006). “Violence and the Body: Somatic Expressions of Trauma and Vulnerability during War.” Medical Anthropology Quarterly, 20 (3): 379-398. Jenkins, Janis H. and Elizabeth A. Carpenter-Song. (2008). “Stigma despite recovery: Strategies for living in the aftermath of psychosis.” Medical Anthropology Quarterly, 22 (4): 381-409. Assignment: Suggested Reading Review Paper (October 23) (SR) Amrami, Galia Plotkin. (2016). “Competing etiologies of trauma and the mediation of political suffering: The disengagement from the Gaza Strip and 6   West Bank in Secular and Religious Therapeutic Narratives.” Ethos, 44 (3): 289-312. (SR) Fassin, Didier. (2007). “Critical Evidence: The Politics of Trauma in French Asylum Politics.” Ethos, 35 (3): 300-329. (SR) Van Eijk, Marieke. (2014). “Ideologies of Self, Suffering, and Gender Nonconformity in a U.S. Gender Identity Clinic.” Medical Anthropology, 33 (6): 497-512. Week Nine October 30; November 1, 3 Hospital Encounters, Then and Now Cooper, Amy. (2015). “The doctor’s political body: Doctor-patient interactions and sociopolitical belonging in Venezuelan state clinics.” American Ethnologist, 42 (3): 459-474. Lux, Maureen K. (2016). “Life and Death in an Indian Hospital.” Separate Beds: A History of Indian Hospitals in Canada, 1920s-1980s. Toronto: University of Toronto Press, pp. 94-129. Documentary: “The Waiting Room.” (2012, 1 hour 22 minutes) (SR) Hoberman, John. (2012). “Black patients and white doctors.” Black & Blue: The Origins and Consequences of Medical Racism. Berkeley: University of California Press, pp. 18-70. (SR) Pylypa, Jen. (2007). “Healing Herbs and Dangerous Doctors: ‘Fruit Fever’ and Community Conflicts in Biomedical Care in Northeast Thailand.” Medical Anthropology Quarterly, 21 (4): 349-368. Week Ten November 6, 8, 10 Reading Break Reading Break and Remembrance Day – No Classes Week Eleven November 13, 15, 17 The Politics of Reproduction Andaya, Elise and Joanna Mishtal. (2016). “The Erosion of Rights to Abortion Care in the United States: A Call for a Renewed Anthropological Engagement with the Politics of Abortion.” Medical Anthropology Quarterly, 31 (1): 40-59. Fordyce, Lauren. (2012). “Responsible choices: Situating pregnancy intention among Haitians in South Florida.” Medical Anthropology Quarterly, 26 (1): 116-135. Assignment: Assigned Article Review Presentations, Groups 5 and 6 (November 17) (SR) Buchbinder, Mara. (2016). “Scripting Dissent: US Abortion Laws, State Power, and the Politics of Scripted 7   Speech.” American Anthropologist, 118 (4): 772-783. (SR) Council on Anthropology and Reproduction. (2016). “Society for Medical Anthropology Council on Anthropology and Reproduction (CAR) Policy Statement: The Council on Anthropology and Reproduction (CAR) Opposes Legislation that Creates Barriers to Safe Abortion Care.” Medical Anthropology Quarterly: 7 pages. (SR) Mishtal, Joanna Z. (2009). “Matters of ‘Conscience’: The Politics of Reproductive Healthcare in Poland.” Medical Anthropology Quarterly, 23 (2): 161-183. (SR) Rivkin-Fish, Michele. (2004). “’Change Yourself and the Whole World Will Become Kinder’: Russian Activists for Reproductive Health and the Limits of Claims Making for Women.” Medical Anthropology Quarterly, 18 (3): 281-304. (SR) Singer, Elyse Ona. (2016). “From Reproductive Rights to Responsibilization: Fashioning Liberal Subjects in Mexico City’s New Public Sector Abortion Program.” Medical Anthropology Quarterly, 0 (0): 1-9. Week Twelve November 20, 22, 24 Chemosphere: Drugs, Toxicity, and Affliction Shapiro, Nicholas. (2015). “Attuning to the Chemosphere: Domestic Formaldehyde, Bodily Reasoning, and the Chemical Sublime.” Cultural Anthropology, 30 (3): 368393. White, Amiran. (2010). “A Legacy of Suffering.” Visual Anthropology Review, 26 (2): 144-150. (SR) Campbell, Brian C. (2015). “Confrontations on Karst: Antibiocide Activism in the Ozarks, United States.” Culture, Agriculture, Food and Environment, 37 (2): 96106. (SR) Gamlin, Jennie. (2016). “Huichol Migrant Laborers and Pesticides: Structural Violence and Cultural Confounders.” Medical Anthropology Quarterly, 30 (3): 303-320. (SR) Goldstein, Donna M. and Kira Hall. (2015). “Mass hysteria in Le Roy, New York: How brain experts materialized truth and outscienced environmental inquiry.” American Ethnologist, 42 (4): 640-657. (SR) Kline, Nolan and Rachel Newcomb. (2013). “The Forgotten Farmworkers of Apopka, Florida: Prospects for Collaborative Research and Activism to Assist African American Former Farmworkers.” Anthropology and 8   Humanism, 38 (2): 160-176. (SR) Saxton, Dvera I. (2015). “Strawberry Fields as Extreme Environments: The Ecobiopolitics of Farmworker Health.” Medical Anthropology, 34 (2): 166-183. Week Thirteen November 27, 29; December 1 Crisis and Conflict Pfingst, Annie and Marsha Rosengarten. (2012). “Medicine as a Tactic of War: Palestinian Precarity.” Body & Society, 18 (3-4): 99-125. Redfield, Peter. (2005). “Doctors, Borders and the Ethics of Crisis.” Anthropology News, September: 34. Smith, Catherine. (2013). “Doctors that Harm, Doctors that Heal: Reimagining Medicine in Post-Conflict Aceh, Indonesia.” Ethnos: Journal of Anthropology, 1-20. Documentary: “Living in Emergency: Stories of Doctors Without Borders.” (2008, 1 hour 33 minutes) (SR) Redfield, Peter. (2005). “Doctors, Borders, and Life in Crisis.” Cultural Anthropology, 20 (3): 328-361. (SR) Varley, Emma. (2016). “Abandonments, Solidarities, and Logics of Care: Hospitals as Sites of Sectarian Conflict in Gilgit-Baltistan.” Culture, Medicine, and Psychiatry, 40 (2): 159-180. Week Fourteen December 4, 6 Necropolitics Mbembe, Achille. (2003). “Necropolitics.” Public Culture, 15 (1): 11-40. Stevenson, Lisa. (2012). “The psychic life of biopolitics: Survival, cooperation, and Inuit community.” American Ethnologist, 39 (3): 592-613. (SR) Samsky, Ari. (2012). “Scientific sovereignty: How international drug donation programs reshape health, disease, and the state.” Cultural Anthropology, 27 (2): 310332. (SR) Smith, Christen A. (2015). “Blackness, Citizenship, and the Transnational Vertigo of Violence in the Americas.” American Anthropologist, 117 (2): 384-392. 9