Intro To Med Anthro Mid Term

Front 1

What is medicalization?

Back 1

As every complaint and disorder begins to be sought of as being treatable in a western biomedical context, many aspects of disorder or "uncomfort" in human life are seen as being medical problems that can be treated in a medical setting. Consequently, the social relations contributing
to illness and other forms of disease are in danger of
being medicalized, according to Schepper-Hughes. Everything from marital discord to poor school performance can be appropriated and treated by medicine in new (and
improved) therapies.

Medicalization of work setting: stressed related to powerlessness as a source/cause of high blood pressure. Instead of being examined as a social problem, indiv. labeled as stressed.

Front 2

What is clinical medical anthropology?

Back 2

Clinically applied anthropology is medical anthropology practiced in a clinical setting with anthropologists often working as as consultants as educators for doctors on cultural issues. Example: Doctor in New Mexico and sulfur. It tends to ensure that communication between practitioners and clients is effective and it helps
practitioners understand the individuals and communities they serve. APPLIED

Front 3

What is critical medical anthropology?

Back 3

Critical medical anthropology by its very nature is non-applied in that it steps back to view processes without involvement in order to obtain a more objective view. As outlined by Schepper-Hughes, it is an activist approach that examines issues of biomedical hegemony, patient and environment interaction, power relations in the medical setting, and so forth. She demands that anthropologists cut loose their ties to biomedical premises and epistemologies.

Removin anthropology from biomedical hegemony.

Front 4

What is witnessing?

Back 4

Witnessing is dialogical in that it involves communication between the anthropologist and the afflicted. As Das quotes, "We cry, you listen.," the anthropologist is to listen and give voice to those who have an illness. By recording their experience and sharing it, it is thought that anthropologists can actually help people realize their own abilities and strengths. I believe Kleinman was witnessing when he spoke with the little girl. One can also be like schepper-hughes with organ watch and listen then report.

Front 5

What is biomedical hegemony?

Back 5

See medicalization and critically applied medical anthropology. This is also addressed in Dr. Gordon's tenacious assumptions in that the biomedical model and its coinciding assumptions of naturalism and individualism permeate our culture.

Also, by sheer fact of the dualisms that control it of naturalism and empiricism, etc. it works as a stopper to the acceptance of other forms of knowledge.

Front 6

What is meant by "anthropologist as jester"

Back 6

This is an idea posed by Schepper-Hughes as a metaphor for how the anthropologist working in the realm of medical anthropology and examining biomedical hegemony, etc. should act. A jester is at once inside and outside of the court, not making decisions but having enough access to see what is happening. By their ability to joke, they are the only ones able to criticize the king, but they are putting him in a new light for others to see.

Front 7

Explain Dewey's Thinker

Back 7

This is outlined by Paul Rabinow . For dewey, thinking is an action called forth and set into motion by a discordance. The function of
thinking is to rectify—in the sense of "realign"—the factors that have produced,
and/or have been altered by, a disruption. Thinking, then, is a situated practice
of active inquiry, the role and goal of which is to initiate a motion that results
in a movement from a discordant situation to a less discordant situation. Dewey is pragmatic in how he views thinking much like a physician.

Front 8

Explain Foucault's concept of problematization.

Back 8

As opposed to Dewey and supported by Rabinow, Foucault believes that foremost should not be putting a situation of dicord into less discordance, but examining what is was that made that situation discordant in the first place. "Why is this a problem and what are the different dynamics?" A problematization then is both a kind of general historical and social
situation—saturated with power relations, as are all situations, and imbued
with the relational "play of true and false," a diacritic marking a subclass of
situations—as well as a nexus of responses to that situation. In contrast to earlier positions he held, Foucault's thinker is by definition
neither entirely outside of the situation in question nor entirely enmeshed
within it without recourse or options. The defining trait of problematization
does not turn on the couplings of opposites (outside or inside, free or constrained),
but rather on the type of relationship forged between observer and
problematized situation.

Front 9

Explain Emergent Social Forms

Back 9

This is the type of Anthropology that Rabinow uses in Mdst Anthro's Theories. Bioethics is a realm constantly being changed and recreated. Opposite to studying island culture. US Institutionalization of brain deahts for organ transplantation: builds a whole new life form of permanent vegetative states.

Front 10

What are the limits to Objectivity?

Back 10

How black is the table? (obj.) Is it pretty? (sub.) Is observer knowledge really possible and desirable? Is illness and science truly universalizable? What are we losing of whole experience?

Front 11

What is illness?

Back 11

As defined by Kleinman, Illness is a socially constructed reality. Illness is the embodied experience of disease. Illness includes the experience of suffering. Illness has a story. Illness may not be definable in modern medicine.

Front 12

What is disease?

Back 12

Disease is the biomedical definition of what is affecting the person, putting their body in discordance, or the anomaly without the acknowledgment of embodiment, suffering, etc.

Front 13

What is emplotment?

Back 13

As defined by Mattingly, emplotment is giving a story like a physical therapist to live out.
o Mattingly claims that healers actively struggle to shape therapeutic events t=into a coherent form organized by a plot. They attempt to emplot clinical encounters by enfolding them into larger developing narrative structures. The notion of emplotment clearly reflects an etic framework as far removed from medical discourse.
o Emplotment involves making a configuration in time, creating a whole out of a succession of events.
o “making a whole” is also meaning making which that we can ask what is the point/moral
o Explanation by emplotment – gains coherence by its placement within an archetypal narrative form.

Front 14

Describe disclosure practices

Back 14

Gordon: Embodying Cancer, ITaly. Tell or do not tell. Tell family members. What is more important: telling truth or keeping person hopeful functioning member of society?
o Impt issue of private vs. public knowing. Patients “know” they have cancer and thus the real taboo may be in publicly acknowledging this knowing. This is the most forceful and social one. Truth is defined socially.

Front 15

What is a semantic illness network?

Back 15

Good: Heart. Illness is shaped by webs of ideas and words and ideas are within a society in which the illness is occuring. Semantic Network: a term used to understand the meaning of medical knowledge as it is used in various communicative contexts. A disease thus is not simply a set of defining symptoms, but a ‘syndrome’ of typical experiences, a set of words, experiences, and feelings which typically ‘run together’ for the members of society.

Front 16

What is biosociality?

Back 16

Biosociality is from the Rabinow on Artificiality. ESF. He talks of genetic research. Genes being studied allows humans to be categorized in different ways- genetic disposition. The new biomedicine we have shapes our understanding of ourselves and our relationships. nature will be changed through culture and thus will become artificial, which would bridge the
gap between nature and culture

Front 17

What is individualism?

Back 17

Gordon: Ten.

The self is the building block of society. Atomism: can break down a society to the individual, Self comes first

It is a complex of values and assumptions asserting the primacy of the individual and individual freedom

Front 18

What is illness? simple.

Back 18

refers to a person’s perceptions and experiences of certain socially disvalued states including, but not limited to disease.

Front 19

What is disease, simple.

Back 19

he abnormalities in the structure and/or function of organs and organ systems;pathological states whether or not they are culturally recognizeable; the arena of the biomedical model.

Front 20

What is naturalism?

Back 20

Naturalism is drawn with nature in the middle of the circle and culture around it. It preaches that we can know the world through its mechanisms and that objects are thus knowable. Nature has no gray area. Finds universal truths. It preaches empiricism, rationality, etc.

Front 21

What are Cartesian dualisms?

Back 21

This comes from Schepper-Hughes. It is the artificial separation of mind and body. His legacy permeats in medicine today as a mechanistic conception of the body and its functions and a failure to conceptualize a "mindful" causation of somatic events. "It is in the body or it is in the mind."

IE: individual/society; masculine/feminine; reason/passion; mind/body;nature/culture

Front 22

What is the Mindful Body?

Back 22

Schepp-Locke.

Individual Body: The lived experience of the embodied self, with the intuitive sense of being different from other bodies.

Social Body: representational uses of the body as a natural symbol with which to think about nature, society, and culture. "The body in health offers a model of organic wholeness and the body in sickness offers a model of social disharmony, conflict, and disintegration." o Body is a rich source of metaphors – cultural constructions about the body are useful in understanding vies of society.

Body Politic, Foucault: the regulation, surveillance, and control of bodies in all aspects of human life from reproduction to sexuality to human deviance.

Front 23

What is epistemology?

Back 23

Ways of knowing

Front 24

What is the empiricist paradigm?

Back 24

Good "Problem of Belief"

Related to naturalism and objectivity: goes into field already knowing what is true.

em·pir·i·cism: The view that experience, especially of the senses, is the only source of knowledge.

Biomedical thought is empirical.

Evans-Pritchard reluctant to accept that witches make granaries collapse. "Since we know that witches cannot exist empirically, it is argued, the rationality of Zande thought is called into doubt.

Good works opposite to this in "The Heart of the MAtter"

Front 25

The Medical Model

Back 25

. The “Medical Model” assumes that diseases are universal biological or psychobiological entities… These produce “signs” that can be measured in a clinical laboratory as well as symptoms that are communicated as an ordered set of complaints

Front 26

Belief vs Knowledge

Back 26

Good:

“Belief” in anthropology is most often associated with cultural accounts of the unknowable or of “mistaken understandings” of the natural world.

Some cultures do not have the differentiation between knowledge and belief… All the same.

Pritchard states that the Azande believe that some people are witches, but know diseases by their major symptoms.

Front 27

Azande witchcraft

Back 27

■ Witchcraft is part of everyday Zande life (fishing, hunting, agriculture etc)
o If misfortune occurs, they are not awestruck by supernatural forces. They are more annoyed, knowing someone has had spite or is ill intended for them.
o What is seen as witchcraft is particular occasion  such as went someone was exercising particular care as they walk and still cut their feet. Or when house collapses on top of people, why at that time when they know it would eventually fall due to termites?
o Heat of day + termites + people needed some shade = in our minds why granary collapsed. For us, the only relationship between these 2 independently caused facts is coincidence in time/space. We have no explanation for why it happened then. But Zande philosophy does…witchcraft explains coincidence
■ Witchcraft even explains why events are harmful to man and not how they happen. Zande perceive how they happen just like us. He doesn’t see a witch hurt a man, but an elephant.

Front 28

Techniques of the Body

Back 28

Mauss,
o Techniques = ways in which from society to society men know how to use their bodies.

what is effective and traditional. Body is first and most natural instrument

Front 29

Embodiment

Back 29

# To give a bodily form to; incarnate.
# To represent in bodily or material form: "As John Adams embodied the old style, Andrew Jackson embodied the new" (Richard Hofstadter).
# To make part of a system or whole; incorporate

Basis of theories of Bourdieu(habitus) and Merlea-Ponty (emphasis of perception of subject-object).


1. Both men attempt to collapse dualities common to perception, using embodiment as a methodological principle.

4. Perception begins in the body, with his use of the term preobjective
a. Boulder is already there to be encountered, but is not perceived as an obstacle until it is there to be surmounted. Thus, the cultural interpretation of this object is based on intentionality (MP)

Paradigm of embodiment shifts analysis from perceptual categoriesand questions to classification and differentiation, to perceptual process and questions of objectification and attention/apperception.

Front 30

Habitus

Back 30

How a person interacts within a social field: their preferences, inclinations, dispositions, not always conscious.

Front 31

Agent and Field

Back 31

Agent is the invidual with the embodiment of their cultural, familial, class, professional, etc. experiences.

A field is a place of mutual recognition of knowledge among agents.

Habitus is constantly changing as agent gains experience (piano...practice)

Bodies have property of being open to the world

Front 32

Anthropology of Affliction

Back 32

Addresses types of problems related to health that are not medicalized (or are not the responsibility of the medical realm) Suicide of women in China: not addressing disenfranchised, cannot have goods, etc. S.Hughes

Social problems that cannot be understood with the clinic

Front 33

Anthropology of Sickness

Back 33

Young: Takes doctor/patient relationship and looks at what larger social issues that demonstrates.Why go to doctor? Why chemo? Why that doctor? Power? Why that diagnosis?

o Sickness is then, a process for SOCIALZING disease and illness
 In pluralistic med systems, a single set of sings can designate more than one sickness, and social forces help to determine which people get which sickness.

Front 34

Efficacy

Back 34

Favret-Saada: . “In short, typical stories can be summarized as a brilliant demonstration of magical efficacy, for their aim is to combine the two assertions basic to witchcraft thinking: spells are true and unbewitching works.”

capacity for producing a desired result or effect; effectiveness: a remedy of great efficacy.

Front 35

"pollution" as disorder

Back 35

Douglas

■ Dirt  example of a non isolated event. Dirt means there is a system, a byproduct of a systematic ordering and classification of matter. SYMBOLIC systems of PURITY.

inhere the structure of ideas itself and punish a symbolic breaking of that which should be joined or joining of which should be separate. It follows from this that pollution is a type of danger which is not likely to occur except where the lines of structure, cosmic or social are clearly defined.

pollution is the key concept of disorder


ritual brings person (patient) back into norm

Front 36

Shamanistic Complex

Back 36

Levi-Strauss: Quesalid

■ Efficiency of magic implies a belief. 3 aspects:
o the sorcerer’s belief in the effectiveness of his techniques;
o the patients/victims belief in the sorcerer’s power
o faith and expectations of the group, which act as a gravitiatonal field within which the relationship between sorcerer and bewitched is located and defined.

Front 37

Efficacy cont

Back 37

FS: not important what is true or false, but the effects of it and why

Front 38

Skill Acquistion Model

Back 38

1) Novice: map, explicit knowledge, theoretical 2)Advanced Beginning : know the lay of the land 3)Competent: most cultural expertise 4)Proficient: intuition but must think about response 5)MAster: chess master

Front 39

Bodily Knowledge

Back 39

Skill Acq model

Front 40

explanatory model

Back 40

A key concept in ethnomedicine is "explanatory model," introduced by Arthur Kleinman (1980). Explanatory models (EMs) are notions about the causes of illness, diagnostic criteria, and treatment options. In a clinical encounter, the EMs held by practitioners, patients, and family often differ. The ensuing communication and negotiation of decisions for managing illness lead to the cultural "construction' of illness. To the extent that disparity among EMs continues because of cultural, ethnic, or class differences,communication remains problematic.

Front 41

Cultural Competency

Back 41

SF chick; SF General hospital CEO – Gene O’Connell) mentioned cultural competency as the hospital being able to cater to people of all languages and educational background/literacy rates

Front 42

Ontology and empiricism

Back 42

ways of being and ways of knowing

Front 43

Problematization

Back 43

Rabinow:■ You problematize something that is already a given, or taken for granted. Turning a sphere of knowledge into a problem
■ Situations need thiking to settle them. When he puts forth a diagnosis, it means you are introspectively questioning why it is to begin with. What makes that response possible? (pg 138)
■ Culture of “rights” is one example. It’s a new problematization. The emergence of complex discourse of ethics is a problematized domain because today we ask why is it such a big deal today