Antropologia Vietii IMP

The Anthropology of theBeginnings and Ends of Life

Sharon R. Kaufman

1

and Lynn M. Morgan

2

1

Department of Anthropology, History and Social Medicine, University of CaliforniaSan Francisco, San Francisco, California 94143-0646; email: Kaufman@itsa.ucsf.edu

2

Department of Sociology and Anthropology, Mount Holyoke College, South Hadley, Massachusetts 01075-1426; email: lmmorgan@mtholyoke.edu Annu. Rev. Anthropol.2005. 34:317–41 The

Annual Review of Anthropology

is online atanthro.annualreviews.orgdoi: 10.1146/annurev.anthro.34.081804.120452Copyrightc

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2005 by Annual Reviews. All rightsreserved0084-6570/05/1021-0317$20.00

Key Words

Medical anthropology, biopolitics, social studies of science,personhood, birth, death

Abstract

This essay reviews recent anthropological attention to the “be-ginnings” and “endings” of life. A large literature since the 1990shighlights the analytic trends and innovations that characterize an-thropological attention to the cultural production of persons, thenaturalization of life, and the emergence of new life forms. Part I of this essay outlines the coming-into-being, completion and attenua-tion of personhood and how life and death are attributed, contested,and enacted. Dominant themes include how connections are forgedor severed between the living and the dead and the socio-politicsof dead, dying, and decaying bodies. The culture of medicine is ex-amined for its role in organizing and naming life and death. Part IIis organized by the turn to biopolitical analyses stimulated by the work of Foucault. It encompasses the ways in which the biosciencesand biotechnologies, along with state practices, govern forms of living and dying and new forms of life such as the stem cell, em-bryo, comatose, and brain dead, and it emphasizes the production of value. Much of this scholarship is informed by concepts of liminality (a period and state of being between social statuses) and subjectiﬁ-cation (in which notions of self, citizenship, life and its managementare linked to the production of knowledge and political forms of regulation).

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Contents

INTRODUCTION ................ 318Problematizing “Beginnings”and “Endings” ................ 320PART I. MAKING THE PERSON, THE LIVING, AND THEDEAD .......................... 320Producing Persons ............... 320 The Dead Make the Living: Attachment, Disengagement,and Rituals of Mourning ...... 323Dead, Dying, and Decaying Bodies 325 The Culture of MedicineOrganizes the End of Life ..... 326 When Death Comes at theBeginning of Life ............. 327PART II. THE BIOPOLITICS OFLIFE AND DEATH ............. 327Emergent Cultural Forms at theBeginnings and Ends of Life ... 329 Making Value .................... 330Between Life and Death,Beginnings, and Endings ...... 332CONCLUSION. BEGINNINGS,ENDINGS, AND THEETHNOGRAPHIC ............. 332

INTRODUCTION

A desperately poor young mother dies of AIDS.Halfaworldaway,achildisbornastheresult of a $50,000 in-vitro fertilization pro-cedure. By juxtaposing the literature that ex-plores such discordant events—low-tech andhigh-tech births and deaths, traditional ritu-als and innovative biomedical practices—thisreviewspeakstothedissimilarconditionsthatallow humans to come into and out of ex-istence, and the range of analytic reflectionon sociallysignificant thresholdsandborders. Anthropologists have often used the marginsof life as a site for examining the making andunmaking of persons and relationships, socialand corporeal bodies, and life itself. Yet neverhas the anthropological literature on the be-ginnings and ends of life been as stimulat-ing as it is now. Over the past fifteen years,scholars have become increasingly concerned with how the boundaries of life and death areasserted and negotiated, and with the iden-titycategoriesthatsuchboundariesconstruct,protect, and redefine. In this sense, the lit-erature on the anthropology of the begin-nings and ends of life echoes the recent an-thropologicalinterrogationofotherepistemicboundaries,suchasthosebetweendisciplines,forms of knowledge, subjects, and territories. The beginnings and the ends of life are the-maticallylinked,then,byattentiontothevar-iedwaysthathumansconstituteanddisassem-ble themselves and their social worlds. This review considers the consistenciesand innovations that characterize anthropo-logical attention to these topics. In trademark fashion, anthropologists continue to attend(reflexively)totheworkofcultureandthecre-ation of meaning: the lived experience of in-dividual actors, the collective ascription andattenuation of personhood, and the produc-tion and reproduction of material and cos-mological worlds. Yet anthropologists havealso extended their reach to encompass sci-entific practice and knowledge production,paying particular attention to the increasingbiologization of political and private life. Themove toward studying the production andcultural effects of bioscience, bio-citizenship,and the biosocial indicates a major shiftin anthropological representations of begin-nings and endings, stimulating new thinkingabout social production, authoritative knowl-edge,culturalfacts,andtherepresentationsof life. Anthropological investigations of the be-ginnings and ends of life have undergone amajor shift from the early days of ethnog-raphy, from descriptions of normative prac-tices surrounding birth and death within dis-crete societies to recent studies of the culturalproduction of forms of life and death, includ-ing the ambiguous boundaries between them,and to an interest in the socio-political de-bates concerning when life begins and ends.

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Late nineteenth through mid-twentieth cen-turystudieswereconductedwithintheframe- works of the anthropology and sociology of religion, ritual, the family, the sacred andsecular, and structural-functionalism. Thoseframeworks remain salient in recent ethno-graphies where they are often consideredthrough the lenses of globalization, postcolo-nialism, and bioscience. The rise of feminismfromthe1970scontributedtoarangeofstud-iesofchildbirthandpostpartumpracticesthatfocused on cultural variability in the makingof birth (although it did not equally inspirestudies of care for the dying). Late twentiethcentury and early twenty-first century stud-ies have responded both to the impacts of thegenetic sciences and clinical medicine on in-dividual experience (especially reproductivetechnologies and technologies surroundingdying) and to the shifting politics, ethics, anddiscourses about the beginnings and endingsof life itself that accompany developmentsin the biological sciences and biomedicine. These writings have been influenced, too, by the explosion of work in the social studies of science, medicine, technology, and the body.Our essay is divided into two broad partsto reflect what we see as a potentially produc-tive tension between studies that foregroundsocial organization and cultural representa-tion and those that analyze the biopolitics of making and allowing life and death. Thesetwo approaches are not entirely mutually ex-clusive, but represent general trends betweenstudies of culture and cultural studies. PartI is concerned with the production and at-tenuation of personhood and how life anddeath are attributed, contested, and pragmat-ically enacted in social contexts. The creationof persons through reproduction and birth isclosely tied to the production of mothers, fa-thers, viable children, and families (Ginsburg& Rapp 1995). At the end of life, ethnog-raphers have focused their attention on thedistinction between the social and biologicaldeathofthepersonandthepracticalandethi-calquandariescreatedbythelatemodernabil-ity and desire to authorize and design one’sowndeath,andthewaysinwhichdeathisspo-ken, silenced, embraced, staved off, and oth-erwise patterned (see Seale 1998 for review). Themes of identity, liminality and mem-ory are central to this work. Beginnings areconstitutedthroughprocessesofsocialrecog-nition (James 2000), and are contingent onthe attribution of personhood and sociality.Endings depend on the culturally acknowl-edged transformation of a living person tosomething else—a corpse, nonperson, spirit,ancestor, etc. Both are frequently character-ized by a time of provisionality, indetermi-nacy, and contestation as social relations arereordered. The politics surrounding assertions anddenials of personhood have received a greatdeal of attention in the last two decades, ashave the ways in which tensions between tra-dition and modernity are enacted in individ-ual, community, and institutional responsesto assisted reproduction, genetic screening,abortion, euthanasia, assisted suicide, pallia-tive and life- or death-prolonging medicaltreatments, and death. Human, women’s, andother rights discourses support shifting no-tions of personhood and offer rich terrain fornegotiation about beginnings and endings.Part II outlines the turn to biopoliticalanalyses which has been shaped largely by developments in the biomedical sciences andclinical medicine as they are deployed, under-stood, and enacted. The delineation of cul-tural forms and structural sources of subject-making are central to this approach, whichstresses how scientific practice, together withdiscursivepowerarrangements,shapesunder-standings of the parameters of life, death, andthe person and creates particular desires andneeds. Under the rubric of the social stud-ies of science, this approach covers studiesof life enabled by the laboratory and clinicand ended through medical technique. It ex-plores the creation and cessation of life as de-bated and decided in changing regimes of au-thority. Biopolitical analyses also explore howpoverty, body commodification, and notionsof risk and control are lived and shaped by the

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The Beginnings and Ends of Life 319

A n n u . R e v . A n t h r o p o l . 2 0 0 5 . 3 4 : 3 1 7 - 3 4 1 . D o w n l o a d e d f r o m a r j o u r n a l s . a n n u a l r e v i e w s . o r g b y M O U N T H O L Y O K E C O L L E G E o n 0 9 / 2 2 / 0 5 . F o r p e r s o n a l u s e o n l y .