ANTH/HSERV 475 Autumn 2009 University of Washington Tue & Thu 10:30 – 12:20 Condon 139
Janelle Taylor Office: Denny M39 Phone: 543-4793 Office hours: Thu 1:30 - 3:00 email@example.com
Perspectives in Medical Anthropology
Course Syllabus About the Course
This course is an introduction to some aspects of the field of medical anthropology. We shall focus especially on theoretical and methodological questions of how one approaches “illness,” “healing” or “medicine” as an object of ethnographic study. Though we shall read articles based on research carried out in many different parts of the world, many concern illness experience and medical practice in the United States. All of the scholars whose work we shall read examine illness, healing and medicine in sociocultural and historical context. Most rely on ethnographic research methods, especially open-ended interviews and observation of social life over an extended time. Within this very broad consensus, however, there remain significant differences in the kinds of questions medical anthropologists ask, and the kinds of insights they achieve. The course is organized in a manner intended to highlight these differences. We thus begin by reading work that focuses on “interpretive” medical anthropology, in other words work which emphasizes questions of meaning, experience and language. From there we move on to approaches that join attention to “interpretive” questions with a heightened concern for dynamics of power at work in the making of meanings around illness. We turn next to “critical medical anthropology,” meaning works that examine health, illness and medicine from the perspective of how they are bound up with inequality and power – though, as we shall see, the researchers understand “power” in a range of different ways. We then consider some work that considers the biotechnologies upon which so much of contemporary medical practice depends, the global inequalities with which medicine is entangled, and the practices in which caring consists. My goals for students in this course are: 1) to gain a working knowledge of theoretical issues in the field of medical anthropology; 2) to practice applying this knowledge to specific topics; 3) to gain some understanding of current issues in US and world medical systems; and more generally 4) to develop analytical skills that will help us think critically about issues of health, illness, and medicine as we encounter them in our lives and in our world. Texts: One textbook has been ordered for this course at the University Book Store; it is Exploring Medical Anthropology, 3rd Edition, by Donald Joralemon. All other readings are included in a course packet of photocopied articles has also been prepared specifically for this class, and will be available for purchase at Ave Copy on University Ave (near the intersection with 42nd Street). 1
Class Schedule and Assignments
First Meeting Oct 2 Introductions (no readings assigned) Week 2: Opening New Perspectives Through Ethnographic Research Oct 6 Joralemon, chapters 1-2 Firsthand “description” account due Oct 8 Lock, Margaret. 2002. “Medical Knowledge and Body Politics,” in Exotic No More: Anthropology on the Front Lines, ed. Jeremy MacClancy. Chicago: University of Chicago Press, pp. 190-208. Kaufman, Sharon. 2005. “Appendix A: About the Research” and “Introduction,” in …And a Time to Die: How American Hospitals Shape the End of Life. New York: Scribner, pp. 327-332 and 1-20. Week 3: Questions of Meaning, Experience, and Language Oct 13 Frank, Arthur. 2002. “Becoming Ill,” “Illness as Incident,” “Becoming Ill Again.” In At the Will of the Body: Reflections on Illness. Boston: Houghton Mifflin, pp. 8-28. Becker, Gay. 1994. “Metaphors in Disrupted Lives: Infertility and Cultural Constructions of Continuity.” Medical Anthropology Quarterly 8(4):383-410. Oct 15 Aggegard Larsen, John. 2004. “Finding Meaning in First Episode Psychosis: Experience, Agency, and the Cultural Repertoire.” Medical Anthropology Quarterly18(4):447471. Mattingly, Cheryl and Mary Lawlor. 2001. “The Fragility of Healing.” Ethos 29(1):3057. Week 4: Narrative Struggles and “Noncompliance” Oct 20 Rouse, Carolyn. 2004. “ ‘If She’s a Vegetable, We’ll Be Her Garden”: Embodiment, Transcendence, and Citations of Competing Cultural Metaphors in the Case of a Dying Child.” American Ethnologist 31(4):514-529. Oct 22 Hine. Janet. 2008. “Managing the Unmanageable: Elderly Russian Jewish Emigres and the Biomedical Culture of Diabetes Care.” Medical Anthropology Quarterly 22(1):1-26. Chapman, Rachel R. 2003. “Endangering Safe Motherhood in Mozambique: Prenatal Care as Pregnancy Risk.” Social Science and Medicine 57:355-374.
Week 5: Workings of Power and Narrative in Epidemics Oct 27 Joralemon, chapters 3-5 Paper #1 due Oct 29 Kroeger, Karen A. 2003 “AIDS rumors, imaginary enemies, and the body politic in Indonesia.” American Ethnologist 30(2):243-257. Briggs, Charles. 2004. “Theorizing Modernity Conspiratorially: Science, Scale, and the Political Economy of Public Discourse in Explanations of a Cholera Epidemic” American Ethnologist 31(2):164-187. Week 6: Structural Violence, State Policies, and Embodied Consequences Nov 3 Farmer, Paul. 2005.“On Suffering and Structural Violence: Social and Economic Rights in the Global Era,” in Pathologies of Power: Health, Human Rights, and the New War on the Poor. Berkeley: University of California Press, 29-50. Scheper-Hughes, Nancy. 1992. “Nervoso: Medicine, Sickness, and Human Needs,” in Death Without Weeping: The Violence of Everyday Life in Brazil. Berkeley: University of California Press, pp. 167-215. Nov 5 Horton, Sarah. 2004. “Different Subjects: The Health Care System’s Participation in the Differential Construction of the Cultural Citizenship of Cuban Refugees and Mexican Immigrants.” Medical Anthropology Quarterly 18(4):472-489. Janes, Craig and Oyuntsetseg Chuluundorj. 2004. “Free Markets and Dead Mothers: The Social Ecology of Maternal Mortality in Post-Socialist Mongolia.” Medical Anthropology Quarterly 18(2):230-257. Week 7: Power/Knowledge in Biomedicine Nov 10 Joralemon, chapter 6 Good, Byron. 1994. “How Medicine Constructs Its Objects,” in Medicine, Rationality, and Experience: An Anthropological Perspective. Cambridge: Cambridge University Press, pp. 65-87. Nov 12 Rhodes, Lorna. 1990. “The Game of Hot Shit,” in Emptying Beds: The Work of an Emergency Psychiatric Unit. Berkeley: University of California Press, pp. 55-80. Davenport, Beverly Ann. 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. Week 8: Bodies, Commodities, and Biotechnologies Nov 17 Joralemon chapters 7-9
Nov 19 Sharp, Lesley A. 2001. “Commodified Kin: Death, Mourning, and Competing Claims on the Bodies of Organ Donors in the United States” American Anthropologist 103(1):112-133 Tober, Diane. 2002. Semen as Gift, Semen as Goods: Reproductive Workers and the Market in Altruism. In Commodifying Bodies, ed. Nancy Scheper-Hughes and Loic Wacquant. London: Sage, pp. 137-160. Week 9: Medicine and Global Inequalities Nov 24 Paper #2 due Petryna, Adriana. 2005. Ethical Variability: Drug Development and Globalizing Clinical Trials. American Ethnologist 32(2):183-197. Nov 26 NO CLASS (Thanksgiving Holiday) Week 10: Caring (about) Practices Dec 1 Harbers, Hans, Annemarie Mol, and Alice Stollmeyer. 2002. “Food Matters: Arguments for an Ethnography of Daily Care.” Theory Culture & Society 19(5/6):207-226. Taylor, Janelle. 2008. On Recognition, Caring, and Dementia.” Medical Anthropology Quarterly 22 (4): 313-335 Dec 3 NO CLASS (instructor attending American Anthropological Ass’n conference) Dec 4 Reflection Paper due via Catalyst website (by 5pm) Week 11 Dec 8 Seventh-Inning Stretch (Readings TBD) Reflection Paper groups assigned Dec 10 Final Discussion (where everything magically comes together!) Read the Descriptions and Reflections of classmates in your group, and come prepared to discuss them, with at least two thoughts/comments/questions on individual papers and/or on the group of papers that you read, written out in advance.
1. Class participation: In addition to reading texts and writing papers, learning about anthropology requires listening, reflection, dialogue, and engagement with an intellectual community. In order to cultivate these essential skills you must participate. Attending class regularly, preparing well, and taking part actively are important for your learning in this class. As an element of participation you will be asked, over the course of the quarter, to prepare for particular discussion roles (“jargon scout,” “contextualizer,” etc.) as discussed and announced in class. 2. Found Object (5% C/NC): You will also be asked to try using questions and concepts of medical anthropology can be used to query the world around us, by finding and sharing (on the Catalyst website, and also in class if possible) one “found object” – something you encounter or discover that connects. Here are some options: A) Post a new article, together with a short annotation (max 200 words) that explains how you see it connecting with issues discussed in the course. B) Provide a link to a website of interest, together with a short annotation (max 200 words) that explains how you see it connecting with issues discussed in the course. C) Write a short (max 300 words) review of a work of fiction, documentary or feature film, museum exhibit etc., evaluating it in terms of how it addresses questions we have considered in the course. Last names A-H post some time within weeks 1-4, Last names I-O post some time within weeks 5-7 Last names P-Z post some time within weeks 8-10 3. Short papers (30% each, 60%): You will be asked to write two papers, ~5 doublespaced typed pages each, due at the beginning of class on October 27th and November 24th, in response to questions that will be distributed in class in advance. These papers are an opportunity to pursue in greater depth and detail directions developed through our active and thoughtful collective engagement. 4. Firsthand Account: Description, Revision, and Discussion (40% C/NC): Description: The first written assignment for the course is a description of some episode or event that has some bearing on health, illness, and healing, which you either experienced, participated in, or witnessed at first hand. As you consider which episode to write about, bear in mind how we will be using these accounts subsequently; please select an episode that you feel merits sustained reflection, and one you will comfortable sharing with your classmate. Write your account before you have read anything at all – just try to clearly and accurately convey the episode in question. This should be roughly 2-3 double-spaced pages in length, and is due at the beginning of class, on the second class meeting, and should be posted on the Catalyst site as well. Reflection: At the end of the quarter, you will be asked to revisit this descriptive firsthand account, and write a short and coherent (4-5 page) reflective essay that brings to bear upon your original account some of the ideas, perspectives, questions, and comparative examples encountered in the course of our
readings. Detailed guidelines for this revision process will be distributed shortly. This is due no later than 5pm via the course Catalyst site, on December 3rd Discussion: In the last class meeting Dec 10th, we shall use the experience paper and the process of revising it as a springboard for a concluding discussion of medical anthropology and the perspectives that it offers. You will be asked to read the papers of a few of your classmates, and to come prepared to contribute to this discussion (some guidelines will be distributed in advance). Policies: Assignments are due when they are due; late papers will not be accepted. If truly extraordinary circumstances make it impossible for you to meet a deadline, talk to the instructor as early as possible. All work must be completed in order to receive a passing grade for the course.