Critical Medical Anthropology

'I'm always on the lookout for what could be going wrong': mothers' concepts and experiences of health and illness in their young children

by Deborah Lupton

Sydney Health & Society Group Working Paper No. 1

Mothers in contemporary western societies are expected to adhere to the principles of intensive parenting, spending a... more Mothers in contemporary western societies are expected to adhere to the principles of intensive parenting, spending a great deal of time and effort caring for their children, protecting them from risks and promoting their health, development and wellbeing. This paper draws upon research involving indepth interviews with 60 mothers of infants and young children living in Sydney. The discussion focuses in detail on three major topics discussed in the interviews: how the interviewees conceptualised good health and illness in their children; the role of diet and physical exercise in promoting children’s good health; and space, physical safety and bad influences. The study found that the interviewees reported that they ‘read the signs’ of their children’s bodies and had to ‘know’ their bodies intimately in order to do so. They also interpreted the signals of their own bodies – their ‘gut instincts’ – as part of the process of maintaining careful surveillance of their children’s health state. They represented diet and physical exercise as the most important dimensions of promoting their children’s health, and were very concerned about the risk of obesity in their children. Notions of space and judgements about the bodies within these spaces were also important to some of the women’s concepts of protecting their children’s health and wellbeing.

Discourse analysis: a new methodology for understanding the ideologies of health and illness

by Deborah Lupton

Discourse analysis is not so much a 'new' methodology any more, as this paper was originally published 20 years ago. I have regular requests for copies, however, so have scanned it and uploaded it here.

Chamberlain, K., Madden, H., Gabe, J., Dew, K. & Norris, P. (2011). Forms of resistance to medications within New Zealand households. Medische Antropologie, 23(2), 299-308.

by Kerry Chamberlain

Although considerable research documents resistance to medicines, much of this focuses on specific types of... more Although considerable research documents resistance to medicines, much of this focuses on specific types of medication, particularly psychotropic medication, and seeks to classify users of medication, frequently as resisters or rejecters. However, this research tends to overlook the varieties and subtleties of resistance to medications that can occur. In this paper, we explore the varied forms of resistance to medications reported by lay people taking diverse forms of medication. Data were gathered within fifty-five diverse households using multiple methods. Findings document the wide range of ways that medications are resisted. These are discussed in terms of the variability of resistance, its functionality and the logic of care that resistances can manifest.

Hodgetts, D., Chamberlain, K., Gabe, J., Dew, K., Radley, A., Madden, H., Norris, P., Nikora, L. (2011). Emplacement and everyday use of medications in domestic dwellings. Health & Place, 17(1), 353-360.

by Kerry Chamberlain

DOI: 10.1016/j.healthplace.2010.11.015.

To extend knowledge of relationships between people and domestic settings in the context of medication use, we... more To extend knowledge of relationships between people and domestic settings in the context of medication use, we conducted fieldwork in twenty households in New Zealand. These households contained a range of ‘medicative’ forms, including prescription drugs, traditional remedies, dietary supplements and enhanced foods. The location and use of these substances within domestic dwellings speaks to processes of emplacement and identity in the creation of spaces for care. Our analysis contributes to current understandings of the ways in which objects from ‘outside’ the home come to be woven into relationships, identities andmeanings ‘inside’ the home.Wedemonstrate that, as well as being pharmacological objects, medications are complex, socially embedded objects with histories and memories that are ingrained within contemporary relationships of care and home-making practices.

Immigration Status

by Sarah Willen

Willen, Sarah S. 2012. “Immigration Status.” In Sana Loue and Martha Sajatovic, eds. Encyclopedia of Immigrant Health. New York: Springer. 886-888.

'The best thing for the baby': mothers' concepts and experiences related to promoting their infants' health and development

by Deborah Lupton

Risk as Moral Danger: the Social and Political Functions of Risk Discourse in Public Health

by Deborah Lupton

Blurring the boundaries: breastfeeding and maternal subjectivity

by Deborah Lupton

Femininity, Responsibility, and the Technological Imperative: |Discourses on Breast Cancer in the Australian Press

by Deborah Lupton

Abstract_Thesis_Grard_Fr_En

by Julien Grard

PhD in social anthropology, Summa Cum Laude. Thesis defended on the 25t of october, 2011. Paris, France, EHESS.

The problematization of medical tourism: a critique of neoliberalism

by Kristen Smith

Published in 'Developing World Bioethics', Vol. 12, Iss. 1, 2012, pp. 1-8.

ABSTRACT

The past two decades have seen the extensive privatisation and marketisation of health care in an... more ABSTRACT

The past two decades have seen the extensive privatisation and marketisation of health care in an ever reaching number of developing countries. Within this milieu, medical tourism is being promoted as a rational economic development strategy for some developing nations, and a makeshift solution to the escalating waiting lists and exorbitant costs of health care in developed nations. This paper explores the need to problematize medical tourism in order to move beyond one dimensional neoliberal discourses that have, to date, dominated the arena. In this problematization, the paper discusses a range of understandings and uses of the term ‘medical tourism’ and situates it within the context of the neoliberal economic development of health care internationally. Drawing on theory from critical medical anthropology and health and human rights perspectives, the paper critically analyzes the assumed independence between the medical tourism industry and local populations facing critical health issues, where social, cultural and economic inequities are widening in terms of access, cost and quality of health care. Finally, medical tourism is examined in the local context of India, critiquing the increasingly indistinct roles played by government and private sectors, whilst linking these shifts to global market forces.

Foucault and the medicalization critique.

by Deborah Lupton

In Petersen, A. and Bunton, R. (1997) (eds), Foucault, Health and Medicine. London: Routledge, pp. 94--110.

Health Reform in India: From Private to Public - Plans for the Future

by Tanja Ahlin

A mini-statement for CAHG initiative at AAA meeting in Montreal, Canada, 2011.

A Tibetan Medical Perspective on Irritable Bowel Syndrome

by Eliot Tokar

Tokar, Eliot 1998, A Tibetan medical perspective on irritable bowel syndrome: building a means of discourse for integrative medicine, Alternative and Complementary Therapies, 4(5): 343-349

This article will compare the diagnostic approaches of Western biomedicine and Tibetan medicine. The biomedical... more This article will compare the diagnostic approaches of Western biomedicine and Tibetan medicine. The biomedical disease irritable bowel syndrome will be used as a case study. It will be contrasted with the multiple nosological categories that could be used in TIbetan medicine to achieve a differential diagnosis for patients with symptoms that are typical of this biomedical disease.

As a result of the grassroots alternative medicine movement, for four decades Americans have increasingly used a wide diversity of natural medical approaches. Among these are ancient systems of traditional natural medicine such as Tibetan medicine. As the use of such medical alternatives expand it is important to consider how they can be best utilized within our society.

The integration of such systems into the existing medical industrial complex is an approach sponsored by powerful voices within the government, academia and the medical industry. Alternatively, many laypeople and health professionals advocate for medical pluralism in order to provide a means for promoting the greatest possible healthcare diversity and freedom. In analyzing the debate between integration and pluralism it is vital to consider how they will each effect the actual practice of traditional natural medical systems as well as the indigenous cultures from which such disciplines originate. This article will draw upon the history of Tibetan medicine to inform the debate between integration and pluralism. Finally, it will pose some critical questions regarding medical reform.

Cultural conservation of medicinal plant use in the Ozarks

by Justin Nolan

Ethical and Efficacious Interventions: HIV Pre-Exposure Prophylaxis, Behavioral-Pharmaceutical Slippage & Biomarkers

by Ryan Whitacre

Undergraduate Student Paper Prize, AIDS and Anthropology Research Group (AARG), 2011

Medical interventions for HIV treatment and prevention are susceptible to the influences of controversial histories,... more Medical interventions for HIV treatment and prevention are susceptible to the influences of controversial histories, characterized by legacies of activism, terminated projects and ethical concerns. With similarly troubling histories, clinical trials must navigate particularly carefully through the ethical landscape of HIV treatment and prevention. A decade after the beginning of the first clinical trial testing a pharmaceutical pre-exposure prophylaxis (PrEP) as an effective means for HIV prevention, many HIV PrEP clinical trials have been abandoned as the result of ethical disputes concerning the safety of participants or due to insufficient evidence for the efficacy of an intervention. Recently, however, one trial provided evidence for the efficacy of HIV PrEP and was deemed safe for use upon successful completion of a phase III clinical trial. This paper presents important differences between the successful trial and its failed predecessors through a discussion of ethical and efficacious methodologies, in practice and representation. In this investigation definitions of ethics multiply. Such multiplicity is pronounced as principal investigators and HIV physicians promote the development of pharmaceuticals and their deployment as ethical necessities and utilize innovative methods to garner proof for the efficacy of the pharmaceuticals. In this process pharmaceutical interventions are represented as separate from and more effective than behavioral interventions.

The market for healing and the elasticity of belief: Medical pluralism in Mpumalanga, South Africa.

by Robert Thornton

In M. Dekker and R van Dijk (eds.), Markets of Well-being: Navigating Health and Healing in Africa (African Dynamics Series, African Studies Centre).  Leiden, Netherlands: Brill.

The demand for healing appears to produce a kind of ‘market for healing.’ It is often not possible to evaluate... more The demand for healing appears to produce a kind of ‘market for healing.’ It is often not possible to evaluate healing’s effectiveness, utility, or economic efficiency (‘value for money’), however, The market for healing, therefore, is governed less by price than by a parallel market for belief.  In the Umjindi (Barberton) municipality, Mpumalanga Province, South Africa, medical choices are made on the basis of belief systems since the effectiveness of therapies is itself contingent on belief (‘placebo/nocebo effect’). Because beliefs change in order to accommodate choice of therapies, and because the perceived effect of therapies often influences belief, ‘markets’ for belief and healing are closely related.  But not all ‘healing’ in this market produces health.  Healing also offers ‘protection’ from other people, from other healers and from other therapies and their effects or side effects.  Since few therapies in this market produce reliable results, belief permits clients to evaluate moral states of being rather than mere evidence of efficacy as they search for healing.  Belief in the therapy allows clients to evaluate their choices and participate in healing with a greater sense of certainty.  In short, what a person believes is believed to influence how and whether he/she can be healed, and to what extent the therapy has been effective.

Natural Hegemonies: Sleep and the Rhythms of American Capitalism

by Matthew Wolf-Meyer

American capitalism finds its force and legitimacy in hegemonic understandings of nature and society, especially as... more American capitalism finds its force and legitimacy in hegemonic understandings of nature and society, especially as expressed in human biology. In this article, I address the ways American capitalism depends on the deployment of sleep and wakefulness within the institutional contexts of school and labor, with particular attention to the recent medicalization of sleep disorders. Across American institutions and social science literature, I argue that sleep, like capitalism, has been discursively ascribed the powers of inevitability and universality, rendering them both transhistorically natural. To make these claims, I draw on ethnographic research in sleep clinics with scientists and clinicians, interviews with disordered sleepers, and textual and policy analysis. In conclusion, I offer suggestions toward elucidating the historical and continuing biopolitical projects of capitalism.

Extremities: Thresholds of Human Embodiment

by Matthew Wolf-Meyer

Les redéfinitions d'une révoLution

by P. Sean Brotherton

Sabrina Doyon and P. Sean Brotherton. Les Redéfinitions d’une Révolution: Pratiques et politiques dans les secteurs de la santé et de l’environnment a Cuba. Anthropologie et sociétés 32(1-2): 193-216.