Medical Anthropology Quarterly最新文献

In 2018, vaccine hesitancy marked the nationwide measles-rubella vaccination campaign in the Indonesian province of Aceh. The hesitancy, which was supported by the provincial government, stemmed from concerns over porcine contamination in the vaccine product. "Tidak cocok" (incompatible) became a pervasive statement used to rationalize the refusal to participate in the vaccination program, permeated personal narratives, public responses to a vaccine allergy case, and an official meeting to determine the vaccination campaign's future. In this article, I theorize incompatibility as a lexical item of decoloniality. Incompatibility fosters a sense of liberation, paving a pathway to refuse tools and systems considered unfit according to locally situated knowledge and historical experience. It further reclaims what has been marginalized, delegitimized, and ignored by dominant epistemic and political structures. I also suggest that many Islamic expressions arising during the vaccine hesitancy have given a distinct local flavor to the decolonial critique on vaccination. [Aceh, decoloniality, incompatibility, Indonesia, Islam, vaccine hesitancy].

Recent mental health reforms have embraced patient autonomy and shared decision-making, where care unfolds through collaboration between clinicians and patients. However, how decision-making can improve in marginalized psychiatric clinics remains unclear. This paper examines how social psychiatrists at a Japanese community clinic engage with patients’ will—especially when it appears resistant, ambivalent, or self-destructive. At Sakura Clinic in Kanagawa, the challenge lies in navigating “strong will” (tsuyoi ishi)—instances where patients reject treatment, defy medical logic, or say, simply, “I'd rather die.” Here, decision-making stretches across time, shaped by evolving attunement between patients, clinicians, and their environments. When patients make risky choices, psychiatrists face an urgent ethical question: is this will an existential stance to be respected, or the mark of structural violence to be refused?

Following the overturning of Roe v. Wade, the political, legal, and medical boundaries of spontaneous, elective, and selective abortion are blurring. Based on ethnographic research on Turner Syndrome, a genetic condition with a 98% miscarriage rate and uncertain abortion rates, this article examines the visual politics of reproduction and disability in the United States through the ambiguous treatment of miscarriage. Although infertile, my interlocutors with Turner syndrome emphasized how disability stereotypes, abortion unknowns, and miscarriage statistics impacted their lives. Centering our play More Than Just the Two Percent, I demonstrate how my interlocutors embodied various actors in reproductive experiences, including miscarried fetuses, to navigate the visibilities of their diagnosis and specify the value of their lives as social funds of knowledge—a process I term envisioning. Envisioning complicates notions of viability, personhood, privacy, spirituality, risk, luck, and survivorship that pro-life/pro-choice rhetorics flatten and may contribute to a more disability-oriented reproductive justice.

This article traces the viral life of HIV conspiracies in Turkey, not as peripheral noise but as central to the ways public health crises are interpreted, contested, and experienced. By offering “epidemiology of conspiracy” both as a metaphor and an analytic, the article treats disease conspiracies not as epistemological failures, but as vernacular tools of meaning making—fragile yet forceful ways of navigating biopolitical abandonment, institutional opacity, and medical precarity. The paper examines three distinct conspiratorial narratives—ranging from infected vaccines to murderous patients to superspreaders hired by Big Pharma—and argues that these stories, while often dismissed as illogical or paranoid, are saturated with socio-political meaning and historical memory. Ultimately, the paper calls for a reparative, rather than dismissive, reading of conspiracy in medical anthropology, especially when studying epidemics in places where data is scarce, speech is policed, and stigma circulates with viral efficiency.

Critical social science research demonstrates that evidence-based medicine (EBM) emerged through its proponents’ deliberate efforts to defend EBM's knowledge production methods as credible and independent of commercial interests. In the present study, we expand this discussion by showing how EBM is co-produced with profit-making within the context of private clinics in Russia. Drawing on the ethnography of three private clinics in Russia, we explore how they strategically articulate EBM ideals to demarcate the boundaries between good and bad medical practices. We identified four forms of boundary work that private clinics perform to define their epistemic culture as different from those applying poor quality evidence, providing harmful prescriptions, over-relying on clinical experience, and practicing a top-down approach in patient relations. We discuss how, in the Russian healthcare context, EBM, instead of becoming the opposite of commerce, has become interwoven with and even dependent on private healthcare.

The position of pregnant women in clinical research remains a topic of international ethical debate. Yet, the reflections of actual and potential trial participants, including pregnant women themselves, often remain absent. Following a policy reversal in 2019, pregnant women were eligible to participate in a second Ebola vaccine trial during an epidemic in the eastern Democratic Republic of the Congo (DRC). This article follows how this decision was perceived in Goma, a city in the DRC, the meanings and functions of the rumors that emerged about reproductive health, and how these rumors influenced pregnant women's experience of the trial. I argue that the womb became a site to discuss broader biopolitical anxieties about collective survival, but that rumors also became a vehicle for ethical debate amid uncertainty. Ethical debates about medical research continue locally through other ethical vernaculars- like rumors- and center on contested ideas of acceptable risk, shaped by collective historical experiences.

This article describes an ethnographic study of adherence to iron supplementation protocols in 50 anemic preschoolers and their caregivers living in a peri-urban district in Lima, Peru. I use aspects of the syndemic approach to highlight the challenges caregivers face in following the recommended treatment and burden of treatment theory to develop a deeper understanding of adherence in a community with persistent childhood anemia. Interpreting adherence as an ideology also helps illuminate how health professionals’ claims about patient behavior reflect social inequalities. Thematic analysis of qualitative data identified three major challenges to iron supplementation adherence—time constraints, acute health concerns, and child agency. These themes show how socioeconomic conditions and emotional burdens impact caregivers’ ability to follow the prescribed treatment. Despite these challenges, the relatively high rate of adherence contests assumptions that lack of adherence is the primary explanation for persistent anemia rates among preschoolers living in this community.