Anthropology & Medicine最新文献

This paper takes as its focus the caregiving efforts of a group of mothers in Dublin who were homeless, struggling with addiction, and separated from their children. It explores their ongoing orientation towards their distant children, in terms of their affective longings, practical actions, and moments of faltering, for despite yearning for an ongoing role in their children's lives, many of my interlocutors struggled to maintain a consistent caregiving engagement. The paper argues that the halting nature of my interlocutors' caring efforts does not preclude the sincerity of their affective concerns for their children, and that if we only judge care based on practical action and output, we overlook the tough realities of caregiving on the ground. Moreover, appreciating this fluctuating pattern of caregiving is necessary to understanding my interlocutors' oscillating trajectories through homelessness and substance use, and how these trajectories were shaped by their vacillating relationship with hope. This paper thus introduces the concept 'faltering care': care which encompasses conjoined moments of lapsed practical action and sustained affective concern, but which nonetheless reflects the care provider's hopeful reach towards leading a moral life.

This article explores the creation, significance, and implications of patienthood within biomedical psychiatric hospital care practices, a topic that has often received insufficient attention from researchers. Using an ethnographic approach and discursive narrative framework, I argue that patienthood in this mental hospital is a social status deliberately constructed to facilitate decision-making regarding treatment and to guide social interactions within the hospital context. While patienthood is created within the hospital, its effects extend beyond its walls. I demonstrate that patienthood is a multifaceted concept emerging from 'assemblage practices' within the hospital, involving numerous human and nonhuman entities contributing to its creation and perpetuation. The processes underpinning patienthood are dispersed and collectively shaped by multiple 'agents', often diminishing the patient's active agency. This paper contributes to empirical knowledge and enhances our theoretical understanding of doctor-patient relationships and the evolving concept of 'patienthood' over the past six decades. It bridges the divide between older and contemporary literature and perspectives on doctor-patient relationships and patient agency, particularly concerning the Parsonian 'sick-role' and 'assemblages' theory. Furthermore, the article addresses the implications of its findings for mental health care, paving the way for a more comprehensive understanding of the complexities involved in caring for individuals with mental health issues.

This paper explores cancer as a 'total social fact', considering it both a specific material entity and an immaterial phenomenon with social, political, and legal implications. Based on long-term ethnographic field studies on cancer as anticipation in the Danish welfare state, specifically within lung cancer diagnostics and the surveillance for 'tissue changes', the paper explores how cancer is constituted and experienced. Analyzing this new and rising cancer phenomenon, the paper attends to scale by focusing analytically on three levels (national, institutional, and intersubjective) and conceptualizes how cancer manifests at these different levels through practices of temporal curation. Temporal curation is conceptually directed at understanding both how past, present, and future exist concurrently in the diagnostic space, and how cancer is produced, preserved, and brought into the future. Hence, this paper contributes to understandings of the modern in healthcare systems, specifically arguing for a shift in discussions on diagnostics beyond a narrow focus on classificatory processes to comprise how a diagnostic phenomenon becomes temporal and sociopolitical.

This paper traces how the meaning of symptoms and the positioning of selves are entangled and discursively constructed in therapeutic conversations between parents and therapists at a pain clinic for children and young people (age 8 to 18) with recurrent or chronic pain or other somatic symptoms with no established biophysical pathology. Based on data material from an ethnographic fieldwork it is examined how the selves of respectively children/young people and their parents are discursively positioned in conversational encounters and the role positioning of selves play in the context of establishing and negotiating the symptoms' meaning. The bearer of medically unexplained symptoms is oftentimes subjected to moral assessments. In this paper it will be shown that parents, in the institutional setting of the pain clinic, enter the negotiation of moral assessments assigned to their children, and that these moral assessments not only concern the sufferers' selves but also the selves of the parents. The overall argument is that dialogues between parents and therapists concerning the meaning and source of their children's symptoms are simultaneously negotiations in which not only the sufferers'  but also their parents' moral positions are at stake.

Scholars in medical anthropology note that, despite more than 25 years of anthropological studies on cancer, much of this scholarship remains marginal in mainstream public health approaches. This paper examines social practices, biases, and unnoticed assumptions in mainstream global health research culture that prevents anthropology from having a more influential role in cancer research and policy agendas. It focuses on the day-to-day, ordinary, micro academic practices in which differential power distribution exacerbates inequity within the field, ignoring the role played by approaches with disciplinarian, epistemological and geopolitical peripheries. Inspired by a Bourdieusian epistemic reflexivity, this autoethnography systematized and analyzed through decolonial lenses some deterrents within real-world-research practices, including as the corpus own studies on cancer and inequalities studies that were based on collaborative ethnography (2013-2024). Six categories account for such deterrents in the global field: 1) Public health mainstream-centrism and the lack of recognition of anthropological knowledge principles; 2) Restrictive conception of ethics; 3) Similis Simili Gaudet biases - to be inclined to select what is alike; 4) Ethnocentric and naïve assumptions in relation to the road from evidence to practice; 5) Unconsidered dimensions of collaborations: Strengthening citizenship; 6) The moral economy of (only) professional trajectories interests and hidden priorities. It concludes by noting that anthropology has a lot to provide in the search for a genuinely democratic, plural, and decentralized knowledge in global cancer equity debates strengthening paradigms of dialogue, still so fragile and invisible in the field of cancer and public health in general.

The stigmatization of lesbian, gay, bisexual, transgender, and queer (LGBTQ) individuals has a direct impact on the patient care experience and eventual health outcomes of this population both in the United States and abroad. The stigmatization of LGBTQ individuals in the healthcare system can lead to poor patient care and LGBTQ patients' self-removal from the healthcare system entirely. This self-removal could lead to untreated health issues, as well as the spread of communicable diseases throughout the LGBTQ community. This commentary reviews the Report of the 2019 Southern LGBTQ Health Survey. Recommendations are made for improving provider education on LGBTQ issues, which would, in turn, improve the LGBTQ patient care experience and health outcomes for this population.

The practices surrounding pregnancy ends and pregnancy remains shift and change depending on the cultural and historical context. Based on ethnographic research in one group NHS Hospital organisation in England, the paper explores what practices around pregnancy remains reveal about the values afforded the material in different contexts by different actors and the moments when these intersect. It argues that framing miscarriage as bereavement helps to structure caregiving in clinical settings and that clinical practices produce foetal personhood in ways that may not be in keeping with women's notions of their pregnancy material. It illustrates that hospital practices contain notions of value which become legitimated as the appropriate approach with consequences for normativity. This may lead to women feeling isolated and abnormal when their approach is at odds with that of the clinic. Through an exploration of how women encounter and negotiate disposal practices, the paper argues that current practice requires revision to flexibly respond to diversity but also shifting meaning and values attributed to these experiences and materials.

Since 2006, simple outdoor gyms have been installed on public squares all over Brazil. From the beginning, they were mainly conceived as for use by older people - especially women - within an international movement of 'healthy cities'. Based on an ethnography in Rio de Janeiro, our aim is to show in particular the politico-commercial dimensions of the fitness equipment. By insisting on this way of articulating a material dimension of care, different kinds of connectivity are highlighted - something we want to call connective materiality. The juxtaposition of data gained through observations, as well as formal and informal interviews with politicians, equipment manufacturers, and aging users of such fitness spaces, enlarges the notion of fitness as a measure of self-care and prevention, and frames fitness as political and connective.