Anthropology & Medicine最新文献

Relying on long-term ethnographic fieldwork with Western herbalists this paper attends to herbalist narrative and practice around training for, assessing, and valuing embodied knowledges about plants and plant extracts. It describes the ways that herbalists in the Northeast of the United States strive to remap the world of organoleptic, bodily knowledge into and across regulatory knowledge forms like chemical assays, recordkeeping practices, and machines like the mass spectrometer or spectrophotometer. The paper argues that their remappings constitute an herbalist epistemic pluralism, outlining this as a key mode of practice for Western herbalists, whether in the classroom or in the production facility. This mode of doing technoscience otherwise imagines and enacts a world where many ways of knowing are possible. Ethnographic evidence demonstrates how herbalist epistemic pluralism both instantiates and undergirds attempts to achieve legal legibility for embodied knowledge with Federal regulatory organizations and indicate ways in which epistemic pluralism may be conceptually useful to anthropologists beyond attention to Western herbalism.

This paper is a call for a renewed critical medical anthropology (CMA) of the COVID-19 pandemic, one that attends not only to the pandemic's acute phase but also to its enduring afterlife. We argue that COVID-19 persists as a structuring condition that continues to impact individual experiences as well as domestic and global politics and culture. We introduce the concept of 'narrative compression' to describe how public and institutional discourses have foreclosed space for the ongoing suffering of individuals with long COVID and others marginalized by pandemic legacies. By tracing how closure is epistemically and politically produced, this paper reframes COVID-19 as an ambient and persistent crisis. We advocate for an anthropological approach that remains with the pandemic to diagnose its transformations and imagine more accountable health futures.

People increasingly inhabit toxic and damaged urban environments that change not only their bodies but also their affective relations with the city. This paper focuses on 'urban ecomelancholia,' an affective response to experienced or anticipated environmental damage and loss, and the corresponding attachment to memories of past urban environments. As grieving with transformative potential, melancholia provides a lens to late industrialism's ambiguities of harm and hope. Focusing on middle-class urban dwellers in India, this paper asks how they experience and affectively relate to urban environmental change, harm, and loss. Situating urban ecomelancholia within scholarly debates on melancholia, this paper first examines urban dwellers' sensorial experiences of heat and its changes. Next, it traces residents' grief-tinged memories of one city's lost and polluted lakes and some of their attempts at ecological repair. Reflecting on melancholia's potential for activist work, these accounts are juxtaposed with a discussion of a visual artist's melancholic depictions of a polluted river and a Carnatic singer's music video in the midst of ecological ruins.

This paper draws on 35 in-depth, semi-structured interviews with Japanese men to conceptualise embodied experiences of benign prostate enlargement and prostate cancer as 'onco-economics.' The experiences of prostate-related conditions provide a lens through which Japanese men's subjectivities are expressed and contested, especially in relation to expectations around masculinity, aging, and economic responsibility. The data challenges the normative assumptions embedded in the 'middle-class self,' which refers to the ideology that Japan is a homogenous and stable middle-class society, by drawing attention to the feminisation of care in clinical settings and the emergence of niche markets. These markets-spanning food, medicine, pharmaceuticals, and health insurance-commodify aging male bodies and reinforce consumerist ideals tied to middle-class identity. Ultimately, the study highlights how onco-economics reveals tensions between health, masculinity, and economic structures in contemporary Japanese society.

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.

National Health Service England established the Race and Health Observatory as an independent expert body in 2021 to advance meaningful changes for Black and minority ethnic communities, patients, and healthcare professionals. It serves as a 'proactive investigator' by commissioning and facilitating research to achieve long-term transformation in health outcomes. However, medical anthropologists have largely overlooked the Observatory (and the research it commissions) in critical assessments of race and health. This commentary discusses the 2024 review into "health communications with (and for) Jewish communities" vis-à-vis the ethnographic record. On the one hand, the intention behind the Observatory's review is laudable because Jews have been excluded from critical discussions on race and health in the UK as well as the US and Europe. While the review has potential for rendering health inequality in Jewish communities visible, some of the overly general findings may lead to pitfalls and healthcare professionals may need additional guidance or support by establishing diverse steering groups. This comment argues that observing the Observatory on Race and Health is important to ensure accountability over its research and recommendations, and from a conceptual standpoint, to examine the evolving apparatus that shapes public and political reckonings with race, ethnicity and in/equality.

This essay juxtaposes the (informed) 'consent' sections of the American Anthropological Association's (AAA) Statement on Ethics (2012) and the Ethical Guidelines for good research practice (2021) of the Association of Social Anthropologists (ASA) of the UK. It discusses two a priori and uncritical assumptions that constitute the premise of the informed consent doctrine, as it has been incorporated in anthropology: that research participants and anthropologists organise their worlds in temporally coherent ways; and that research participants employ verbal and/or written modes of communication. I argue that erstwhile critiques of the informed consent doctrine in anthropology are somewhat limited, to the extent that they do not always recognise the exclusionary implications of these underlying assumptions. Acknowledging these assumptions in the context of anthropological research with 'psychotic' patients might allude to the impossibilities of-seeking 'informed' consent from such patients, and thus perhaps of ethnographically approaching 'psychotic' expressivity and subjectivity. I offer a way out of this impasse by drawing on specific ethnographic vignettes of the 'embodied voice' of psychotic patients. The essay then concludes with a suggestion for professional anthropological associations to develop alternative, more inclusive, and nonconventional ways of locating informed consent.

In this paper, we bring together medical anthropology of stigma with sociology and public health work on structural stigma to show how interpersonal and structural stigmas are co-produced through social, professional, and institutional exchange. Stigma of psychiatric nurses in Ghana works to exclude them from professional exchange - training, practice of skills, advocacy - and thereby co-produces interpersonal and structural stigma - lack of infrastructure, equipment, supplies, and funding for psychiatric care. Exchange also figured in the reasons nurses gave for the neglect of the mental health sector, which, they explained, did not generate revenue for the government or sufficiently restore patients into productive workers or human resources. At the same time, stigma may not simply exclude people from exchange but create other forms of exchange, such as care.

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.

Over the past few decades, it has become common for medical anthropologists to provide vivid and graphic descriptions of bodily suffering in their work. In this commentary, the author offers some critical reflections on this mode of writing. Emerging from the author's response to the descriptions of bodily suffering contained in Amy Moran-Thomas's recent book about diabetes, this commentary offers some reasons why medical anthropologists might want to be more cautious about describing bodily suffering in graphic forms. While anthropologists often want to incite an ethical response from their readers and encourage them to confront the effects of global patterns of inequality and injustice, this commentary suggests some reasons for caution. Not only are these modes of writing deeply connected to Christian and biomedical frames of 'seeing' suffering bodies, but they also raise longstanding moral questions about what it means to produce records of people's lives that foreground bodily devastation.