Paper short abstract:

This paper presents findings from a collaborative ethnography of primary care in Walker, a poor neighbourhood in Newcastle, showing how the complex relationship between injury and care is mediated by the presence and function of pharmaceutical compounds, such as painkillers and antidepressants.

Paper long abstract:

“First do no harm” remains a foundational principle of medical care. Yet harm and care are sometimes not so easy to distinguish. This paper reports on the early findings of an ongoing collaboration between a sociologist, anthropologist, and general practitioner (GP) to explore the impact of poverty on primary care outcomes in Walker, a deprived neighbourhood in the East End of Newcastle upon Tyne characterised by high rates of painkiller and antidepressant prescription, which bring with them the promise of relief as well as the risk of harm. We present a series of everyday clinical episodes that reveal the various ways in which harm and care can become entangled - for patients, clinicians, and researchers. We find that, in a relational context highly suffused and heavily mediated by the presence of pharmaceutical compounds, injury and therapy present themselves not as self-evident social or medical facts but as objects of reflexive moral reasoning, which encompass but also exceed purely biomedical logics. Attending to this fact invites a reconsideration of some of the key assumptions of both mainstream medical ethics and the critical medical humanities, as well as suggesting new ways of thinking about the relationship between injury, therapy, and moral agency in urban environments and academic research collaborations.