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- Convenors:
-
Matteo Valoncini
(Alma Mater Studiorum - University of Bologna)
Xu Liu (Goldsmiths, University of London)
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- Formats:
- Panel
- Mode:
- Face-to-face
- Location:
- Facultat de Geografia i Història 313
- Sessions:
- Thursday 25 July, -, -
Time zone: Europe/Madrid
Short Abstract:
While medical anthropology demonstrates the connectivity of interdisciplinary research, its epistemological approach needs further reflections. We welcome papers reflecting on the challenges of medical anthropology’s role in public engagement and transforming disciplinary boundaries.
Long Abstract:
In these changing times, medical anthropology increasingly finds itself as a pivot point for multi/interdisciplinary projects, posing epistemological, methodological, and ethical questions. Therefore, medical anthropologists always engage with practices of health professionals and/or institutions, building up a connected epistemological realm in various contexts. However, sometimes the engaging approach to the knowledge production of health is seen as a simple add-on rather than the reshaping of epistemological framework in biomedical and health research. Especially, within the public sphere, knowledge produced with qualitative research on biomedical topics sometimes becomes secondary, while the biomedical expertise of science and technology, the persuasion of big data, and even the performative manipulation of discourses remain unchallenged. Thus, we find the following questions increasingly urgent: what knowledge do we produce in relation to healthcare and biomedicine? What discourse do we engage and with whom? Are qualitative approaches immersed within health professional practices, or are they merely the endorser of ethical insights? We wish to put our inquiry into the positioning of medical anthropology, situated at the intersection of perceiving and interrogating the expanding development of health and medical sciences. Meanwhile, we aim to critically approach medical anthropology’s epistemological effect, considering its stance towards the engagements with biomedicine and healthcare. We welcome contributions drawing on empirical cases and conceptual, epistemological inquiries, which could facilitate the reflections on medical anthropology’s, or the qualitative social studies’ role in bridging the social construction and the scientific knowledge production of health and medicine.
Accepted papers:
Session 1 Thursday 25 July, 2024, -Paper Short Abstract:
This paper wants to present and reflect on a research project based in Rimini (Italy) aimed at co-designing the processes of reorganisation of its local health system, focusing on the role of medical anthropology and its ability to reshape health care practices with interdisciplinary collaboration.
Paper Abstract:
The need to transform social and health services and the overarching hospital-centred health system towards a proactive and community-based approach is increasingly recognised, especially since the 'syndemic'. This shift is not just an innovation, but a return to the basic principles of Comprehensive Primary Health Care (PHC) established at the Alma Ata Conference in 1978 and advocated over the years. However, local health authorities often lack the necessary tools and expertise to develop these interventions. This lack can sometimes be an opportunity to open up to other disciplines, such as anthropology. This paper therefore arises from a similar opportunity that emerged in a city in Italy (Rimini), where my PhD is currently taking place, alongside a wider research project with the Centre for International and Intercultural Health, aimed at co-designing the process of reorganisation of the city's health system. This will be achieved by involving local health professionals at different hierarchical levels, from clinical governance to general practitioners, through in-depth interviews and participant observation of established boards and key health services from a PHC perspective. The tools of ethnography and participatory action research will be used to collect good practices, needs and aspirations to understand the semantics of health professionals, while building interdisciplinary collaboration between anthropologists and health professionals. By analysing the language dynamics and power structures within healthcare organisations, the paper aims to provide insights into how medical anthropology can adapt, negotiate and collaborate to share knowledge with different health professionals in order to reshape established practices of care.
Paper Short Abstract:
How can collaborative research navigate the tension between a scientific framework and non-Western knowledge? Recognizing the Urarina’s expertise in balancing the delicate borders between Self and Other, this contribution discusses how relational ontologies can inspire new approaches to reciprocity.
Paper Abstract:
Collaborative health policy guidelines prove ineffective, as the scope of participation assigned to subaltern knowledge is confined to aspects that align with the Western framework. Neglecting the reciprocal question concerning the (im)possibility of integrating biomedicine into the Indigenous framework sustains the hegemonic power imbalance, self-undermining the goal of addressing health disparities.
Drawing from six months of medical practice at a local health station, followed by another six months of immersive ethnographic engagement with the Urarina of Peruvian Amazonia, this contribution reflects on the impact of shifting perspectives. Guided by Community Based Participatory Research principles, the methodology involved collaborative workshops with Indigenous Community Health Workers (CHW), participant observation of illness cases and interviews with patients and local healers. Reflecting on the conceptual tensions this inquiry poses for the multidisciplinary researcher complements the analysis of CHWs' plural perspective.
The study interprets the role of Indigenous CHW as a contemporary continuity of shamanic practice: diplomats negotiating across the borders of multiple ontological worlds who’s intricate dynamics of temporary overlapping manifest in cases of illness.
Practical engagement with Animism stimulates the (un)doing of universalism as the notion of radical alterity disperses through the recognition of shared underlying logics. Combining ontological and practical approaches opens novel opportunities to learn from the practice of shifting perspectives closely linked to relational ontologies. This can help Western stakeholders to engage in plurality, fostering collaborative approaches to address structural and intercultural barriers in seeking and promoting health.
Paper Short Abstract:
Drawing on ethnographic research on psychotherapy that centered anthropology and deemphasized psychology, I demonstrate how medical anthropology provided therapists with a therapeutic voice to support their patients. Anthropology was also used to police the authenticity of their therapeutic voice.
Paper Abstract:
What are the effects of deemphasizing psychological and psychiatric expertise in favor of anthropological expertise in psychotherapy? I examine a kind of psychotherapy developed in France to support people who are immigrants, refugees, and non-francophone. In this form of psychotherapy, therapists are encouraged to draw less on the modes of interpretation and questioning of the psy- professions, and instead turn to their own lived experience and understandings of anthropology to become more attuned to their patients’ experiences of distress. I draw on nearly two years of ethnographic research in France in four clinics that practice this kind of psychotherapy, as well as interviews with 65 therapists and their students. My analysis of the ways that therapists used anthropology reveals how these therapists navigated between improvisation and authority in the ways they spoke with patients and each other. I argue that engaging medical anthropology helped therapists witness the experiences of their patients and provided a therapeutic voice. Anthropology could also be used to police the speech of therapists when their therapeutic voice was considered irrelevant or inauthentic. I conclude by examining how anthropological and psychological/psychiatric expertise haunt one another in this form of therapy and in anthropologically oriented clinical practice and training more generally. I expand on this ethnographic case to develop the notion of the haunted curriculum in health professions education, which examines how sites of clinical training and expertise can counter and/or reproduce forms of injustice.
Paper Short Abstract:
Drawing on fieldwork among women fighting for a PMDD diagnosis, this paper examines epistemic clashes and overdiagnosis, underscoring the need for anthropological insights into health trends, and emphasizing the risk of "medicalized medical anthropology."
Paper Abstract:
In this paper, I articulate the concern that the field of anthropology is susceptible to medicalization. Drawing from my ongoing research on women advocating for recognition of Premenstrual Dysphoric Disorder (PMDD), I elucidate the epistemic battles arising between these women and health authorities. These conflicts manifest when patients' interpretations of symptoms diverge from clinical practices' interpretations, but they may also arise when expansive disease definitions potentially result in overdiagnosis. While medical literature extensively documents overdiagnosis and its harms, this has gained only little attention in anthropology. I contend that the emphasis on representation in anthropology in which we do not question the interlocutors' experiences, leads to the risk of unreflectingly reproducing biomedical language and symptom definitions, and thus neglects the broader structural and institutional factors contributing to patients' symptoms and distress.
I argue that anthropological insights and nuanced ethnographic knowledge are essential to comprehend the repercussions of overdiagnosis and medicalization on individuals' daily lives, self-perception, and responses to bodily experiences. Consequently, a critical examination of established medical entities and diagnostic processes becomes imperative in understanding the deep-rooted connections between overdiagnosis and escalating trends of healthism, characterized by heightened attention to health and diagnosis. This examination necessitates sustained scrutiny of medical anthropology, mindful of the risk highlighted by Browner as "medicalized medical anthropology" (Browner 1999).
I aim to begin a critical conversation on the knowledge that medical anthropology produces, not only in our cross-disciplinary engagement but also within the relation to our interlocutors and the academic discourse that we create.
Paper Short Abstract:
My research focuses on the transmission of knowledge and practice of – and in – Chinese medicine, comparing a clinic and a university in Taiwan. Based on my case study, I will attempt to reflect on the challenges medical anthropology faces to better understand contemporary Chinese medicine.
Paper Abstract:
Chinese medicine (CM), commonly referred to as traditional Chinese medicine (TCM), represents one of the oldest and most widespread medical systems worldwide. Its importance is evidenced not only by its increasing use by Eastern and Western countries but also by the World Health Organization's continuous push to integrate CM into local medical systems. It follows that, in the era of globalisation, it becomes necessary to consider the role of Chinese medicine when reflecting on the concepts of health and medicine. But what is the role of medical anthropology in better understanding contemporary CM? What challenges does it face in analysing the process of learning and teaching the knowledge and practice of Chinese medicine?
In this paper, I discuss the importance of using the qualitative method of ethnography to better understand the pluralism of Taiwanese Chinese medicine and, broadly, different ideas of medicine and healthcare. Based on my case study, through a comparative approach between different modes of transmission of knowledge and practices of CM in Taiwan, I will attempt to reflect on the challenges of medical anthropology. My study draws on nine months of ethnographic research in a private clinic in Taipei and at China Medical University in Taizhong. Methodologically, I observed Chinese medicine lectures and medical practices, conducted semi-structured interviews with doctors and practitioners, and carried out participant-observations, both in the clinic and at the university.
Paper Short Abstract:
In this paper, I explore the potentialities and limitations of medical anthropological praxis in unsettling hegemonic biomedical discourses on health/illness and the suffering body within contexts of forced displacement, and implications of such a shift for reimaginations of systems of care.
Paper Abstract:
In this paper, I seek to explore the potentialities and limitations of medical anthropological praxis in unsettling hegemonic biomedical discourses on bodies, health, and suffering within contexts of forced displacement. Drawing on a systematic literature review, policy analysis, insights from prior research with resettled refugees through a quantitative/public health lens, and preliminary observations from my current doctoral fieldwork through an ethnographic/medical anthropological lens, I reflect on how the objective, material, biological, and externally knowable suffering body has become the primary site for the production of ‘truth’ in contexts of displacement and asylum-seeking. I examine how knowledge production regarding the body of the forced migrant becomes circumscribed within authorised and inaccessible spaces, thus divesting refugees of the epistemic capacity to know themselves and their wellbeing. I consider how quantitative and population-level constructions of refugee health are co-constituted with regimes of health care and humanitarian protection for refugees, critical for rendering refugees visible, legible, and thus governable, and how such paradigms may contribute to failures to alleviate or even exacerbations of illness/suffering. I then consider how medical anthropology might contribute to rethinking the theoretical and epistemological parameters through which we might comprehend body-environment entanglements and aetiological origins of challenges to health/wellbeing in refugee communities. Even more radically, I wish to consider the potentiality of the discipline along with co-productive/collaborative methodologies in restoring the epistemic agency of the subjective/experiential body of the refugee to know itself, and the implications of such an epistemological shift for reimagining systems of care and alleviating preventable illness/suffering.