Send message to Authors

Paper short abstract

Technocratic logics and process management are displacing medical knowledge as the structural bases of many healthcare institutions. We argue this shift has deadening effects on both research and care, and call for anthropology that melds experience of bureaucratic governance with lively critique.

Paper long abstract

Medical anthropologists conducting fieldwork today encounter challenges of access and ethical approvals set by increasingly technocratic healthcare institutions. While clinical governance processes act on ethnographers wherever they seek to enter clinical settings, the work of ‘giants’ in medical anthropology often edits out the frictions of access. Drawing on our experiences navigating bureaucracies to access English NHS hospitals as field-sites, and our subsequent fieldwork in an NHS an inpatient psychiatric ward and emergency department, we consider the significance of bureaucracy within changing medical institutions.

We argue that the displacement of medical knowledge by technocratic specialisation and process optimisation (as related to ‘patient flow’, risk assessment, and referral ‘pathways’, for example) necessitates a new kind of medical anthropologist: one capable of writing evocatively from positions of entrapment in the bureaucratic mesh that risk creating ‘dead zones of the imagination’ (Graeber 2012) for clinicians and ethnographers alike. In our analysis, we ‘stand on the shoulders of giants’ adjacent to medical anthropology - including Graeber and Navarro-Yashin - as well as contemporary writers who have inspired us in ways personal and academic. As healthcare becomes increasingly modularised and mediated by uncaring technologies, a new generation of medical anthropologists can move past poetics of knowledge, power, and actor-network theory to more closely align experience and analysis, and propose more human ways to animate healthcare's ‘dead zones’.