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- Convenors:
-
Simon Cohn
(London School of Hygiene Tropical Medicine)
Annelieke Driessen (University of Amsterdam)
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- Format:
- Panel
- Sessions:
- Friday 21 January, -
Time zone: Europe/London
Short Abstract:
Having to define or defend research through a language of methods is not only restrictive, but frequently a deception. This panel will explore the role of 'methods' as a category we continually have to negotiate in medical anthropology, even though it often epitomises the antithesis of our aims.
Long Abstract:
Every research proposal and grant application is expected to make explicit ties between the questions and aims stated early on, and the methods of data collection and analysis described later. This neatness is not only a requisite for successful bids, but is also a form of deception. Because, as anthropologists, we know that methods are never so instrumental; that good anthropology should always be sensitive to reformulating what the topic might be and how we might engage with it; and that, in many instances, the best ethnographic research gets done either before or after the tape recorder has been turned off, so to speak. In this panel, we invite medical anthropologists to reflect on the fictions and seductions of 'method', and the implied style of knowledge-making that can be at odds with work we think is meaningful and potentially important. Contributors might consider both what gets lost through a focus on methods, and what can be gained in spite of it. They are invited not to simply dismiss or confess, but to suggest a new conceptual language for our work that both allows us to do research that can adapt and transform through its enactment, and yet may also recognised as legitimate by others.
Accepted papers:
Session 1 Friday 21 January, 2022, -Paper short abstract:
In this talk I reflect on the process of selecting interview excerpts for a Healthtalk module on COVID19 and intensive care in the UK. I ask how -with and despite the fluidity and multiplicity of COVID19- we may learn from these narratives for peer support and improvement of healthcare services.
Paper long abstract:
Health and sickness are shaped culturally and socially, and change over time. In this regard, COVID-19 is no different than other conditions, although the pace of its transformation makes its fluidity particularly visible.
COVID-19 was first diagnosed and lived in the UK in the spring of 2020. At that time, much was unknown about the new virus, and information has been continuously changing since. In contrast to thinking about this in terms of ‘discovery’, shifting our epistemological take allows to see the ‘enactment’ of the virus. For some intensive care COVID19 survivors it is a condition that causes significant long-term effects on breathing, energy and mental wellbeing, and for which a pathway to support must be continuously fought for and negotiated depending on the medical specialty they are seeking help from. For others it is a vehicle to demonstrate their ability to achieve a rapid recovery. For family members the condition was mostly an obstacle to their access to hospital.
In developing a module about Intensive Care experiences with COVID19 for Healthtalk.org, the questions of fluidity and multiplicity become methodological concerns: how to tame these for the online module? What of early pandemic experiences remain relevant to know for an audience interested in COVID-19 ‘now’? How to depict patient experiences ‘of' COVID19 when its contours are shapeshifting? In this talk I draw out learnings about the temporal and geographical ‘translations’ of narratives, and how we may nevertheless learn from them for peer support, and improvement of healthcare services.
Paper short abstract:
I will present a study exploring how working-age adults with multimorbidity navigate complex care systems. The study draws on collaborative methods as an inevitably open-ended form of knowledge-making that allows the focus of this project to emerge from what matters most for patients.
Paper long abstract:
Multimorbidity is regarded as one of the greatest emerging challenges for healthcare systems. However, despite many attempts to clarify the definition and its measurement, the concept remains elusive.
Instead of trying to pin the concept down by defining it, I investigate what multimorbidity means for people living with it.
As such, the research aims are explorative and open-ended, presenting a challenge for proposing a fixed methodological approach.
I propose the use of Vigh’s (2009) concept of ‘social navigation’ as a novel empirical approach. This approach situates patients’ day-to-day experiences in the multiple social contexts in which they occur. As Vigh reminds us, navigation indicates motion within motion. Studying navigations circumvents assuming a fixed social structure but looks at how people move in moving environments and how this, in turn, moves them.
People’s daily movements are the primary unit of analysis, leaving open the possibility for exploring spaces that are often not in first instance considered as care systems. The challenge is to look for methods that can adapt according to what matters most for research participants. I propose the use of collaborative methods as vital in achieving this, because of their inherently open-ended nature. Incorporating participatory projects into the research proposal means that predetermined research aims are per definition not desirable. It pushes the boundaries on what is definable within a protocol and allows moving beyond preconceived notions of what constitutes ‘the field’. Loosening control of knowledge-making technologies transforms the research process into a group-based activity centred on the affective.
Paper short abstract:
Anthropologists have long complained about the methodological straightjackets implied by the “governance” norms that review boards or equivalent bodies seek to enact. As this paper explores, the introduction of the EU General Data Protection Regulation (2018) may have aggravated such a situation.
Paper long abstract:
Since institutional review boards and similar bodies became institutionalized, anthropologists have complained about the straightjackets implied by the regulations those bodies seek to enact. Although anonymity, confidentiality and consent play a central role, the basic issues are methodological and epistemic. Critics have noted that the evaluation processes devised by science governance bodies suit the hypothesis-testing designs and randomized clinical trials of biomedical research. Didier Fassin’s asking “The end of ethnography as collateral damage of ethical regulation?” encapsulates anthropologists’ worries. Margaret Strathern’s apparently obvious remark of 2006, “Persons […] are the anthropologist’s human subjects” is a rejoinder to the bureaucratization of “ethics.” While in the 1960s, this term could evoke anthropologists’ social responsibility, four decades later it meant compliance with regulations about “human-subject research.” And when in 2018, the EU General Data Protection Regulation (GDPR) replaced the notion of “human subject” by that of “data subject,” it went a step further. Its goal is to safeguard individual privacy as potentially affected by providers of “goods and services,” or by the gathering and handling of large-scale personal data. But GDPR applies everywhere, and its norms and language have been incorporated into the “ethical” assessments of anthropological research projects. So much so that the question, “Is anthropology legal?” has been used to underline GDPR’s impact on anthropological knowledge-making. This paper outlines and discusses such a situation.