40 terms

Medical Anthropology II

Terms from the second half of Med. Anthropology
Wallerstein's World Systems Model
global south, 3rd world
non-industrialized, poor, menial labor, export raw materials and cheap labor
lower end of health disparities
categorization as a form of epistemology (method of rationalizing diversity); establishes typological differences between humans
characterizes racial groups based on qualities of varying importance (racist essentialism)
"raw materials"
products provided by colonialism (bodies for testing, new ecology) that allowed for expansion of biomedicine
increased prestige of the physician
establishing differences between groups of people based on comparative anatomy, i.e. craniometry
form of scientific racism
racial formation
Omi and Wanant
process of historically situated projects in which human bodies and social structures are represented and organized through symbolic (slaves as universally black) and structural (slaves as commodities) representation
Wallerstein's World Systems Model
global north, 1st world
industrialized, wealthy, skilled labor, export high profit consumption goods and receive raw materials
higher end of health disparities
biological determinism
Hernstein, Murray
difference between people entirely determined by biology, and socioeconomic distinctions are inherited as a result of genetics (society is a reflection of biology)
medical pluralism
co-existence of various forms of healing knowledge and practice within a cultural context; can exist within a healing system
"missing the revolution"
Orin Starn, "Shining Path"
problem of scale and focus of research; if too focused on details then macro-scale processes will be ignored
Body Politic
Scheper-Hughes, Lock (3rd body)
individual and collective body is subjective to social and political control and is justified for sake of social/political order
producing proper bodies for a secure nation, i.e. Boy Scouts
medical tourism
travel to other countries for biomedical procedures that could otherwise not be afforded (necessary or otherwise)
scientific racism
arguments for biological racial differences that are supported and driven by racist ideologies

claim scientific objectivity and neutrality (cultural constructions)
Bell Curve Study
Hernstein, Murray
American society as increasingly meritocratic, and positive social outcomes are based on intelligence, an inheritable factor; therefore, some races are more determined to succeed based on inheritable characteristics
form of biological determinism
Tuskeegee Syphilis Experiment
experiment performed by the US Public Health Service to determine the long-term effects of untreated syphilis in poor African-American subjects of Alabama
highly unethical; scientific racism
Social Darwinism
Herbert Spencer
application of natural selection to humans and societies; "survival of the fittest"
used to justify imperialism and slavery
Individual Body
Scheper-Hughes, Lock (1st body)
body as the self and how we experience it; Cartesian duality (emphasis placed on body as epitome of truth)
atomized self: personhood shaped by individualism
socially-dispersed self: personhood shaped by family and social relations
attention to lived, sensate experience of patients to examine the experience in a healing system
focus on personal story at expense of theory
Social and Cultural Body
Scheper-Hughes, Lock (2nd body)
representation of the body through natural symbols, i.e. heart (spirit, emotion)
Omi, Wanant
reproduces structures of domination and is based on essentialist categories of race
improving the genetics of a population through selective breeding, genocide, and compulsory sterilization (scientific racism)
(early) considered a biological category based on lineage of evolutionarily different histories
(contemporary) race exempted from biological categorization, and is based on subjective categories
behavioral paradigm in HIV/AIDS discourse in Africa
paradigm that disparity in HIV transmission between Africa and the rest of the world is due to marital polygamy and ancestor worship (behaviors)
ignores macro-scale processes such as poverty and illness
healing tourism
traveling across international borders to receive a healing treatment; commodification of culture (medical pluralism)
world-systems analysis
multidisciplinary, world-scale approach to world history and social change which stresses that world systems, not nation states, should be the focus of analysis
highlights the economic relationships of exploitation between richer and poorer countries (core v. periphery)
structural violence
mechanisms through which macro-scale historical and economically-driven forces inflict individual suffering and constrain personal agency
extension of a nation's authority through the territorial expansion of government structures and institutions
political economy
world capitalist systems produce inequalities within and between different regions of the world
informed by world systems analysis
relationship between Western medicine and imperialism
imperialism - extension of power through legitimization via Western medicine knowledge, practice, and self-control
Western medicine - imperialism provided the raw materials; "white man's burden"
both arose from racist ideologies and Enlightenment ideals
hierarchy of resort
sequence by which people use different therapies in a medical pluralist state (traditional sought first)
limits: assumes logical choices, doesn't account for personal experience, assumes global access)
Critical medical anthropology
examine individual experience and the broader matrix in which it is embedded to see how macro-scale historical and politco-economic forces affect personal disease and illness
projects of domination premised on the colonizer's belief in their own superiority and their ordained mandate to rule
categorical approach in cultural competence
describe relevant attitudes, values, beliefs and behaviors to increase knowledge of culture in health-care providers
problems: conflate race, ethnicity, nationality; promotes stereotypes; frame health issues as patient choice; suggest that culture is a skill that can be mastered
cultural competence
understand social and cultural influences on patient's health beliefs, how these factors interact in healthcare delivery, and ensure the quality delivery of healthcare to a diverse patient population
goal: patient adherence to physician recommendations
cultural humility
lifelong process between patients and healthcare providers on an ongoing basis
objectives: mutual understanding and mediation, recognize inequalities, physician self-reflection and life-long learning
patient-focused interviews
culture (competence v. humility)
competence - reduced to a list of traits, static, stereotype
humility - dynamic, changing on a daily basis
explanatory model of illness (EM)
patient-centered interview model in medical school that uses ethnography to mediate between physician and patient
Kleinman's Eight Questions
Kleinman's Suggestions:
-disregard compliance
-embrace mediation
-recognize influence of culture on biomedicine
preference hypothesis
attribute disparities to patient choice
-weak - no systematic study
-unlikely that patient preferences are primary driving force
bias hypothesis
attribute disparities to physician bias (racial/ethnic stereotypes)
Schumann 1999: disparity in physician response based on race and gender
-oversimplified model of bias and racism based on skin color
communication hypothesis
attribute disparities to interaction between patient and physician (most effective hypothesis)
dialect, communication, power relations, context (sociopolitical, historical, ideological)
tragic narrative form
hamartia: protagonist virtue becomes weakness, leading to downfall, i.e. Hmong pride and stubbornness of Neil
catharsis: purging/purifying of emotions that teaches endurance of tragedies
conclusion leads to inevitable clash (Hmong vs. biomedicine)