An anthropology of biomedicine

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An anthropology of biomedicine

Margaret Lock and Vinh-Kim Nguyen

Wiley-Blackwell, 2010

  • : hardcover
  • : pbk

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Includes bibliographical references (p. [430]-489) and index

Description and Table of Contents
Volume

: pbk ISBN 9781405110716

Description

An Anthropology of Biomedicine is an exciting new introduction to biomedicine and its global implications. Focusing on the ways in which the application of biomedical technologies bring about radical changes to societies at large, cultural anthropologist Margaret Lock and her co-author physician and medical anthropologist Vinh-Kim Nguyen develop and integrate the thesis that the human body in health and illness is the elusive product of nature and culture that refuses to be pinned down. Introduces biomedicine from an anthropological perspective, exploring the entanglement of material bodies with history, environment, culture, and politicsDevelops and integrates an original theory: that the human body in health and illness is not an ontological given but a moveable, malleable entityMakes extensive use of historical and contemporary ethnographic materials around the globe to illustrate the importance of this methodological approachIntegrates key new research data with more classical material, covering the management of epidemics, famines, fertility and birth, by military doctors from colonial times onUses numerous case studies to illustrate concepts such as the global commodification of human bodies and body parts, modern forms of population, and the extension of biomedical technologies into domestic and intimate domainsWinner of the 2010 Prose Award for Archaeology and Anthropology

Table of Contents

Acknowledgments xii Introduction 1 Improving Global Health: The Challenge 3 Biomedicine as Technology 4 Does Culture Exist? 6 A Word about Ethnography 9 Outline of Chapters 11 Part I: Technologies and Bodies in Context 15 1 Biomedical Technologies in Practice 17 Technological Mastery of the Natural World and Human Development 19 Technology and Boundary Crossings 20 Biomedicine as Technology: Some Implications 22 Technologies of Bodily Governance 24 Technologies of the Self 27 The Power of Biological Reductionism 29 Techno/Biologicals 30 2 The Normal Body 32 Cholera in the 19th Century 33 Representing the Natural Order 35 Truth to Nature 35 The Natural Body 37 A Numerical Approach 38 Other Natures 39 Interpreting the Body 42 How Normal Became Possible 43 When Normal Does Not Exist 46 Problems with Assessing Normal 47 Pathologizing the Normal 50 Limitations to Biomedical Objectivity 53 Better Than Well? 54 3 Anthropologies of Medicine 57 The Body Social 57 Contextualizing Medical Knowledge 60 Medical Pluralism 61 The Modernization of Traditional Medicine 63 Medical Hybridization 64 Biodiversity and Indigenous Medical Knowledge 65 Self-Medication 66 A Short History of Medicalization 67 Opposition to Medicalization 70 The Social Construction of Illness and Disease 71 The Politics of Medicalization 75 Beyond Medicalization? 78 In Pursuit of Health 79 In Summary 81 4 Local Biologies and Human Difference 83 The End of Menstruation 84 Local Biologies 90 Rethinking Biology in the Midst of Life s Complexity 92 Is Biology Real? 93 Kuru and Endocannibalism 95 Racism and Birth Weight 98 Of Microbes and Humans 99 Antibiotics and Resistant Microbes 102 Debates about the Origin of HIV 103 In Summary 108 Part II: The Biological Standard 111 5 The Right Population 113 The Origins of Population as a Problem 115 Addressing the Problem of Population 117 Improving the Stock of Nations 118 Alternative Modernity and Indian Family Planning 123 The One-Child Policy 127 Biomedical Technology and Sex Selection 132 Contextualizing Sex Selection: India and Family Balancing 133 Contextualizing Sex Selection: Disappeared Girls in China 136 Sex Selection in a Global Context 139 Reproducing Nationalism 142 In Summary 144 6 Colonial Disease and Biological Commensurability 146 An Anthropological Perspective on Global Biomedicine 147 Biomedicine as a Tool of Empire 148 Acclimatization and Racial Difference 149 Colonial Epidemics: Microbial Theories Prove Their Worth 151 Resistance to the Biomedicalization of Epidemics 153 Microbiology as a Global Standard 154 Infertility and Childbirth as Critical Events 157 Birthing in the Belgian Congo 158 A Global Practice of Fertility Control 160 Intimate Colonialism: The Biomedicalization of Domesticity 160 Biomedicine, Evangelism, and Consciousness 162 The Biological Standardization of Hunger 163 The Colonial Discovery of Malnutrition 164 Albumin as Surplus 166 The Biologization of Salvation 168 Madness 170 In Summary 174 7 Grounds for Comparison: Biology and Human Experiments 176 The Laboratory as the Site of Comparison 177 The Colonial Laboratory 178 Experimental Bodies 179 Rise of the Clinical Trial 180 Taming Difference by Chance 183 The Alchemy of the Randomized Controlled Trial 184 The Problem of Generalizability 184 Medical Standardization and Contested Evidence 187 Globalizing Clinical Research 188 Creating Markets for Biomedical Technologies in Developing Countries 190 Testing Biomedical Interventions for the World s Poor 192 Disputes over Perinatal HIV Transmission Trials 192 What Should Count as Signifi cant Evidence? 196 Living with Vampires: Perceptions of Research 197 Experimental Communities: Social Relations 200 In Summary 202 Part III: Moral Boundaries and Human Transformations 203 8 Who Owns the Body? 205 Commodification of Human Biologicals 206 Objects of Worth and Their Alienation 208 The Wealth of Inalienable Goods 209 A Bioeconomy of Human Biologicals 210 Who Owns the Body? 211 The Commodification of Eggs and Sperm 213 Immortalized Cell Lines 216 The Exotic Other 218 Biological Databases 220 Concluding Comments 226 9 The Social Life of Organs 229 Bioavailability Who Becomes a Donor? 230 A Shortage of Organs 234 Inventing a New Death 236 The Good-as-Dead 239 Struggling for National Consensus 241 The Social Life of Human Organs 244 When Resources Are Short 248 Altruism, Entitlement, and Commodifi cation 252 10 Kinship, Infertility, and Assisted Reproduction 254 Assisted Reproductive Technologies 255 Problematizing Infertility Figures 256 From Underfertility to Overfertility 257 Reproducing Culture 264 Assisted Reproduction in the United States 266 Assisted Reproduction in Egypt 269 Assisted Reproduction in Israel 273 ART in Global Perspective 277 Part IV: Elusive Agents and Moral Disruptions 281 11 The Matter of the Self 283 The Discovery of an Unconscious Self 284 Unlocking the Pathogenic Secret 285 The Pathogenic Secret as a Technology of the Self 286 The Making of Post-Traumatic Stress Disorder 287 The Practitioner-Self 289 The Sources of Therapeutic Effi cacy 290 The Self s Therapeutic Powers 292 Technologies of Health Promotion 295 Technologies of Empowerment 296 Technologies of Self-Help 297 Confessional Technologies 298 Conclusion 301 12 Genes as Embodied Risk 303 From Hazard to Embodied Risk 304 From Generation to Rewriting Life 306 Genomic Hype 308 Geneticization 310 Genetic Testing and Human Contingency 311 Genetic Citizenship and Future Promise in America 315 Biosociality and the Affi liation of Genes 316 Genetic Screening 319 Preimplantation Genetic Diagnosis 325 13 Genomics, Epigenomics, and Uncertain Futures 330 Dethroning the Gene? 332 Eclipse of the Genotype Phenotype Dogma 333 Epigenetics: Beyond Genetic Determinism 335 Epigenomics 337 The APOE Gene and Alzheimer s Disease 339 Genetic Testing for Late-Onset Alzheimer s Disease 343 Interpretations of Risk Estimates 345 Learning (Again) to Live with Uncertainty 347 14 Human Difference Revisited 348 Molecular Biology and Racial Politics 351 The Molecularization of Race 353 Commodifying Race and Ancestry 356 Looping Effects 357 Epilogue 359 Notes 365 Bibliography 430 Index 490
Volume

: hardcover ISBN 9781405110723

Description

An Anthropology of Biomedicine is an exciting new introduction to biomedicine and its global implications. Focusing on the ways in which the application of biomedical technologies bring about radical changes to societies at large, cultural anthropologist Margaret Lock and her co-author physician and medical anthropologist Vinh-Kim Nguyen develop and integrate the thesis that the human body in health and illness is the elusive product of nature and culture that refuses to be pinned down. * Introduces biomedicine from an anthropological perspective, exploring the entanglement of material bodies with history, environment, culture, and politics * Develops and integrates an original theory: that the human body in health and illness is not an ontological given but a moveable, malleable entity * Makes extensive use of historical and contemporary ethnographic materials around the globe to illustrate the importance of this methodological approach * Integrates key new research data with more classical material, covering the management of epidemics, famines, fertility and birth, by military doctors from colonial times on * Uses numerous case studies to illustrate concepts such as the global commodification of human bodies and body parts, modern forms of population, and the extension of biomedical technologies into domestic and intimate domains * Winner of the 2010 Prose Award for Archaeology and Anthropology

Table of Contents

Introduction. Improving Global Health: the Challenge. Biomedicine as Technology. Does Culture Exist? A Word about Ethnography. Outline of Chapters. Part I: Technologies and Bodies in Context. Chapter 1: Biomedical Technologies in Practice. Technological Mastery of the Natural World and Human Development. Technology and Boundary Crossings. Biomedicine as Technology: some Implications. Technologies of Bodily Governance. Technologies of the Self. The power of biological reductionism. Techno/Biologicals. Chapter 2: The Normal Body. Cholera in the Nineteenth Century. Representing the Natural Order. Truth to nature. The natural body. A numerical approach. Other natures. Interpreting the body. How normal became possible. When normal does not exist. Problems with making normal. Pathologizing the "normal". Limitations to biomedical "objectivity". Better than well? Chapter 3: Anthropologies of Medicine. The Body Social. Contextualizing Medical Knowledge. Medical Pluralism. The Modernization of "Traditional" Medicine. Medical Hybridization. Biodiversity and Indigenous Medical Knowledge. Self-Medication. A Short History of Medicalization. Opposition to Medicalization. The Social Construction of Illness and Disease. The Politics of Medicalization. Beyond Medicalization? In Pursuit of Health. In Summary. Chapter 4: Local Biologies and Human Difference. The End of Menstruation. Local biologies. Rethinking Biology in the Midst of Life's Complexity. Is Biology Real? Kuru and Endo-Cannibalism. Racism and Birth Weight. Of Microbes and Humans. Antibiotics and Resistant Microbes. Debates about the Origin of HIV. In summary. Part II: The Biological Standard. Chapter 5: The Right Population. The Origins of Population as a "Problem". Addressing the "problem" of population. Improving the Stock of Nations. Alternative Modernity and Indian Family Planning. The One Child Policy. Biomedical technology and sex selection. Contextualizing sex selection: India and "family balancing". Contextualizing sex selection: disappeared girls in China. Sex selection in a global context. Reproducing Nationalism. Summary. Chapter 6: Colonial Disease and Biological Commensurability. An anthropological perspective on global biomedicine. Biomedicine as a tool of Empire. Acclimatization and racial difference. Colonial epidemics: Microbial theories prove their worth. Resistance to the biomedicalisation of epidemics. Microbiology as a global standard. Infertility and childbirth as critical events. Birthing in the Belgian Congo. A global practice of fertility control. Intimate colonialism: the biomedicalization of domesticity. Biomedicine, evangelism and consciousness. The biological standardization of hunger. The colonial discovery of malnutrition. Albumin as surplus. The biologization of salvation. In Summary. Chapter 7: Grounds for Comparison: Biology and Human Experiments. The laboratory as the site of comparison. The colonial laboratoryExperimental bodies. Rise of the clinical trial. Taming difference by chance. The alchemy of the randomized controlled trial. The problem of generalizability. Medical standardization and contested evidence. Globalizing Clinical Research. Creating markets for biomedical technologies in developing countries. Testing biomedical interventions for the world's poor. Disputes over perinatal HIV transmission trials. What should count as significant evidence? Living with Vampires: perceptions of research. Experimental communities: social relations. In summary. Part III: Moral Boundaries and Human Transformations. Chapter 8: Who owns the body? Commodification of Human Biologicals. Objects of Worth and their Alienation. The Wealth of Inalienable Goods. A BioEconomy of Human Biologicals. Who Owns the Body? The Commodification of Eggs and Sperm. Immortalized Cell Lines. The Exotic Other. Biological Databases. Concluding Comments. Chapter 9: The Social Life of Organs. Bioavailability -- Who becomes a donor? A Shortage of Organs. Inventing a New Death. The Good-as-Dead. Struggling for National Consensus. The Social Life of Human Organs. When Resources are Short. Altruisim, Entitlement, and Commodification. Chapter 10: Kinship, Infertility, and Assisted Reproduction. Assisted Reproductive Technologies. Problematizing Infertility Figures. From Underfertility to Overfertility. Reproducing Culture. Assisted Reproduction in the United States. Assisted Reproduction in Egypt. Assisted Reproduction in Israel. ART in Global Perspective. Chapter 11: The Matter of the Self. The Discovery of an Unconscious Self. Unlocking the pathogenic secret. The pathogenic secret as a technology of the self. The making of post-traumatic stress disorder. The practitioner-self. The sources of therapeutic efficacy. The self s therapeutic powers. Technologies of health promotion. Technologies of empowerment. Technologies of self-help. Confessional technologies. Conclusion. Part IV: Elusive Agents and Moral Disruptions. Chapter 12: Genes as embodied risk. From Hazard to Embodied Risk. From Generation to Re-Writing Life. Genomic Hype. Geneticization. Genetic Testing and Human Contingency. Genetic Citizenship and Future Promise in America. Biosociality and the Affiliation of Genes. Genetic Screening. Preimplantation Genetic Diagnosis. Chapter 13: Genomics, epigenomics, and uncertain futures. De-Throning the Gene? Eclipse of the Genotype-Phenotype Dogma. Epigenetics: beyond genetic determinism. Epigenomics. The APOE Gene and Alzheimer's Disease. Genetic Testing for Late Onset Alzheimer's Disease. Interpretations of Risk Estimates. Learning (again) to live with Uncertainty. Chapter 14: Human Difference Revisited. Molecular Biology and Racial Politics. The molecularization of race. Commodifying "race" and ancestry. Looping effects. Epilogue. Notes. Bibliography. Index.

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