Blog Archive: Latour’s AAA 2014 Address

In this installment of the blog, we revisit one of our first conference features. This commentary piece examined Bruno Latour’s Distinguished Lecture address at the 2014 Annual Meeting of the American Anthropological Association in Washington, DC. You can access the original post here.


 

This year at the American Anthropological Association 2014 Meeting, Bruno Latour was invited to deliver the distinguished lecture. Entitled “Anthropology at the Time of the Anthropocene,” Latour discusses the rise in the term anthropocene to describe our current stage of natural history. Although the term makes reference to how “human” (anthro) our current age may be, Latour jests that this term was introduced by geologists, not social scientists. In the anthropocene, it is humans that play the defining role in our geological historical moment.

Logo_of_the_American_Anthropological_Association

via Wikimedia Commons

The assumption, Latour notes, is that human agency is the prime source of action that shapes the physical world. Humans are responsible for climate change, for pollution, for altering the literal, natural fabric of our world. Yet we know that not all humans have the same impact on our environment. As Latour quips, there is not “One Human” who is responsible for the changes we see in our climate or environment. We are simultaneously assessing human power as a plural, collective entity, as well as using this concept to suggest that the blame for global change does not fall evenly across all humans. As anthropologists and cultural theorists, we know how fragile human agency can be when we divide it amongst many contending social and cultural groups.

Is there another way to think about human action that does not problematically configure humans as both collective and individual, acting but not universally accountable for all human actions? Latour posits that rather than focusing solely on agency, with a strong emphasis on human intention and purpose when committing action, we could think instead about animation, or what forces–human and non-human– are in motion in a given social space. To do so, we can no longer assume that the human agent is a colloquial be-all-end-all.

How does this assertion speak to medical anthropology, social medicine, and medical humanities? At first, we might raise our brows at the discussions of geography, environment, and most of all the suspicion surrounding the primacy of human agency. Decentralizing the human agent, we might say, is perhaps the least humanistic approach to the study of human experience. Indeed, medicine is the care of humans by humans!

However, our human ability to question our own power and position in the universe, amidst other natural and non-human forces, is a mark of our species. Whether through philosophy, religion, or social science, humans have a proclivity for ruminating about our place in the material, corporal world. We crave knowledge about what sets us apart from non-human things, and how we are sometimes reliant on them. For scholars of medicine, such inquiries about our relationships with the physical universe is key. We consider the place of non-human agents in disease and care. We ask: why do physicians rely on certain tools? Why do patients see stethoscopes, thermometers, and scalpels as making a clinician legitimate in his or her practice? How are medical traditions made unique by their tools and pharmaceutical formulas? Could the layout of a hospital or clinic itself alter the way care is given?

In an age where technology permeates developed and developing societies, Latour’s suggestion to destabilize human agency is productive when considering medicine as a cultural object. We must think not only of ourselves, but the physical environments we live in and the material objects and devices we cannot seem to live without.

Many scholars understandably resist Latour’s idea that non-humans could have some primitive agency. Yet even if we do not assign agency to non-human tools, things, and environments, thinking seriously about their role in sociocultural systems is informative. Medicine is a lively site of exchange between patients and physicians, as well as practitioners and devices, patients and new medical innovations, and the built environments which house them. As Latour invites us to do, we should pause to consider humans within the midst of a rich material world around us that– like humanity itself– is constantly in motion.

 

Advertisements

Book Release: Tomes’ “Remaking the American Patient”

9781469622781

Images via UNC Press website

Released in January 2016 from the University of North Carolina Press is Nancy Tomes’ Remaking the American Patient: How Madison Avenue and Modern Medicine Turned Patients into Consumers. Through historical and cultural analysis, Tomes illuminates the threads between public relations and marketing in medicine, asking throughout: how have patients in the United States come to view health care as a commodity to be “shopped” for? What connections are shared between the history of medicine and the growth of consumer culture? Likewise, Tomes investigates what it means to be a “good patient” in this system of marketed care, and how “shopping” for care can both empower and disorient patients in the contemporary age. She also reviews the resistance, and ultimate yielding, of the medical profession to this model of care seeking. The book was recently reviewed in the New York Times (read the article here.)

The book will prove insightful for both historians of medicine and medical anthropologists who study the political-economic landscape of biomedicine and patienthood in the United States. It will also speak to conversations in bioethics about patient autonomy, choice, and medical decision-making.

About the Author

Nancy Tomes serves as professor of history at Stony Brook University. She is also the author of The Gospel of Germs: Men, Women, and the Microbe in American Life, published by Harvard University Press (details here.)

Have you published a recent book in medical anthropology, history of medicine, social medicine, or medical humanities? Email our blog editor (Julia Knopes) at jcb193@case.edu with a link to the book’s page at the academic publisher’s website, and we will feature it here.

Blog Archive: Medical Museums in the USA

After almost 2 years online, the Culture, Medicine & Psychiatry blog has established a growing collection of guest posts, commentaries, and special features. In a new intermittent series on the blog, we will be reposting some of our most popular past blogs, with added updates, new information, or prefaces related to current events.

This week, we revisit one of our most-viewed posts from the early months of the blog: an extensive list of medical museums across the United States. In the updated list, we’ve added links to all of the institutions for easy access to museum hours, location, and related resources. Access the original post here.


 

cropped-2009cover-copy

 

Boston, MA

The Warren Anatomical Museum in partnership with Harvard University contains the skeletal remains and the infamous tamping iron of Phineas Gage, as well as phrenological casts and other objects in the history of the study of the human body. Details here.

The Public Health Museum is located on the grounds of the former Tewksbury Hospital, and features exhibits on the development of public health in history. Details here.

Chicago, IL

The International Museum of Surgical Science, located on the shores of Lake Michigan just north of “The Magnificent Mile,” is a collection of surgical instruments, medical artifacts, and displays on the history of anatomical and surgical learning housed in a beautifully restored former mansion. Details here.

The Museum of Science and Industry in the Hyde Park neighborhood is an enormous building which houses not only a permanent collection of plastinated and preserved cadaveric specimens, but features many exhibits on human health, the body, and other areas of scientific and industrial development. Details here.

Cleveland, OH

The Dittrick Museum of Medical History houses a newly-renovated exhibit on medical instruments and devices, as well as the Percy Skuy Collection of artifacts in the history of contraception and abortion. It also features exhibitions on the history of birth and on medical practice in the Cleveland area. Details here.

Danville, KY

The McDowell House Museum is the restored home and office of Dr. Ephraim McDowell, who for the first time in history in 1809 successfully removed an ovarian tumor. The museum features a collection of early medical equipment in the USA, gardens, and a recreated 19th century apothecary. Details here.

Houston, TX

The Health Museum features a series of interactive exhibits about the human body and disease, with rotating exhibitions on various aspects of biomedical technology and science. It is a family-friendly destination if you happen to be in town with little ones. Details here.

Indianapolis, IN

The Indiana Medical Museum can be found on the grounds of the former Central State Hospital, inside the old pathology building. The museum highlights the early history of biomedical psychiatry, and in its own words: “maintains a collection of scientific artifacts from the nineteenth and twentieth centuries in a completely authentic setting. Constructed in 1895 and inaugurated in 1896, the nineteen-room Pathological Department Building, as it was then called, is equipped with three clinical laboratories, a photography lab, teaching amphitheater, autopsy room, and library.” Details here.

Kirksville, MO

The Museum of Osteopathic Medicine at A.T. Still University is the first museum dedicated to osteopathic care. It is home to an impressive collection of over 50,000 artifacts in the history of osteopathy, many from the founder of the field: Dr. Andrew T. Still, whose cabin is on the museum grounds. Details here.

New York, NY

The Morbid Anatomy Museum, newly opened by independent scholar Joanna Ebenstein, is located in Brooklyn. It features an array of exhibits on the intersections of death, art, and medicine, as well as a coffee café on the bottom level. Details here.

Philadelphia, PA

The Mütter Museum is a world-renowned collection of medical oddities and human pathological specimens, including (not for the faint of heart) the mummified body of a woman whose fat chemically decomposed into a soap-like material. The Mütter Museum has partnered with the Penn Museum of Archaeology and Anthropology to offer a one-price two-museum admission ticket, if you wish to visit both institutions. Details here.

Rangley, ME

The Wilhelm Reich Museum, situated inside the former home and estate of psychiatrist and psychoanalyst Dr. Wilhelm Reich, displays Dr. Reich’s collection of scientific devices and artwork. It also features a bookstore with the widest selection of his publications, as well as a conference center on the estate grounds. Details here.

Rochester, NY

The Rochester Medical Museum and Archive is located in the Rochester Academy of Medicine, and houses a collection of photos, articles, and vignettes on display that document the history of medicine in the Rochester area. The museum also features a climate-controlled storage area for clinical costumes and other artifacts in the history of medicine. Details here.

Washington, DC / Metro Area

The National Museum of Health and Medicine highlights not only the historical development of medicine in America, but the impact of medicine during important moments in American history, such as the Civil War and the assassination of President Abraham Lincoln. Details here.

The NIH US National Library of Medicine, an impressive collection of medical books and artifacts, is open to the public. Details here.

The National Museum of Civil War Medicine features exhibits on medicine and care in the Civil War era, as well as highlighting the changing roles of women and medical professionals in the delivery of treatment at that time. Details here.

From the Archive: Informed Consent and Medical Research

In our “From the Archive” series, we revisit articles from past issues of the journal. This installment of the series will focus on the nature of informed consent in medical research: here through a case of using radioactive plutonium on living hospital patients. In response to our readership poll, this article was chosen for its discussion of themes valuable to both medical anthropology and to science and technology studies. The article touches on issues pertinent to social studies of health, human subjects research, and the relationships between government, science, and public knowledge.

cropped-cropped-2009cover-copy1.jpg

Today in From the Archive, we will explore Sharon R. Kaufman’s article “The World War II Plutonium Experiments: Contested Stories and their Lessons for Medical Research and Informed Consent” (Culture, Medicine & Psychiatry June 1997. Volume 21 Issue 2, pages 161-197.) Kaufman opens her argument by asserting that “informed consent is shown to be an evolving process and discursive practice that cannot be understood apart from its historical and cultural embeddedness.” To address this point, she draws on the public response to medical research carried out on 18 patients across the United States who were injected with plutonium: a WWII-era experiment that illustrates the evolving nature of consent between the past and the present. Kaufman suggests that, rather than simply maligning this past research as unethical, we must consider how consent itself is not a static concept.

The author begins by explaining that this experiment, which operated between 1945-1947, only entered common public knowledge in 1993, when once-classified documents about the research were released. The release led to widespread outrage, as media outlets decried the federal government for sponsoring the secret project and endangering the lives of patients. Two central narratives emerged from the information release: a report penned by a journalist, and a report developed between 1994-1995 by a faculty committee at the University of California San Francisco (UCSF) where three of the patient experiments had formerly occurred. The faculty committee’s report aimed to develop a scientific and ethical account of the experiment to be made available to the public and the “university community.”

Though both reports drew information from numerous primary historical documents that described the case, Kaufman cautions us that both accounts are anachronistic, and each crafts a contemporary story consistent with the audience and the authorship of each piece. The journalist’s scathing report emphasized the vulnerability of individual citizens and the hazards of a government able to “harm and deceive,” whereas the committee report instead highlighted the ethics of scientific research and the methodology of the experiment, while paying less heed to the matter of government secrecy. The latter report concluded that the research did not meet either modern measures of informed consent or consent practices of the era in which the experiment was performed; the journalist’s report did not draw this distinction, instead suggesting that the experiment was unethical in both past and present because of the long-term effects of the research on participants or their families.

Kaufman writes that while both reports rightfully agreed that the experiment was “troubling” and that it had undeniable effects on research participants, they simultaneously direct us to a larger issue. Consent, she posits, is scarcely stable: it is situated within too many contexts to be defined in any single fashion. For instance, she notes that patients cannot always distinguish between “therapy” and “experiment” in medical research: thus meaning that the trust participants have in their clinicians’ recommendations for care, and informed consent for research on their illness, cannot always be separated. Likewise, high-risk experiments are not inherently unethical despite being potentially ‘unsuccessful,’ in whatever manner this is defined by researchers and participants. Thus there is no stable measure for informed consent which can be applied to all experiments, in all historical periods.

Kaufman also remarks that such discussions about the “elusive” nature of consent did not formally begin until 1966, the year that Henry Beecher published a landmark article on ethics in clinical research. This was historically much later than the era of the plutonium experiments in the 1940s, when “consent, however informal in character before the war, frequently took a back seat to the sense of urgency and necessity for human experimentation brought on by the war.” Today’s conversations about the autonomy of the patient, transparency surrounding the risks and aims of medical research, and the strengthening of informed consent arrive out of a “different” historical moment, the author states.

This leads Kaufman back to the two plutonium narratives published in the 1990s. She concludes that “as evocations of a moral stance, the narratives
challenge us to compare the past with the present and to reconsider the
idea of moral progress in human experimentation. They promote scrutiny
of contemporary ethical discourses about trust, risk, and the nature of the
physician/investigator-patient/subject relationship.” Kaufman’s article, in sum, invites us to consider the social and historical situatedness of consent in medical research. Rather than characterizing consent as stable across time, she presents a case that underscores how past experiments, contemporary perspectives, and current ethical standards intersect to create new narratives about the complexities of medical research.


 

To access the full article, click here: http://link.springer.com/article/10.1023/A%3A1005360928209

2016 Conferences in Medical Humanities and Social Medicine

One of the running features here at the blog is a recurring series on upcoming conferences in fields of interest to our readers, namely medical anthropology, medical humanities, and other cultural studies of health and illness. In this installment, we present a master list of conferences in 2016 that span these disciplines or that encourage interdisciplinary approaches to the social study of medicine. All conferences are listed chronologically. Many of these conferences have abstract submission deadlines that are swiftly approaching: these dates are listed below in the description of each conference posting.

If you would like to add a conference or meeting to this list, please submit details via email to our social media editor, Julia Knopes, at jcb193@case.edu. We welcome postings for both domestic (USA) and international conferences.


2016 International Conference on Medical Humanities

March 11th-12th 2016

Warsaw, Poland

Details here.

This conference welcomes papers from all areas of medical humanities as well as medical anthropology, sociology, and medical education. Papers presented at the conference will be published in a collected volume. Deadline for abstract submission is January 20th 2016.

Vancouver-logo

SfAA 2016 Meeting Logo, via SfAA website.

Society for Applied Anthropology 2016 Meeting: SMA Co-sponsored

March 29th-April 2nd 2016

Vancouver, British Columbia

Details here.

The Society for Medical Anthropology is a co-sponsor of this year’s SfAA Meeting in Vancouver. Though the deadline for abstract submissions has passed, attendees can view the preliminary program for the conference here.

American Ethnological Society 2016 Meeting

March 31st-April 2nd 2016

Washington, DC

Details here.

Though this annual conference welcomes work in all aspects of cultural anthropology, this year’s meeting focuses on disorder and normativity: particularly salient themes in medical anthropology and social medicine. Deadline for proposal submission is January 31st 2016.

A Palpable Thrill: An Introduction to Medical Humanities 2016

May 6th-7th 2016

Hamilton, Ontario

Details here.

The organizers state that this event will be “an interdisciplinary conference that seeks to promote inclusion of the humanities in medical education and, conversely, encourage arts students and scholars to find salience and inspiration in medicine.” Deadline for abstract and other presentation submissions is January 15th 2016.

Medical Anthropology Young Scholars (MAYS) 2016 Meeting

June 23rd-24th 2016

Lisbon, Portugal

Details here.

MAYS, a network under the European Association for Social Anthropologists, is holding its annual meeting at the University of Lisbon. Meeting themes include intergenerations and temporality. Deadline for abstract submissions is February 7th 2016.

7th International Comics & Medicine Conference: Stages & Pages

July 7th-9th 2016

Dundee, Scotland

Details here.

This year’s conference will explore the nature of performativity and how comics engage with themes of clinical roles, medical spaces, and the body-as-stage. Deadline for abstract submission is February 12th 2016.

Issue Highlight: Vol 39 Issue 4, Incarceration & Medical Anthropology

This blog post is the second installment of our three-part issue highlight on the new December 2015 issue of Culture, Medicine & Psychiatry (the full issue is accessible here.) In this week’s blog, we examine Carolyn Sufrin’s article on the shared roles of clinicians and anthropologists working with incarcerated women in the United States.


cropped-cards.jpg

Clinician-anthropologists are in a unique position to lend voice to their participants and to care for their medical needs. For Carolyn Sufrin, who served both as a physician and an ethnographic researcher for incarcerated women in the United States, the clinical and anthropological roles intersected in deeply meaningful ways. Sufrin notes that in these dual roles, she observed with female prisoners and analyzed their experiences, and provided reproductive health care and delivering the same women’s babies in a county hospital, where imprisoned women gave birth. The women were alternately enrolled in Sufrin’s study upon ceasing to officially be her patients, or were individuals that Sufrin cared for during her tenure as their OB/GYN.

Sufrin uses her case as an example of how to interpret the ethical consequences of working as a clinician-anthropologist. Part of the challenge she faced as both a physician and anthropologist to the women was that IRB and HIPAA regulations divided the types of data she could use in her anthropological research. Though some details of her participants’ lives, such as past trauma or childhood abuse, were essential to their experiences as mothers and as incarcerated women, she could not use this data inasmuch as it had been shared with her in the context of a patient-practitioner interaction: in other words, it was considered classified personal health information that could not be subsequently utilized in her ethnographic research. These methodological hurdles, Sufrin explains, shed light on the complexities of what constitutes “sacrosanct” data. It also suggests how the safeguarding of medical data does not necessarily translate to the “protective” collection of ethnographic data which is not isolated to the case of individual patients, and which relies on knowledge of participants and their connections to other people (in this instance, to individuals in the participant’s life who had caused past psychological harm.)

Likewise, as stated earlier, relationships between the participant/patient and the clinician/anthropologist are another form of interpersonal connection which must be reconfigured depending on the nature of the exchange taking place. In Sufrin’s case, this meant being clear with her participants that– upon entry into her anthropological study– she was no longer their physician, and that the nature of their exchanges and their professional relationship would take a new form. She could share their information (albeit de-identified), unlike information drawn solely from their medical records or from an examination.

Yet here, Sufrin notes that the anthropologist– like the clinician– is still engaged in an ethic of care. For example, one of Sufrin’s former patients in the prison was charged with child endangerment after giving birth in an alley and handing her child to a stranger, unable to afford treatment at a hospital following her release from prison. The story made news headlines, and as public knowledge, was within the realm of information that Sufrin employed in her ethnographic analysis of reproductive health in the American prison system. However, Sufrin knew an added piece of information that was not already publicized from her interaction with the woman in prison: a clinical detail that she understood as a physician, but was shared during her time as an ethnographic researcher. This detail would have enhanced her analysis of the situation, but she chose to omit it out of concern that to publicize the detail would be to betray the woman’s trust in her as a researcher and as someone who served in the prison as a physician.

In other instances that Sufrin discusses, her role as both an anthropologist and clinician led the women she worked with in each capacity to feel as if she was especially attentive and caring. Rather than always relying on her medical authority, Sufrin underscores her decision to remain non-judgmental and supportive even when the women in her study had made potentially harmful choices; for example, she chose not to openly admonish a woman who was continuing to use crack upon release from jail, despite being thirty-two weeks pregnant. Sufrin notes that her silence hid her own frustration with this choice, but it strengthened the woman’s trust in her as an anthropologist and “as a doctor.”

In sum, these dual roles ultimately bolstered her relationships to the incarcerated and formerly incarcerated women that she served. Thus, the author argues that both anthropologists and clinicians share an “ethic of care” in their relationships with research subjects or patients. This ethic involves a careful fostering of the professional, interpersonal connections that ethnographers make with research participants, or that physicians make with their patients. This care entails the protection of private information and the researcher/clinician’s conscious attendance to interpersonal exchanges that bolster the patient/participant’s trust in the clinician/anthropologist. Likewise, an analysis of the clinician role alongside the anthropological one demonstrates both the delineations between multiple forms of care and social connection, as well as the shared commitment in medicine and anthropology to the sensitive attendance to patient and participant experiences.

4S 2015: Sessions on Biomedicine, the Body, and Knowledge

Last year, we featured blog posts that highlighted paper sessions on various topics in medical anthropology and social medicine presented at the annual AAA (American Anthropological Association) meeting in Washington, DC. This year, we are heralding in conference season by featuring details on two upcoming events: the AAA meeting and the annual meeting of the Society for Social Studies of Science (4S). Both conferences will be held in November 2015 in Denver, CO. You can find out more about the AAA Meeting here (http://www.aaanet.org/meetings/) and the 4S Meeting here (http://www.4sonline.org/meeting.)

Logo of 4S via the organization's website

Logo of 4S via the organization’s website

The 4S organization brings together researchers whose works span all aspects of scientific research, production, and the impact of science on society. Despite the organization’s breadth of represented interests, many scholars of social medicine take a science and technology studies (STS) approach and are active in 4S. This week, we highlight sessions at the 4S Meeting that emphasize their research and paper sessions on biomedicine. Sessions are organized chronologically by date and time.


Sex and Gender in Biomedicine

Thursday, November 12th 8:30-10:00am

Click here for details on this session.

This session will feature three presentations on sex and gender in biomedicine focused on the following topics: cosmetic surgery in South Korea and the United States, the history of biological sex as defined by the sciences, and the role of a parasite transmitted through sex on the reproductive lives of humans. The papers propose new understandings of sex and gender as constructed through scientific knowledge and practice.

Examining the Exceptional: Case Studies of Knowledge Production in Biomedicine and Science

Thursday, November 12th 10:30am-12:00pm

Click here for details on this session.

Topics in this session will address: microevolution and genetic science on indigenous men in Brazil; the definition of crisis in emergency medicine in the United States; sickle cell patient advocacy in Brazil; a comparative case of pregnancy monitoring in the USA and the United Kingdom; and immigrant physicians and medical professionals arriving in the United States as an “exceptional” population. These papers will offer various examples of the way that science constructs meaning for patients and practitioners of biomedicine alike.

Biomedicine and Difference

Thursday, November 12th 2:00-3:30pm

Click here for details on this session.

In this session, presenters will explore: human microbiome research; astronauts, race, and physical preparation for conditions in outer space; representations of race in a stroke awareness campaign; past technologies for measuring skin color; and the breakdown of ethnic origin by genetic percentages. These papers will scrutinize the complex and often problematic relationships between race, science, medicine, and the body.

The Body in Biomedical Knowledge

Friday, November 13th 4:00-5:30pm

Click here for details on this session.

This session will address the following topics: food insecurity, the use of inmates as test subjects, obesity, and anatomical and physiological representations in 20th century Chinese medicine. The session will also feature the work of our blog editor, Julia Knopes, on the ontological status of cadavers as objects in Western medical traditions.

Replaceable Parts: Prosthetic Technologies in Biomedicine 

Saturday, November 14th 10:30am-12:00pm

Click here for details on this session.

Presenters in this session will speak about new surgical robots, the role of prosthetic limbs amongst wounded military veterans, cross-cultural readings of prosthetic making in Canada and Uganda, 3D organ printing and facial transplants, and the experiences of amputees in an ever-changing landscape of prosthetic and bionic technologies. The sessions in this paper panel will offer fresh perspectives on the meaning of the cyborg, a continued area of interest for many medical anthropologists and researchers in social medicine.