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Lecture

October 16: Biomedicine/Medicalization

7 Pages
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Department
Anthropology
Course Code
ANTH 2200
Professor
Victor Barac

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BIOMEDICINE/MEDICALIZATION ▯ Kim Hopper 1988 More Than Passing Strange: Homelessness and Mental Illness in New York City ▯ • Research methods? ◦ the interpretive, phenomenological; subjectivity, experience, which the language of biomedicine is ill-equipped to handle ◦ they did fieldwork (1979-1982) and six years of advocacy; engaged anthropologists ◦ deep involvement with the politics of the situation • What are the two histories? ◦ hospitals, the institutional setting where biomedicine is practiced ◦ skid row, asylums, shelters, refers to these extreme settings where homeless people can take shelter ▪ skid row was eventually squeezed • What trend in the 1980s was noticed? ◦ started getting more mental/psychological disorder patients ◦ outreach workers and institutional workers were noticing this trend • What happened to the homeless of NYC in the 1990s? ◦ they were swept off the streets, physically removed ◦ they were taken out of public view ◦ how come the ranks of the homeless swelled in the first place? Not only homeless but mentally ill homeless people? • What is "deinstitutionalization"? ◦ shutting down of support institutions, places that cater to the needs of the mentally ill ◦ very difficult to deal domestically with the mentally ill ◦ why did this process occur? • What question of causality is posed? ◦ neoliberalism, trickling down effect of poverty ▪ everything should be regulated and governed by market; if you can't pay, then you're not an industrious person ▪ "neo-emperialism" (Victor Barac) ▪ reduction of government ▪ there could be government and its services but it's extremely minimal ◦ taxpayers don't want to pay for homeless services; services are cut but these people are thrown back onto their families who can ill afford to maintain and provide for their needs, or they're thrown onto the streets ◦ is the cause mental illness, or is the cause homelessness? Does one exacerbate the other? ◦ Mental problems are often transitory, associated with stress, and are minor; but are they provoked by the trauma of being thrown onto the streets? ◦ the services now provided are made to be demeaning and offered in places where you can get abused ◦ critique biomedicine; homelessness doesn't necessary cause mental illness or vice versa • What is deindustrialization? ◦ the closing up of manufacturing jobs that have provided scores of Americans with a high-standard of living with other people in the world; this industrial system became rapidly moved outwards to the periphery countries for cheaper labour ◦ robotics and advanced technology made a lot of jobs redundant • What is the significance of gentrification? Abandonment? ◦ the gap between the rich and poor is widening, and more of the land and housing available is becoming bought up and more expensive as services are cut for the poor ◦ when areas become extremely run down, landlords will often squeeze what rents they can, get out, and abandon the property because the values have gone down to nil ◦ builders turn into squatter apartments • Why are SROs important? ◦ Single Room Occupancy, flop house, small building that will have several dozen units, and one room, one bathroom in the hallway for use, minimal maintenance, but it gives the mentally ill their own place ◦ foundation for sanity ◦ if left to themselves, mentally ill will at least have minimal maintenance, come out very rarely, and is preferable than living in the streets • How have the homeless poor been reclassified and what are the effects of reclassification? ◦ biomedicine is a process of classification ◦ behaviours that were previously associated with criminality or immortality or bad living, poor choices, now have become medicalized and biological; one of the effects is that it has taken away much of individual responsibility and choice Kaja Finkler 2001 The Kin in the Gene: The Medicalization of Family and Kinship in American Society • What is the principal hypothesis? ◦ suggest that contemporary conceptualizations of heredity builds on the medicalization of kinship, and promotes the importance of family that is counter to the processes of the new millennia ◦ biomedical model presents itself as being a universal standard for ascertaining kinship, but in reality it is culture bound and is arbitrary as any model ◦ essentially reinforces the traditional cultural model of kinship that used to prevail in the US, a model which is no longer viable as a result of diverse family forms that have arisen in recent history • What is NRT? Importance? ◦ New Reproductive Technologies ◦ artificial insemination, amniocentesis, in vitro fertilization, all the medicine and technology associated with surrogacy ◦ what does that do to kinship? ◦ the traditional model has been challenged because of NRT and various other accepted practices (gay marriage, prevalence of adoption, etc) ◦ anthropology started turning its back on kinship during the 80s, but it's difficult to study, technical, arcane symbol system which is not universal or completely standardized, terribly exacting and demanding types of work, not exciting as critique ◦ kinship can be very tedious, but necessary • Schneider on kinship ◦ cultural construct of relatedness, the causality is reversed in America ◦ an emotional grid of how one is supposed to love close members of immediate family, this model is imposed on top of the medical model, and is reinforced by the medical model in turn ◦ model originally imposed by a Roman emperor, and in the current day the medical model actually reinforces this form of kinship • Pre-modern vs modern kinship? Modernity? Giddens? ◦ pre-modern, kinship structured most social and economic relations, regardless of what form of descent system is followed ◦ what access you had to land or resources, who you married, was restrained and allowed by kinship ◦ in modern society these structures have greatly weakened, individualism; the influence people have on our behaviours in terms of our relations has narrowed a lot ◦ this sphere of kinship and family has narrowed because of the primacy of the individual, rights and choices, ▪ basis of democracy ◦ modernity refers to the primacy of urban life and culture, essentially dominates all discourse in contemporary society ◦ Giddens: "American Kinship" • Bilateral descent • Ideology of choice ◦ what characterizes our system when it comes to family ◦ when it comes right down to it, when you become 18 you are no longer a dependent, and you can choose who your family is and who you choose to relate to ◦ routinization of marriage and divorce ◦ families are reconstituted from the fragments of other families ◦ numerous parents can be involved in any situation, series of siblings, half-siblings, step-siblings ◦ Finkler is decrying the definition of the nuclear family because it doesn't widely cover kinship in North America • Postmodern family • Medicalization, deviancy, morality ◦ in general medicalization has a tendency to downplay aspects of morality so that whereas what was considered deviant behaviour in the past (alcoholism, smoking, homosexuality), these things became medicalized at some point ◦ brings a new type of morality into play: health care delivery, and so forth • Interviews with 35 women, 15 adoptees ◦ breast cancer families ◦ adopted people looking for their medical history • Perpetual patients ◦ healthy people who feel they are at risk, waiting for symptoms that will prove they've inherited a disease or disorder from genetics ◦ take action before even symptoms show up ◦ mindset was fed by the concept of genetic risk • Genetic risk and predisposition ◦ genetic counsellors tell people they are at genetic risk because of certain diseases and disorders present in people in their family ◦ when they tell you that you have predisposition to a disease or disorder, it changes the psychology of how you think about yourself • Biomedicine as a cultural system • Phenomenology ◦ central perspective by which to critique biomedicine and disclose biomedicine's cultural quality or aspect • Tocqueville, democracy, memory, alienation ◦ resulted in people having shorter memories, forgetting their
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