Methodology and Mental Health: A Guide for Graduate Students

By Allison Bloom, PhD Candidate, Rutgers University

Anthropology has much to contribute to current debates about mental health in the United States. Within the current political climate, mental health has been enveloped into many contentious conversations, from gun control to school violence to sexual assault. Thus, ethnography has brought anthropology’s study of mental health far beyond basic examples of cultural competency into complicating factors like the structural causes of health inequalities (Metzl and Hansen 2014).

In this increasingly dark era for immigrants in the U.S.—one of detention centers, deep insecurity and devastating immigration policy—we must keep this emphasis on mental health at the forefront of ethnography. No longer just the purview of medical and psychological anthropologists, it is the duty of all ethnographers studying immigrant communities in the U.S. to consider the physical, psychological, emotional, and spiritual components of living under these conditions (Martínez Pincay and Guarnaccia 2007; Reina et. al 2014; Postmus 2014).

Yet ethnography on mental health among potentially vulnerable populations is sensitive research that requires vigilance and conscientiousness that not all graduate students are taught through their doctoral programs. Here I seek to provide some insight into my own methodological quandaries when working with Latina survivors of domestic violence at a crisis center in the U.S. to provide other graduate students with some valuable lessons that I learned along the way.

While I had the great fortune of taking a comprehensive methods course and working with an advisor and committee members well versed in this type of research, I also learned the parameters of my research and contemplated methods as I went along. When initially seeking IRB approval at my university, I emphasized my prior training in mental health and certification in domestic violence work. I highly recommend undergoing some type of formal training relevant to your research—not only will this lend a layer of sensitivity to your research, it will also provide you with first-hand insight into the ideologies behind Western mental health services. I also obtained a Certificate of Confidentiality from the United States Department of Health and Human Services (DHHS). With this Certificate, I could not be forced (for example by court order or subpoena) to disclose information that would identify an informant in any federal, state, local, civil, criminal, legislative, administrative, or other proceedings.

Secondly, while conducting research I had to make decisions about the best way to record observations and interviews in the most sensitive way possible. While observing support groups, for the initial phase I was a less active observer, and wrote down my observations after each session. After building several months of rapport—when clients had a clear sense of who I was, what I was there for, and their level of confidentiality with respect to my work—I began taking hand-written notes during these groups and participating more regularly in their conversations. Out of respect for the dynamics of these groups and the quality of this supportive space, I never audio recorded their sessions. Alternatively, I did take notes and audio record interviews, when the purpose of the conversation was explicitly for my research. When spending time with clients outside the crisis center, it was important to respect the center’s boundaries around confidentiality and avoid disclosing any association between myself and the client in connection to the center. Thus, for the safety of the client, I limited the types of interactions I had with clients out in the community and was particularly vigilant about how I framed the nature of our relationship.

To write up my findings, I also had to decide how to best represent the center and these clients. All clients were given a pseudonym, which I used in my records as well as in my dissertation, publications, and conference presentations. I also worked to eliminate any overly-identifying and unnecessary details. Alternatively, many ethnographers choose to create composites of people encountered in their fields sites. Because of my desire to convey the diversity of my informants, I did not choose this option. To further protect client identities as well as the agency itself, I also gave pseudonyms to the agency and its staff members. This was important so as not to encourage unwanted attention to the agency from abusers or other antagonistic audiences.

Working with these women, I came to understand their complex usage of local health and social service providers, and the savvy ways they would toggle together fragmented resources to best meet their needs. While I was careful not to speak about any individual client to outside service centers, I followed their service paths to these other locales, tracing their routes to healing while gaining a comprehensive view of all available resources. This also gave me a sense of the gaps in these services, and how clients attempted to fill them through spiritual practices and beliefs. Thus, these women serve as an example of what anthropology can contribute to the study of mental health, and what it has left to learn. Their agility within these different service spaces was striking, and highlights the necessity of ethnography for understanding mental health for these immigrant communities in the U.S. I encourage all graduate students to continue with this line of inquiry, and maintain an ongoing conversation about how best to methodologically approach this type of research.

Works Cited

Martínez Pincay, I. E. and P. J. Guarnaccia. 2007. “ ‘It’s Like Going through an Earthquake’: Anthropological Perspectives on Depression among Latino Immigrants.” J. Immigrant Minority Health 9: 17-28.

Metzl, J. M. and H. Hansen. 2014. “Structural competency: Theorizing a new medical engagement with stigma and inequality.” Social Science and Medicine 103: 126-133.

Postmus, J. L., McMahon, S. Silva-Martinez, E. and Warrener, C. D. 2014. “Exploring the Challenges Faced by Latinas Experiencing Intimate Partner Violence.” Affilia: Journal of Women and Social Work Feb: 1-16.

Reina, A. S., Lohman, B. J. and Maldonado, M. M. 2014. “ ‘He Said they’d Deport Me’: Factors Influencing Domestic Violence Help-Seeking Practices among Latina Immigrants.” Journal of Interpersonal Violence 29(4): 593-615.

Read Allison’s article titled The Stakes for Immigration and Mental Health in the Critical Care Blog of the Medical Anthropology Quarterly. The article provides a quick overview of her research project, the importance of which cannot be overemphasized.

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AAA Conference Student Travel Awards

The SMA offers conference travel support to five SMA graduate students, who have had abstracts accepted to the annual meeting of the AAA. This will be in the form of a $500 travel award, to be given out as a check at the SMA Business Meeting during the AAA meeting. Eligibility is restricted to student members of the SMA, who are presenting papers or posters at the AAA meeting.

Applications should include the following:

1.     Proof of current SMA student membership.

2.     Copy of the conference abstract.

3.     Proof of acceptance of the abstract.

4.     Recommendation letter from an advisor.

Awards will be evaluated based on significance, innovation, and clarity of the submitted abstract, as well as the strength of the letter of support from the advisor, who should discuss the significance of the to-be-presented work.

Please compile all the supporting materials in ONE file and save it in PDF format. Email materials and any direct inquiries to the SMA 2016 Student Travel Award committee at roedlach@creighton.edu . The deadline for submissions is September 24, 2016. Awardees will be notified by October 2, 2016.

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Volunteers needed for SMA/SPA Speed Mentoring Event

SMA is looking for looking for at least one MASA member to help with their Speed Mentoring event at the 2016 AAA in Minneapolis.

 The event is on Nov. 17th from 7:30-9:30pm.

 You would be helping with registering people at the event, making sure participants know who to talk to and when, and collecting post-event surveys.

 Any volunteers would be much appreciated, and the event will be catered!

 Please contact Zakea Boeger (zakea@hawaii.edu) if you’re interested in volunteering.

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New SMA/SPA Speed Mentoring Event

SMA-SPA Speed Mentoring at 2016 AAA

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Looking for research, career, or other professional advice?

SMA is partnering with SPA to host a Speed Mentoring event at the 2016 AAA in Minneapolis.

Students will meet with 3-4 mentors for 15 minutes each, and may opt to enter into a longer-term mentoring relationship. Students and mentors will be matched based on similar interests.  The catered event will be held in the evening on November 17th (exact time TBA).

Any graduate student or postdoc attending the 2016 AAA is welcome to apply.

To apply: Submit a short paragraph including your name, institution, field specialty/interests, mentoring area of interests (e.g. grant-writing, publishing), degree/post-doc program and SMA and/or SPA affiliation. Submissions due to Tawni Tidwell (ttidwel@emory.edu) by October 1st.

Mentors—professional members of SMA and/or SPA—are also needed. If interested, please contact Tawni Tidwell (ttidwel@emory.edu) by October 1st and include your name, department and institution, main focus in medical and/or psychological anthropology, mentoring areas of expertise/interest, affiliation with SMA and/or SPA, and willingness to be contacted for continued mentorship by mentees after the event.

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A Very Important Message about SMA’s New Mentoring Program

SMA is beginning a new mentoring program for student members of SMA. Any student attending the AAA meetings may apply to meet with a mentor. The student and mentor will meet over coffee at a time agreeable to both during AAA.

The student application is a few sentences (perhaps one paragraph) to include your name, interests, and degree program. This should be sent to R. Baer baer@usf.edu by Oct.1, 2015

We also need mentors–professional members of SMA. Please indicate your willingness to be a mentor in a few sentences to include your name, department and institution, and main interests in medical anthropology. This should be sent to R. Baer baer@usf.edu by Oct. 1, 2015.

We’ll do our best to match up student and professional-category mentors to those with similar interests.

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$500 SMA Student travel Awards!

SMA is offering five awards for travel to the AAAs in Colorado. See the link below for more details.
http://www.medanthro.net/aaa-conference-student-travel-support/

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First Discoveries in Medical Anthropology

MEDICAL ANTHROPOLOGY IN THE UNDERGRADUATE CLASSROOM

These essays, written by undergraduate medical anthropology students at Luther College are the fourth in the MASA blog’s series of excellent undergraduate writing. Medical anthropology professors interested in submitting the best work of their students should contact Jonathan Stillo (jstillo@gmail.com) the MASA Chair for more information.

Professor’s Introduction:

How are Hmong shamans, Zulu sangomas, Malian midwives, and Wisconsin case workers related? What does it mean to be healthy? What is the cultural meaning of illness? The introductory class in medical anthropology at Luther College allows students to discover the answers to these questions and more. We focus on making familiar strange as we demystify the unfamiliar and exotic. Here we share with you student notes from their first “excursions” into the field of medical anthropology. Sometimes the road to understanding is long and winding. It is often a challenge to acknowledge that some of our most deeply held beliefs about medicine, ethics, and morality might be challenged. Our class took the time to discuss and understand the points of confusion, anger, or frustration by writing forum blogs. Below are a few examples of such deliberations. Perhaps, the students’ first discoveries in medical anthropology will take you back to your own first encounters with the discipline.

Maryna Bazylevych
Assistant Professor of Anthropology and Women & Gender Studies
Luther College

Racial Health Disparities: Environmental Not Genetic Influence, by Elizabeth Hovden

A Culture that Leads to Another, by Tatyana German

What’s a Melting Pot?, by Rachel Skolaski

The Latino Paradox, by Adrianna Vazquez

Brain Death, by Noelle Burreson

Refusing Organ Donations, by Allison Colsch

 

Racial Health Disparities: Environmental Not Genetic Influence

By: Elizabeth Hovden

Elizabeth Hovden is a junior at Luther College majoring in biology with future plans to attend a physician’s assistant graduate program. She longs for a career in medicine as it will provide an opportunity for her to combine her two great passions: exploring science and helping others. Elizabeth volunteers regularly at a community free clinic, which serves a population primarily of Hispanic immigrants, and it is through this opportunity as well as through her studies of Medical Anthropology that her understanding of medicine and its culture has broadened. She has enjoyed learning how different cultures value and practice medicine and how these alternative practices can be complemented by biomedicine. Elizabeth believes it will be important as a medical practitioner to be conscious, considerate, and accommodating of cultural practices.

Biological differences and health disparities are evident among racial groups in the contemporary biomedical literature. Certain racial groups possess greater risks of diseases such as high blood pressure, diabetes, and obesity. These racial differences are often incorrectly explained by genetics based on the understanding that race is a biological concept. Having studied human evolution and genetics as well as medical anthropology, I recognize the flaws in this explanation. I propose instead that race and racial differences are social constructs.

Scholars in the field of applied medical anthropology argue that genetic variation is gradually accumulated as a result of evolutionary processes such as natural selection (N. Jablonski and G. Chaplin 2002, 45). As a result, the vast extent and continuous variation of human characteristics cannot be fully explained by examining only the genetic characteristics of individuals such as allele frequencies (A. Goodman 2000, 41). Scientists agree with this perspective. My genetics professor, for example, shares the perspective that genes alone have little influence on traits. She argues that phenotypic variability is the result of both genes and the environment. Environmental conditions such as sunlight, nutrition, stress, and toxins have a great impact on human biological variation, health, and disease. Access to healthy foods, safe living conditions, and places to exercise are essential determinants of health and often variable among racial groups. The variability of health and disease cannot be explained by genetics alone, for the impact of the environment is critical.

As explained in the television documentary “Unnatural Causes: Becoming American” (2008), Mexican immigrants, despite being poorer, are healthier than most Americans when they arrive. As they become acculturated to the American environment and are faced with economic challenges, the status of their health deteriorates. Through my volunteer work at the Decorah Free Clinic I have witnessed firsthand the effects stress and economic insecurity have on the health of racial minorities. Chronic health concerns such as diabetes, high blood pressure, and obesity are common in the Hispanic immigrants who attend the Free Clinic. The rates of these diseases are influenced little by genetic causes but are explained entirely by environmental conditions. The immigrants who attend the Decorah Free Clinic are faced with a great economic need to work long hours at low income jobs to provide for their families. Economic uncertainty and taxing working conditions provide a chronic stress that is detrimental to their health and increases the occurrence of disease. In this manner, socioeconomic status and its associated stress are social factors directly linked to health.

Understanding the impact one’s environment has on his or her health is essential for creating mechanisms to decrease racial health disparities. To improve the health of all individuals, the environment in which they reside must be altered in ways to promote health. Access to healthy foods, places to exercise, good school systems, and financial security are factors that will decrease stress and foster healthy behaviors. The impact of genetics on health and disease is minuscule in relation to that of the environment. For this reason changes to one’s environment are essential to improving health.

Works Cited:

A. Goodman (2000). “Why Genes Don’t Count (for Racial Differences in Health).” In P. J. Brown and R. Barrett Understanding and Applying Medical Anthropology. Boston: McGraw Hill. Pp 39-43.

N. Jablonski and G. Chapin (2002). “Skin Deep.” In Understanding and Applying Medical Anthropology. Peter J. Brown and Ron Barret, eds. Pp. 44-48. New York: McGraw-Hill Companies.

UNNATURAL CAUSES: Is Inequality Making Us Sick? Episode 3, “Becoming American.” (2008).Vital Pictures.

 

A Culture that Leads to Another

By: Tatyana German

Tatyana German is a graduating senior of Luther College studying Music Performance and Psychology. After graduation she will be enjoying the sights of Italy with Luther College’s Nordic Choir, which will be her third overseas adventure to date. Her home resides in Rochester, Minnesota, but she hopes to eventually move to the Minnesota twin cities or to Chicago in order to pursue a career in opera. Prior to this semester she had never taken an anthropology class, making the subject matter entirely new and unfamiliar. She is glad to have had the opportunity to learn materials outside her major studies under the direction of Professor Maryna Bazylevych.

In class this semester, we read The Spirit Catches You and You Fall Down by Anne Fadiman (2005). The author of this book was able to not only show me the struggles that the Hmong people faced, but opened my eyes to all aspects of the biomedical culture. Biomedicine has been called a “culture of no culture,” and it is a culture about which I was previously unaware. Learning about other cultures, like the Hmong living in the United States, has helped me learn more about this aspect of my own.

The interactions that took place between the Lee family and their doctors both surprised and horrified me. I questioned both sides in their repeated encounters. I wondered along with the author, “[h]ow could the Lees not see that Lia needed more help than a quick fix medication? How could they still believe epilepsy was a gift for their child?” As the story continued, the questions were increasingly directed at the American biomedical professionals: Did they really file for child abuse against the Lee’s? Why are they so unaccepting of the Hmong culture? Why are people so cold towards these foreigners who don’t fully understand our ways or even want to be here? Finally, Anne Fadiman brought up the most important question: What gives us the right to force our cultural beliefs onto those who do not choose become part of it? This is what spoke to me the most.

One day in class discussion, we decided to stand on the line of an invisible spectrum which showed whether or not we thought the doctors had done the correct thing in taking Lia out of the Lee’s custody. At the time, I was leaning towards the idea that this was the wrong course of action. However, I can’t help but to wonder if I would have believed otherwise prior to this class. In the past, if I heard that Lia was ill and her parents refused to give her the medicine she needs simply because they felt it was causing harm with no definite proof, I might have believed that the doctors made the correct decision. I would have believed that Lia needed to be taken care of properly and that it is the doctor’s right to put Lia where she would be best taken care of.

It saddens me that I would think so subjectively, and that many still do. I realize now that Lia’s parents loved her very much and that they chose to stop the medicine because they honestly thought it was harming her. I can’t imagine the pain they went through having their daughter taken away and finding out she got worse after she was forced to take medicine again.

I seriously question whether we, as Americans, would have done the same thing if this had happened to us in another culture. Let’s stop to think about what we would do in a strange country with a sick child. Imagine we were told to give them something that we believed to be hurting them. Then imagine having our child taken away because we didn’t fully understand what was happening – because this strange way of healing appeared to be doing more bad than good. I doubt we would have dealt with it any differently than the Lees did.

We are part of a culture that believes it is better than others. We’ve become so habituated to the judgement and ignorance of our society that we believe it is the fault of others when difficulties arise. There was never a moment when the American doctors looked at the use of shamans and the importance of the soul, yet the Hmong family, though stubborn, sought help from Western medicine. We live in a one sided society that likes to believe we are accepting of all cultures, when in fact we merely want to assimilate those who differ to become more like us.

Why are we so against the idea of the soul being more important than life? Is it because we are scared of death and that is why we avoid the topic as well as those who are dealing with it? The Hmong are a fascinating group and rather than becoming frustrated by their lack of compliance and assimilation, I believe we ought to look at them for new answers and new points of views. These people are seeking refuge in the US, therefore it is incredibly insensitive of us to assume they automatically would want to become part of the culture we have built and deemed superior. America may be known as the giant melting pot, but one can only taste all the flavors of what’s inside if one flavor does not attempt to drown out the rest.

Works Cited:

Fadiman, Anne. 2005.  The Spirit Catches You and You Fall Down. New York: Farrar, Straus, and Giroux.

 

What’s a Melting Pot?

By: Rachel Skolaski

Rachel Skolaski has just graduated from Luther College with a bachelor’s degree. Her major is biology. Rachel is from New Glarus, WI. She is interested in medical anthropology in order to understand how different cultures handle various illnesses. She has always had a keen interest in the human eye and therefore will be attending Indiana University School of Optometry the upcoming fall.

Throughout my medical anthropology course at Luther College this spring, we discussed several stories of immigrants coming to America. They come here, they may or may not adapt, and there is a sense of a clash of cultures.  As Americans, we tend to assume that if people move here, they will conform, at least a little, to our habits and culture.  If they live here, they must become like us, right?  We have tried to force the American ideals and practices down their throats and have disgraced America’s status of “The Melting Pot.”

Americanization was a common theme in this spring course and continues to be an important topic in medical anthropology. We read the book The Spirit Catches You and You Fall Down by Anne Fadiman in which a baby Hmong girl, Lia, and her family emigrated from Laos. Almost immediately, they clash with the doctors of Western medicine.  During the whole experience, each side (American doctors vs. Hmong parents/shaman) could not devise a single treatment to heal Lia, and in the long run lost her body and spirits.  This may tie in to a hint of ethnocentrism from both sides, but can be viewed as a lack of Americanization from Lia’s family.  Her family did not come to America to adapt to our culture and they did not seem to respect our systems and our medical tradition while they were in our country.  We are so accustomed to view our doctors as the professionals, the trusted providers for our health that we can almost become infuriated at Lia’s family at the lack of understanding. Americanization was futile among the Hmong family.

We also recently read about Latino immigrants coming to America.  They came and tried adapting to our culture, only to haves detrimental effects.  In the television documentary “Becoming American,” it was explained that the health of these immigrants was better before they arrived here.  Over a generation, the health of immigrants living in the US was actually degraded.  They became more susceptible to psychiatric illnesses and discrimination after moving to the US.  Unlike the Hmong, they moved to the US and tried to “Americanize” themselves.  They acquired jobs, they pursued educations, and they lived how we lived.  Some immigrant parents even worked so much that their kids could not even be exposed to their old Latino culture.

So maybe it was beneficial for the Hmong to resist Americanization while the Latino population should have fought harder to sustain their cultural identity.  The Melting Pot is supposed to be a mixture of people living in harmony with a common culture.  Obviously this is not the case in America, nor does it seem possible in the near future.

Works Cited:

Fadiman, Anne. 2005. The Spirit Catches You and You Fall Down. New York: Farrar, Straus, and Giroux.

 

The Latino Paradox

By: Adrianna Vazquez

Adrianna Vazquez is a Sophomore at Luther College majoring in International Studies and Political Science. Her region of study is the Middle East. She will be is taking a Arabic course at the University of Wisconsin Madison this summer and will be traveling to Jordan next summer, She is very excited to experience a new culture. She enjoys traveling and reading in her free time.

One thing that we talked touched on briefly this semester was Latino health in the United States. This really interested me because I am half Mexican and much of my family is from Mexico and migrated to the United States. I don’t not know very much about medicine or the medical world, but I found the Latino paradox very interesting. Like most people and many of the doctors in the video, I had assumed the better off individuals in society (the rich white people) would be healthier. However after watching the film for class and discussing it with my father (who is from Mexico) it actually made a lot more sense.

First off the food that many Latinos eat is home cooked meals that are usually bought at a market. The food includes fresh produce and consists of many of the food groups we need to be healthy. From my own experience, the meals prepared also taste much better than any American food I have eaten. One may argue that taste doesn’t really matter, but it still feels good to eat good food. In the United States, you see fast food joints around every corner in the city, and many of the meals made at home are frozen pizza or lasagna and consist of a lot of processed food.

Becoming Americanized causes poor health in our population. Don’t get me wrong: I know there are many Americans who eat healthy, but we have the stereotype internationally of being fat and only eating fast food (which many of us do!). In one film we watched in class, the Bernals ordered pizza. I thought right away, “that is where their unhealthy lifestyle comes from.” Immigrants like the Bernals see that it is American to order Pizza Hut. They also find that it is easier to order pizza with their busy lives because they have to work so hard to pay bills and support their families. They continue to eat this way, get high cholesterol and other health conditions, and suddenly they are no longer healthy.

Another thing the movie emphasized that I found to be spot on was the family ties. It is unclear whether it has as much of an impact as the food, but it was still important. When I go to family gathering on my dad’s side of the family – the Mexican side – we eat and laugh and have a great time. We play games and sing and do activities together. My mom’s side is different: she grew up in Iowa and has a very “American” family. We eat and talk, but then everyone leaves because they have so much to do. Family time is not as important as the errands and work to be done. I think this affects people mentally. I feel really happy to be with my dad’s side of the family, and when I am happy I like to think that I am healthier. I am also happy when I see my mom’s side, but that is only every now and then.

Family ties help you feel connected. When you feel connected and a part of something it helps your mood and health. Overall, I thought it was interesting to look at one specific group of individuals and compare their health to a bigger population and try to connect the dots. This made me look at health in a different way and sparked more interest in me with health and medicine. It taught me that there is more to the medical field than hands on roles like being a physician.

 

Brain Death

By: Noelle Burreson

 Noelle Burreson is from Alexandria, Minnesota, and is graduating this spring from Luther College. She is graduating with an Anthropology major along with a museum studies minor and a communication minor.

In class, we learned about the challenges that are associated with “brain death”. How do we classify it? When are they “dead”? When is it ethical to stop life support? Can we still use their organs to save another person’s life? There are countless number of questions that arise with this topic.

One article that we read, “Inventing a New Death and Making It Believable” by Margaret Lock (2002), discussed the challenges of defining brain death. Before experts could define what brain death was, a special President’s Commission met and debated the topic. This commission tried to establish a single set of standards that would be accepted and adopted everywhere in the United States. Ultimately, they argued that “whole-brain death” corresponded with “irreversible loss of all brain function.” It is believed that the brain-death diagnosis is an irreversible state (Lock 2002: 214-216).

However, Lock points out that it is not entirely possible to establish, with absolute certainty, whole-brain death by conducting tests that are routinely use to determine this condition. She states, “it has been shown repeatedly that in many diagnosed cases of brain death some residual activity remains in the upper brain.” It is understood that this brain activity “has no functional significance or prognostic value and will cease within days, but its existence means that in a strict sense of the term all activity of the brain has not entirely and absolutely ceased” (Lock 2002:215). It was even agreed that two specialists had to make the diagnosis separately, as well as conducting the tests after a certain time interval in order to confirm brain death. The “test” would include making sure the patient could breathe on their own and check the condition of the lower brain/brain-stem. If the brain-stem does not respond, the upper brain cannot survive, thus brain-death could be diagnosed.

This whole matter becomes even more complicated when you add organ donation into the mix. If the person is clinically diagnosed as brain dead, is it ethical to keep a person “alive” just to keep organs functioning until a need for them arises? This is hard to say, especially when brain death is not a clear cut diagnosis. If it was one of my family members, it would be hard to believe that they are “dead” even though their heart it still beating. On the other hand, it would be hard to deny another person a second chance at life just because I could not say goodbye to my family member. Good things can come from organ donations, but good things always come at a cost.

Works Cited:

Lock, Margaret. 2002.    Inventing a New Death and Making It Believable. In Understanding and Applying Medical Anthropology. Peter J. Brown and Ron Barret, eds. Pp. 210-220. New York: McGraw-Hill Companies.

 

Refusing Organ Transplants

By: Allison Colsch

Allison Colsch is a Junior at Luther College studying Biology. Her plans after Luther include attending graduate school for physical therapy. She is from New Albin, IA. Allison has taken Introduction to Cultural Anthropology and Medical Anthropology.

“As Angela was being wheeled into surgery, she began to question her decision to accept a kidney donation from her mother. They spent months talking about the operation, listening to the consequences for both parties, and weighing the pros and cons. Even after all considerations she could not help but feel guilty for accepting such a gift from someone she loved so much. She knew that regardless, it was too late to change her mind. In the final moments before surgery, she recalled something her mother had said in their discussions, ‘Giving you life has been one of the greatest gifts. The only greater gift is the chance to give you life a second time; that is not something all mother’s get to experience’. Remembering her mother’s words gave Angela a sense of peace as she headed into lifesaving surgery” (Elisa Gordon, 2001)

In my medical anthropology class this spring, we talked a lot about organ donation. Organ donation is a highly controversial practice. The pros and cons of this practice are difficult to weigh for both donors and recipients because many aspects of this process are based entirely on individual views. In her 2001 article, “‘They Don’t Have to Suffer For Me’: Why Dialysis Patients Refuse Offers of Living Donor Kidneys,” Elisa Gordon adds to this debate by discussing the refusal of dialysis patients to accept organs from living donors.

In the article, Gordon cites a list of reasons that dialysis patients provided for refusing a kidney donation from a living donor. The list included fear of causing immediate harm to the donor, feelings of guilt, feelings of being a burden, friction in interpersonal relationships after donation, and emotional and financial pressures. Perhaps one of the most cited reasons was that the organ they would receive would constitute a “gift that cannot be repaid” and many were not willing to live with that fact (Gordon, 2001). They did not want the pressure of living a life that was up to the donor’s standards; they were not prepared for someone else to tell them how to live their life. Many also felt that the amount of guilt that came with receiving an organ from a live donor would be too much to bear. They stated that they would feel guilty if the transplant was unsuccessful or if the donor later needed the kidney. Finally, some dialysis patients felt it was unfair to expect a donor to start off their life with a disability, since organ donors are generally younger people.

While the article did a great job of highlighting many of the more negative aspects of live organ donation, an interesting topic to investigate would be the benefits of being a live donor. The process and procedures of organ donation have obvious risks for the donor, but many living donors can cite specific aspects of their lives that have been improved by donation. One of the most common benefits named by living donors is the psychological benefit. The satisfaction of being able to save or improve the quality of life of another human being is a satisfaction that many of us will never be able to feel. Although the above scenario is fiction, I personally know a mother who was able to save her son’s life by live organ donation. Although he was the one with the need, she believes that she benefited nearly as much or more than he did.

Works Cited:

Gordon, Elisa. 2001. “’They Don’t Have to Suffer For Me’: Why Dialysis Patients Refuse Offers of Living Donor Kidneys,” Medical Anthropology Quarterly 15(2):245-267.

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Making the Body Social

MEDICAL ANTHROPOLOGY IN THE UNDERGRADUATE CLASSROOM

These essays, written by undergraduate medical anthropology students at University of Washington are the third in the MASA blog’s series of excellent undergraduate writing. Medical anthropology professors interested in submitting the best work of their students should contact Jonathan Stillo (jstillo@gmail.com) the MASA Chair for more information.

Professor’s Introduction

The essays presented here were written by undergraduate students in an upper level anthropology course at the University of Washington entitled “Anthropology of the Body.” This course was offered without pre-requisites, which attracted not only anthropology majors but also students majoring in biology, public health, political science, international studies, entrepreneurship, and communications.  The following works are included here:

Ethical Concerns and the Medical Gaze, by Emily Shavers

Slaves to Society; How we Lost Control and Ownership of our own Bodies, by Natasha Gay

Implications of Sonographic Imaging; In The Absence Of A Cognitive Mediator, by Amber Brown

Each of these essays selects a unique focal point for interrogating the social construction of the body and individual personhood. Emily Shavers recounts a story of a relative’s recent hospitalization to illustrate potential ethical quandaries that arise from the medical gaze. Natasha Gay engages theories of bodily adornment to discuss how the body is rendered coherent through the reproduction of cultural tropes; she argues that personal expression is inherently limited by these social forms. Amber Brown uses Marcel Mauss’ construct of the triple body to problematize the work of building personhood and identity that is accomplished through fetal imaging. Together, these works reveal students’ capacities for applying medical anthropology’s most classic theories in new and innovative ways.

–Jennifer J. Carroll, PhD (University of Washington)

 

Ethical Concerns with the Medical Gaze

By: Emily Shavers

Emily Shavers graduated from the University of Washington, Seattle with a Bachelor of Science in Public Health.  She spends most of her time working as a Certified Nursing Assistant for a diversified community, volunteering in underserved communities, and continuously following her passion in the public health field. She aspires to be part of a team that follows through with compassion, positivity, dedication, and respect in order to make an impact for the greater good of a population.  Emily has a passion for music, traveling, and staying physically active.

As a public health student, I have been taught at the University of Washington to examine all factors relevant to a population’s quality of life that affects its health and to find ways in which to improve human health. This view looks at all aspects of human health, not just the physical and mechanical parts of the body. In part, it has given me a new perspective on the medical field.

Through weeks of reading and analyzing classic anthropological literature that studied the ways in which the body is looked at through biomedical means, I noticed a significant connection to a recent personal experience.  This personal experience not only accentuated the discourse and enigma of the effectiveness and ineffectiveness of the medical gaze, but rather the need for bridging the gap between patient and physician interaction.

The trip to the hospital occurred on the day my close family member felt an agonizing pain in her body that inhibited her activities of daily living. The physician’s nurse came in and automatically put a blood pressure cuff on my family member’s arm, stuck a thermometer under the tongue, and counted for respiration and pulse. Normal. The physician walked in seeming confused as everything was perfectly in the range of normalcy. Following, the physician asked nonchalant and categorical questions that all physicians are required to ask such as race, age, and ethnicity as well as qualitative questions such as “when did you first notice these symptoms?” and other directed questions based on the patient’s personal history. Check. The answers were not sufficient enough to help determine what may have been the leading cause of my family member’s health status. Lastly, the physician placed her hands over the body to check for abnormal findings. Strange, an inflammation. Notes were written down furiously and later, the patient was asked to wait a few weeks for testing. I was dumbfounded by the promptness and confidence the physician exerted when interpreting the test results and diagnosing the chronic disease as untreatable, however I was also disturbed by the lack of closeness between the physician and my relative. Her identity, opinions, values, spiritual needs, and emotions disintegrated in the authoritative figure and she sometimes felt alone and unimportant as compared to her illness throughout the process.

After taking further courses at the University of Washington, I came to realize that this doctor- patient relationship presented a different way of caring for a human being, which is Foucault’s definition of the medical gaze- objectification of the body. Foucault is a French philosopher of science who wrote The Birth of the Clinic. He devised the term, medical gaze and scrutinized its complications in diagnosing and treating a patient in the 18th century, after the French Revolution, that transformed the roles of physicians as a practitioner and diagnostician and the patient (Hsu and Lincoln 15-34). Foucault further argued that the medical gaze focuses on advancement in medical technologies which assists the physician’s role and “abstracts the suffering person from her sociological context and reframes her as a ‘case’ or a ‘condition’” (Hsu, Hsuan, and Lincoln 23).  I believe that advancements in Western medicine and technology are vital in improving human health, however not only does the use of the medical gaze potentially lead to ethical and moral concerns as it mainly focuses on the body and the disease rather than the holistic view of the individual, but it may also lose its effectiveness in diagnosing and treating a patient.

The medical gaze being a taught and learned, institutionalized method for examining and analyzing the body that is standard across all medical training institutions, it disregards other external factors that may be inhibiting a patient’s overall well- being as well as disregarding the emotional and psychological bond between patient and physician (Foucault 25). Looking at the body through the medical gaze may lead to an objectification of the body if the patient’s personal involvement is not considered to be part of the diagnosis. This is a moral and ethical concern because the individual is not being treated as a holistic individual but rather as a case study. As mentioned previously, the public health ideal is to look at other aspects that may affect human health such as social determinants of health and any other factors related to quality of life. When observing the physicians treating my close family member, I could tell that there were step by step procedures they normally followed, such as the nurse taking her blood pressure, pulse, and respiration. The nurse took these measurements in order to check if the body complied with the standard medical knowledge of normal blood pressure, heartrate, and breathing rate. This shared medical gaze amongst physicians shows that obtaining a patient’s measurements can be compared to known normal measurements to determine the patient’s health status.

In the study of Nancy Scheper- Hughes who is a celebrated figure in the current medical anthropology field, she examined similar concepts as Foucault such that her published studies, The Mindful Body: A Prolegomenon to Future Work in Medical Anthropology, examines the controversies of applying biomedicine in understanding the sickness of a body as there may be other underlying causes and solutions to treat and cure sickness of the individual such as understanding the individual’s emotions, feelings, nature, culture, and lifestyle. Both Nancy Scheper- Hughes and Foucault believe that medicine itself cannot effectively treat a patient with a disease or illness and instead, requires input and value from the patient as well.

The Birth of the Clinic goes into greater depths to explain hierarchy in this patient- physician relationship that may lead to unethical means of moving the patient from an individual to ‘it’. Due to the visibility, understanding, and knowing of undetectable physiological happenings, physicians may use this higher power of knowledge to obstruct the view of the powerless and weak patient. This is detrimental to the gap between physician and patient relationship.

Foucault mentions that there was a significant contrast between past centuries and present day in the western medical field such that the question “‘What is the matter with you?’, with which the eighteenth century dialogue between doctor and patient began, was replaced by that other question: ‘Where does it hurt’, in which we recognize the operation of the clinic and the principle of its entire discourse” (Foucault xvii). I agree with Foucault’s statement because I too have noticed the physician asking the procedural, and categorical questions that physicians are required to ask such as race, age, and ethnicity and qualitative questions such as  “when did you first notice these symptoms?” and more directed questions based on the patient’s personal history rather than the patient’s perspective.

Especially when comparing past and present day practice in the medical field regarding physician and patient relationship, John Berger as an observer in medicine wrote a short story titled A Fortunate Man: The Story of A Country Doctor that depicts the true nature of how a physician should interact with their patients. It is what is still known as “the most important book about general practice ever written” because of the way it describes the doctor treating his patients in a humane, compassionate, understanding, and genuine manner.  The story shows a mature transformation of the doctor’s way of thinking to effectively treating his patients. John Sassall, the doctor, creates several close relationships with his patients just by empathetically listening and figuring out who his patients are. He is emotionally and mentally involved with his patients in order to understand the wholesome of his patients which most likely ended up finding the underlying health problem in his patients.  This example clearly illustrates what Foucault believes to be important instead of relying and focusing solely on biomedicine.

Unlike the eighteenth century as Foucault mentioned, the advancement in medical technology has led to a mechanical way of looking at the health of the body which limits the patient to express themselves.  Patients no longer must describe in detail every pain or feeling when these can be measured electronically through mechanical means such as Magnetic Resonance Imaging scans.  Although the mechanical measurements are exact and informative, it does not completely relieve physicians from the requirements of verbal communications to uncover pertinent information that cannot be found mechanically.  The combination of both verbal communications and mechanical measurements leads to a much more effective and efficient means of identifying, diagnosing, and treating medical conditions.  This idea of the medical gaze in which students are taught a specific way to examine the body from classifying the patient’s disease to analyzing the body’s features, to outlining actions, and so forth shows that the patient is just a case study for the physician (Foucault 61).

Despite the problems of the medical gaze, the protocols and regulations that go along with it have been very effective at curing diseases. I believe that the medical gaze and advancement in western medicine can be effective when diagnosing and treating patients and is needed to cure those who are ill. However my concerns are the moral ethics that come to play which may triumph the good of the medical gaze. This is how I slowly came to realize that most of my physicians treating my close family member focused solely on how to treat and diagnose her disease.

My underlying ethical concern with the medical gaze is that it amplifies the objectification of the patient’s body. As Foucault writes, the medical gaze draws upon “the fundamental perceptual codes that were applied to patients’ bodies, the field of objects to which observation addressed itself, the surfaces and depths traversed by the doctor’s gaze” (Foucault 1963, 54). Focusing on a patient’s body can quickly become the main concern, rather than considering the person as a whole. Excluding a holistic approach may lead to severe procedures such as invasive surgeries as other effective means may be overlooked.  Objectification of the body may also lead to obscuring or hiding certain areas of humanism such as not treating the individual as a valued human being or being able to treat medical conditions with non-surgical means, either of which dehumanizes the patient.  My close family member’s identity, opinions, values, spiritual needs, and emotions disintegrated in the medical gaze and she sometimes felt alone and unimportant as compared to her illness. These factors that are most important in valuing a human being is eventually forgotten when the medical gaze is overbearing on the main central focus to cure only the body. As Foucault mentioned, “those looking through the gaze first looked at the medical bipolarity of the normal and the pathological” before studying the inner human being with its emotions and mental well- being (Foucault 1963, 35).

To conclude, Michel Foucault illuminates the concept of the medical gaze by explaining how physicians observe the body carefully, uncovering the mysteries and hidden truths of particular diseases that others without the medical gaze could not. However, as previously discussed, discounting the patient’s emotional and social dimensions of the illness may prevent developing the least invasive procedures of treatment. As to my main argument, my experience has led me to see the ethical concerns of the medical gaze by observing a patient-physician interaction that discounted the patient’s personal involvement in the diagnosis process. It is one thing that the medical profession is to diagnose and to treat the body, however I believe that there is more to just diagnosing the body in order to improve human health.

Works Cited

Armstrong, Peter. “The Discourse of Michel Foucault: A Sociological Encounter.” Critical Perspectives on Accounting 27 (2015): 29- 42. Print.

Feder, Gene. A Fortunate Man: still the most important book about general practice ever written. The British Journal of General Practice 55.512 (2005): 246-247. Print.

Hsu, Hsuan, and Lincoln, Martha. “Biopower, Bodies… the Exhibition, and the Spectacle of Public Health.” Discourse: Journal for Theoretical Studies in Media and Culture: Vol. 29: Iss. 1, Article 2. Fall (2007): 15-34. Print.

Scheper- Hughes, Nancy, and Lock, Margaret. “The Mindful Body: A Prolegomenon to Future Work in Medical Anthropology.” Medical Anthropology Quarterly 1.1 (1987): 6-41. JSTOR. Wiley on Behalf of the American Anthropological Association. Web. 10 Apr. 2015. <http://www.jstor.org/stable/648769.>.

 

 

Slaves to Society; How we Lost Control and Ownership of our own Bodies

 

By: Natasha Gay

 Natasha Gay a junior at the University of Washington majoring in Anthropology and sociology. A Student-athlete with the women’s crew, she understands the importance of one’s body and the way in which it is read but different social groups. Natasha hopes to apply her sporting background in to future research for youth development in under-privileged communities and with youths at risk, focusing on current cases in the sports arena. 

 

Our bodies are blank canvases, and as society paints a picture, we begin to realize we have very little say in the final outcome. It is impossible to make a decision regarding our own bodies without being influenced by society in one way or another. The most basic example of this is self-presentation; every choice we make is made to go with or against a current trend of society. I believe that this is just a superficial issue amongst deeper issues of body control and ownership. In this paper I will examine the deep rooted issues of body ownership and control and how society has taken this from us. I will do this by utilizing Marcel Mauss’ essay “Techniques of the Body.” As my argument develops, it will become clear that the social body is not the only body affected by society.  The physical and mental are linked and affected as well. This is most adequately summarized by Terrance Turner, who reflects how the boundaries of individuals as biological and mental entities are no longer separate but parts of the “frontier of the social” (Turner 2007:83).

Society’s influence on our bodies is most obvious in Mauss’ essay on techniques of the body (Mauss 2007:66), Mauss suggests that we have three elements of self or three bodies: the physical, mental, and social. The physical body acts as a frontier between the mental and social bodies. Within the physical body, material objects have become a pivotal element of adornment and communication of hierarchy and status. Terrance Turner’s “The Social Skin” (Turner 2007:83) describes the idea that the treatment of the human body responds to societal notions and trends, reflecting the constant influence and control that society has over us. Turner explains how each different bodily adornment is a treatment of society and therefore the norms and structures that are present at the time, it is with this that society turns each individual’s body into a “symbolic stage” (Turner 2007:83). This symbolic stage expresses the social hierarchy in which we stand as individuals as well as the values, beliefs and general attitudes that we associate with. Our bodies then become a slave to society’s values, beliefs and attitudes as we lose ownership of our own bodies with society taking control.

An example of symbolic staging is clothing; the brand and quality of clothing reflects our social status, the cut and style reflects our general attitudes and values. The way that we adorn ourselves with jewelry, piercings and tattoos can materialize our beliefs and views in terms of religion, culture and even tribe. Examples of this can be shown in the tribal tattoos/body paint and particular piecing locations. In many cultures, these tell a story of life events: deaths, marriages, hardships, victories and titles. Hair treatment can also be added to this. The Kayapo tribe (Turner 2007:85), for example, utilizes this as a form to express and represent hierarchy and cultural roles. Another example of this is tattoos which materializes values, beliefs and in some cultures the likes of the wearer of the tattoo. In the past a tattoo would have signified a rebel or an outcast but now as they become more popular they are seen as another way to express individuality. These modes of adornment make aspects of our identity material yet are all influenced by societies. No matter how different societies may be, the adornment they prescribe makes displayed identities an element in the collective society rather than an individual choice. Society is in control of the physical body as well as the social body, as it controls the material markers of an individual’s identity.

Although one would think that our own thoughts and minds are less penetrable to society’s grasp, they are, in fact, some of the most influenced and controlled. With the constant exposure to societal ideas and ideals, our attitudes and beliefs constantly change with society. It is somewhat bewildering that even our values and beliefs are socially constructed and influenced. Stereotypes that society has created, affect us as well as trends; racial, gender and occupational stereotypes being some of the most important. These are pivotal to how our mental selves react to and interact with others. For example, in earlier decades women and minority groups were held in lower regard to others with particular values (fragile, unintelligent etc.) placed on them and therefore individual’s values and beliefs shadowed this. Though these values are not as prevalent today, stereotypes of behavior and appearance are still widely held for women as well as for other groups.

Judith Butler argues that these stereotypical behaviors are prevalent because of “gender performativity” (Butler: 2007:166), in which we are trained to act out the expected social norms and behaviors of our sex. It is not just values and beliefs that society influences, but the ideals that we hold. Ideals of beauty are an example of this. They tend to apply to everyone no matter the group that they may associate with. It is society’s ideas about how our bodies should be shaped and sized that causes the greatest influence in individual ideals and can have such a great influence that it can drive an individual to excessive measures. One such measure is eating disorders. I have had friends who have developed eating disorders due to their feeling that they have no control of themselves. By controlling their eating, they feel they are regaining some sort of control and ownership of themselves and their bodies. This may be the case, but this is a reaction to the influence and ideals of society in terms of body image. By going to these extents we have already lost our bodies to the control and influence of society and this mentally affects us making us feel inadequate. In this case, although society doesn’t directly control our body weight, it has infiltrated our mind and taken control of our thoughts and expectations about how we should appear.

So far I have focused on the way that we view ourselves, examining how society has managed to gain control and ownership of our mental and physical bodies without our consent. Mauss’ third element of the triple body is the social body. The social body is defined by the way that society uses our bodies from their point of view and how we represent their values and attitudes. The social body is defined as the body that society interacts with, and I agree with this but I think it to be short sighted if we cannot see that society now has control and ownership of all three of Mauss’ bodies.

No matter our choice, whether we are acting with or reacting against it, society has infiltrated our bodies and taken control. Using Marcel Mauss’ idea of the triple body, I have segmented our bodies and examined how this has occurred, from the obvious social body to the more personal and closely guarded physical and mental bodies. It is evident that whatever our intentions, we have become a reflection of society in terms of ideals, beliefs and attitudes. As societal trends change so will our bodies, as they are a representation of these values. It can be debated as to whether we ever had any control over our bodies, but it is for sure that we do not at present. In the future we hope to break free of these shackles, but until then we will remain a slave to society as our bodies are owned and controlled.

Works Cited

Mauss, Marcel.  “Techniques of the body.” In Beyond the Body Proper, edited by Judith Farquhar and Margaret Lock. 50-68. Durham: Duke University Press, 2007

Turner, Terence S. “The Social Skin.” In Beyond the Body Proper, edited by Judith Farquhar and Margaret Lock. 83-103. Durham: Duke University Press, 2007

Butler, Judith. “Bodies That Matter.” In Beyond the Body Proper, edited by Judith Farquhar and Margaret Lock. 164-175 Durham: Duke University Press, 2007

 

Implications of Sonographic Imaging; In The Absence Of A Cognitive Mediator

By: Amber Brown

Amber Brown is a senior at the University of Washington where she studies anthropology in the hopes of becoming an archaeologist.  She is a mother to two fantastic children, and she her fiancé enjoy road trips, camping, and spending time with their friends and family.  Amber hopes to settle in Spokane and focus her archaeological work in Eastern Washington, where she would like to engage in a community based approach to discovering more about the earliest inhabitants of the region.  She is currently considering attending law school, where she plans to focus on cultural property rights with the goal of supporting indigenous communities who are asserting authority over their cultural property.

 

 

The body is a complex construct, material in that it is the concrete base of how we define the human experience.  It is dynamic and varied and interacts with its physical and social environments in a highly unique and individualized fashion.  This interaction between the mental and physical occurs from the moment that conception is acknowledged, and it is a process that is enhanced through the use of prenatal imaging.  The way in which the body is addressed before life is reflective of communal values and political hierarchies that use the body as a means to convey social information, as evidenced by the current attempt in multiple states to legally mandate that women undergoing abortion must submit to the process of sonographic imaging.  Unborn bodies, however, lack the necessary cognitive ability to mediate between the physical and social realms, and are thus susceptible to political exploitation that utilizes prenatal imaging to assign bodily attributes and agenda unto the fetus.

As the famed philosopher and sociologist Marcel Mauss would suggest, the body is a multifaceted construct composed of mental, social, and physical factors that form the idea of a whole person.  Mauss drew upon elements of Cartesian dualism in order to establish a triple body approach, one that combines the physical and cognitive factors with cultural values in order to gain a more complete understanding of the body (Mauss 2007:53).  This “Total Man” approach suggests that each element contributes an essential part of what it means to be human. They are part of a dynamic and varied system that interacts within a “biological and social [entity] in whom the psychological acts as a mediator” (Farquhar & Lock 2007:22).  Thus, a whole body contains a mental presence that regulates the interaction between the physical and the social realms.  If one of these attributes is not present, the body ceases to be whole.  When the body is not whole, it is fundamentally inhuman and incapable of active agency.  This severely alters the way that the body is able to interact with the world.  A fetus is representative of this bodily state, for the mental element fails to exist in a functional manner.  For a fetus, the psychological element of the total body is incomplete to the point that it is not able to exercise autonomous control over any other factor.

The idea of the body as a complex construct mediated by cognitive actors is further defined by the anthropologist Terence Turner, who is well noted for his description of the surface of the physical body as the “social skin”.  Turner suggests that the body is “treated not only as the boundary of the individual as a biological and psychological entity but as the frontier of the social self as well” (Turner 2007:83).  This idea is important because it suggests that cultural expression allows the body to be coherent to society, for it to be indicative of a greater meaning or affiliation.  As it is the mind that exercises agency and autonomy over bodily decoration, it is the mind that mediates between the physical and cultural factors.  Thus the body becomes “the frontier” of a mental and cultural compromise, an “interface between self and society” (Turner 2007:85).  As it is the mind that restricts social access to the body, when the mind is not yet fully formed, as in the case of a fetus, the result is a body without the cognitive presence to limit the social element.

Should this cognitive factor not exist, the social influence is no longer restricted by the mind as a mediator and the physical body becomes a channel for social expression.  In the absence of a mind, popular culture is then afforded free reign over the body.  It is in this way that the unborn body becomes relevant in discussions concerning sonogram requirements for women considering abortion.  That which exists before the body comes into being is the subject of a great deal of implied meaning. The body is in this case personified in a manner inconsistent with its capability, as there is the expectation of an a priori level of individual awareness from the hint of inception.  The assignment of personal attributes occurs prior even to conception; with active agency being imparted unto the sperm and passive acceptance unto the egg.

This practice of personification continues onto the fetus via sonographic representation, and as Rayna Rapp explains in her essay Real Time Fetus: The Role Of The Sonogram In The Age Of Monitored Reproduction, it is a procedure that “increases the speed with which fetal development is recognized as a process independent of the mother’s imbedded consciousness” (Rapp 2007: 613).  Once the fetus is recognized as an independent entity it becomes subject to the enculturation processes of the social factor, representing the aspirations of an entire community as opposed to the individual mother.  It is interpreted as an individual, exhibiting personal traits and exercising choice beyond that of its host.  The fetus is then construed as capable of being subjected to interpretation and representation independent of realistic constraints regarding agency and autonomy.  Without the presence of a cognitive factor to limit access to the “social skin”, a developing infant is subject to the ascription of identity and cultural practices from the moment inception is recognized.  In other words, the social factor dominates the physical body when the psychological factor is not present.  It is also important to note that “the objects of scientific and medical scrutiny must be rendered; they are rarely perceived or manipulated in their natural state” (Rapp 2007:612).  This means that there are multiple opportunities for perspective to influence empirical knowledge, artistic representation, and descriptive narration during this process.

Requiring this process of interpretation as part of a medically induced abortion is currently the target of legislation in the United States.  According to the Guttmacher Institute website, as of August 1st, 2014, there are three states that are currently attempting to force every woman undergoing an abortion to first submit to the process of ultrasound imaging and endure the provider’s description of the embryo.  As Matthew Schmidt and Lisa Jean Moore explain in Constructing A ‘Good Catch,’ Picking A Winner: The Development Of Technosemen and The Deconstruction Of The Monolithic Male, this is problematic because by “giving personality to biological objects. . . we naturalize socially, materially, and bodily experienced, but nonetheless constructed” inequalities and oppressive social structures (Schmidt & Moore 2007:557).  This is problematic for numerous reasons, including that the interpretive method and subsequent description are the product of an individual perspective, and are thus incapable of being applied uniformly.  This legislation is reflective of power structures that use the medicalization of pregnancy to subjugate women to a position of passive acceptance as opposed to active agency.

The implications of this are profound; it indicates that each body that we see in this context is but the product of an interpretive paradigm, inherently reflective of the moral and political framework prompting the inquiry.  Terence S. Van Dijk explains that once an examination is made, the fetus is then “surgically, chemically, and artistically modified in accordance with prevailing aesthetic standards” in order to make it comprehendible to the viewer (Van Dijk 2007:653).  This process is highly problematic, as it presents an a posteriori construct as an a priori reality in order to inform personal decisions and influence public sentiment.  It presents a single perspective or interpretation as a single all-encompassing truth. The result of this manipulation of public opinion is effectively illustrated by legislation that attempts to judiciously impose an interpretation of life before birth for political means.

Legislation does not, however, dictate the interpretive paradigm that is to be used during the descriptive process, and so it facilitates full access to the unborn body as a conduit of unmitigated public discourse. Social influences, in the absence of a self-moderating mental presence, are thus able to establish a real presence upon something that does not yet exist.   This is a fluctuating process, both temporally as well as spatially, and so cultural traditions regarding incomplete bodies continues despite the fact that “our means of perceiving the body and embodied experiences are dramatically changing through applications of technologies” (Schmidt & Moore 2007:556).

Our treatment of bodies before life is meaningful because it is a reflection of cultural beliefs and traditions that are utilized to affect social change.  The way in which meaning is ascribed and the factors which are emphasized during that process are significant, as they are indicative of fundamental social values as well as individual interpretations of cultural influences.  The body without a cognitive mediator is an incomplete construct, a conduit by which social structures can operate with impunity, and so it is vulnerable to manipulation beneath highly variable spheres of social influence.  In the absence of a cognitive mediator the visual representation of the body is used by the social factor to ascribe value and assert authority on behalf of the fetus.  The way in which unborn bodies are used is reflective of a social reality rather than an empirical one.

Works Cited

Farquhar, Judith, and Margaret Lock, “Introduction” in Beyond the Body Proper, ed. Judith Farquhar and Margaret Lock (Durham: Duke University Press, 2007), 19-23

Matthew Schmidt and Lisa Jean Moore, “Constructing A ‘Good Catch,’ Picking A Winner: The Development Of Technosemen and The Deconstruction Of The Monolithic Male” in Beyond the Body Proper, ed. Judith Farquhar and Margaret Lock (Durham: Duke University Press, 2007), 550-566

Rayna Rapp, “Real Time Fetus: The Role Of The Sonogram In The Age Of Monitored Reproduction.” in Beyond the Body Proper, ed. Judith Farquhar and Margaret Lock (Durham: Duke University Press, 2007), 608-622

Terence S. Turner, “The Social Skin” in Beyond the Body Proper, ed. Judith Farquhar and Margaret Lock (Durham: Duke University Press, 2007), 83-103

Terence S. Van Dijk, “Bodyworlds: The Art of Plastinated Cadavers” in Beyond the Body Proper, ed. Judith Farquhar and Margaret Lock (Durham: Duke University Press, 2007), 640-657

 

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MASA Graduate Student Mentor Award

Call for Submissions

2015 MASA Graduate Student Mentor Award

Deadline: August 1, 2015

The MASA Graduate Student Mentor Award recognizes excellence in graduate student mentorship, and is aimed at senior or mid-career scholars who have demonstrated an ongoing commitment to teaching and mentorship throughout their careers, particularly those who have taken the time to successfully guide their MA and PhD students through fieldwork and the thesis or dissertation writing process. Previous recipients of the MASA Graduate Student Mentor Award are Juliet McMullin (2014), Marcia Inhorn (2013), Peter Brown (2012), Frances Barg (2011), Mary-Jo DelVecchio-Good and Byron J. Good (2010), Carole Browner (2009), Joe Dumit (2008), Lenore Manderson (2007) and Mac Marshall (2006).

Attributes to Consider

Communicates clearly and supportively with students and offers consistent, positive guidance; provides timely and productive feedback on written work
Creates a friendly, encouraging and academically challenging environment; makes an effort to teach medical anthropology in innovative and effective ways
Encourages students to submit abstracts of their own at conferences, write and submit their own work to journals, teach well and value teaching and begin to function on their own in those public arenas that include medical anthropology
Has a good track record of retaining students: remaining on committees, retaining advisees and actually graduating a good proportion of their advisees
Inspires students to pursue their own research, teaching and advocacy goals in medical anthropology, despite the daunting nature of graduate school and the dissertation process
Helps students connect with other professionals in their field outside of their own departments and helps familiarize them with the unwritten rules of their professional community
Steps back and allows students to learn from their own mistakes; lets them step forward on their own and begin making their own decisions; lets them define and take appropriate risks

Nomination Procedures and Application Materials

A minimum of three letters of nomination should be from current and/or former students outlining the ways in which the candidate has been a strong mentor, advisor and/or teacher. Additional letters may also be submitted by junior colleagues whom the candidate has mentored; however, this is not a requirement. Each letter should consider the above criteria and address any other attributes or practices that have led to supportive, successful mentoring. Nominations for the faculty mentor award will remain open for three years for consideration by the award committee.

Submissions

Nomination and support letters will be accepted until the deadline of August 1, 2015. Please send all nomination letters to Jonathan Stillo at jstillo@gmail.com. The award recipient will be honored during the SMA Business Meeting and Award Ceremony at the AAA Annual Meeting in Denver, Colorado this November.

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SMA Dissertation Award

Deadline: July 1, 2015

In 2006, the Society for Medical Anthropology inaugurated the Medical Anthropology Students Association (MASA) to recognize and serve student members of the society. Students make up one-third of SMA’s membership and represent the future of the field. One way for SMA to honor its student members is through inauguration of an award recognizing the excellence of a recently completed doctoral dissertation. To that end, the SMA Executive Board has established the SMA Dissertation Award (formerly called the “MASA Dissertation Award”), created to recognize an outstanding dissertation in the field of medical anthropology, broadly defined.

On a biennial basis (every odd year) the SMA Dissertation Award is given to the author of a dissertation which is judged to be a significant and potentially influential contribution to medical anthropology. Dissertations are judged on the basis of: (1) scope and excellence of scholarship, including ethnographic research; (2) originality of subject matter; (3) effectiveness and persuasiveness of arguments; and (4) writing quality. Dissertation research of exceptional courage and difficulty is given special consideration.

The SMA Dissertation Award will be publicly announced during the SMA awards ceremony, held during the annual AAA meeting. The winner will receive a $500 cash award.

The SMA Dissertation Award Committee strongly encourages submission of nominations for the competition. Submissions must be dissertations approved, accepted, and filed as the final version with the candidate’s university within nomination deadline period. For the current nomination period, dissertations submitted to the university between the period of July 1, 2013 – July 1, 2015 will be considered.

Submissions: In order to be a candidate for the SMA Dissertation award, students need not have received their PhD degrees in a department of anthropology, nor in a North American university. Students should submit a PDF of their final, defended and accepted dissertation to the Committee Chair, Jonathan Stillo, on or before the final date. In addition, candidates will need two letters of nomination one from the student’s advisor and the other from a dissertation committee member. These letters must state why the dissertation contributes to the field of medical anthropology. The candidate’s dissertation advisor should attest that the submitted dissertation is the version accepted by the dissertation committee. All materials should be sent to SMA Dissertation Award Committee Chair, Jonathan Stillo (jstillo@gmail.com) along with a list of the student’s dissertation committee members to avoid conflicts of interest during the reviewing process.

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