Critical Medical Anthropology

546 Pages·2018·3.93 MB·Portuguese

by  Merrill Singer and Hans Baer

Critical Medical Anthropology
Merrill Singer Hispanic Health Council
and
Hans Baer University of Arkansas at Little Rock
Critical Approaches in the Health Social Sciences
Series Series Editor: Ray H. Elling
First published 1995 by Baywood Publishing Company, Inc.
Published 2018 by CRC Press
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First issued in paperback 2018
© 1995 by Taylor & Francis Group, LLC
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ISBN 13: 978-0-415-78376-7 (pbk)
ISBN 13: 978-0-89503-124-2 (hbk)
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Library of Congress Catalog Number 94-39810
Library of Congress Cataloging-in-Publication Data
Singer, Merrill.
 Critical medical anthropology / Merrill Singer and Hans Baer.
  p. cm. - - (Critical approaches in the health social sciences series) (Political economy of health
care series)
 Includes bibliographical references (p. ) and index.
 ISBN 0-89503-124-8 (cloth). -- ISBN 0-89503-150-7 (paper)
 1. Medical anthropology. I. Baer, Hans, 1944- . II. Title. III. Series. IV. Series: Political economy
of health care series.
GN296.S56 1995
306.4’61--dc20
94-39810
CIP
Dedication
We dedicate this book to the students and colleagues with whom we share
the vision that great progressive change is possible and probably closest at
hand when it seems most distant.
Preface
This book, the culmination of over ten years of shared work by the authors,
seeks to contribute to the effort to re-orient medical anthropology by means
of a political economic contextualization of its field of study and application,
and by way of a re-focus on power and inequality as central explanatory
factors. In this volume, we have pulled together in one place many of the
papers we have written as part of the effort to build a critical medical
anthropology. All of these have been updated and in some cases considerably
expanded. Through this effort we hope to offer a work that will clearly lay
out the perspective and work of critical medical anthropology. While it is our
hope that this book will be of interest to many anthropologists as well as
other social scientists, health care providers, and public health professionals
(including those who will find much to disagree with in it), we have written
this book with a special concern that it be of use to undergraduate and
graduate students. It is the interest of these students in becoming part of the
effort to build a critical approach, especially students in medical
anthropology programs around the country, that has offered the greatest
gratification to us over the years. Some of these students we have gotten to
know well, others we have met only briefly at conferences, forums, and
campus lectures. When they tell us the impact critical medical anthropology
has had on their lives and their careers, we feel that we already have achieved
our objective.
Acknowledgments
We deeply wish to acknowledge the true support of our many
anthropology colleagues who share with us the title of critical medical
anthropologist, as well as those in other subfields of anthropology, in our
health social sciences, and in health care and public health who see the world
in a similar critical way. We greatly value our friendships and professional
relations with these colleagues. Though titles may vary, the struggle is a
common one. Especially, in this regard, we thank Ray Elling, editor of the
book series in which this volume appears, for his many years of friendship
and support. Most of us are uncertain if we ever make a difference in this
world. Through his effort to always stay true to his principles, Ray Elling has
made a difference. Also, we extend warm thanks to Bobbi Olszewski for her
production work on the book and the entire crew at Bay wood Publishing
Company for the effort put into bringing out Critical Medical Anthropology
in a timely fashion.
Several of the chapters to follow were written especially for this volume,
others are expansions of a series of articles the authors have published on
critical medical anthropology since the mid-1980s. For allowing us to include
revised versions here, the authors gratefully acknowledge and thank the
journals and books in which the following earlier versions of several of the
chapters were first published:
Hans Baer, Prophets and Advisors in Black Spiritual Churches: Therapy, Palliative, or Opiate, Culture,
Medicine and Psychiatry, 5:145–170, 1981.
Hans Baer, The Drive for Professionalization in British Osteopathy, Social Science and Medicine,
79:717–724, 1984.
Hans Baer, The American Dominative Medical System As a Reflection of Social Relations in the
Larger Society, Social Science and Medicine, 28(11): 1103–1112, 1989.
Hans Baer, Towards a Critical Medical Anthropology of Health-Related Issues in Socialist-Oriented
Societies, Medical Anthropology, 77(2): 181–194, 1989.
Hans Baer, Kerr-McGee and the NRC: From Indian Country to Silkwood to Gore, Social Science and
Medicine, 30(2):237–248, 1990.
Hans Baer, How Critical Can Clinical Anthropology Be? Medical Anthropology, 75(3): 299–317, 1993.
Merrill Singer, Cure, Care and Control: An Ectopic Encounter with Biomedical Obstetrics, in
Encounter with Biomedicine: Case Studies in Medical Anthropology, Hans Baer (ed.), Gordon and
Breach Science Publishers, pp. 249–265, 1987.
Merrill Singer, Lani Davison, and Gina Gerdes, Culture, Critical Theory, and Reproductive Illness
Behavior in Haiti, Medical Anthropology Quarterly, 2:370–385, 1988.
Merrill Singer, Postmodernism and Medical Anthropology: Words of Caution, Medical Anthropology,
72(3):289–304, 1990.
Merrill Singer, Freddie Valentín, Hans Baer, and Zhongke Jia, Why Does Juan Garcia Have a Drinking
Problem?: The Perspective of Critical Medical Anthropology, Medical Anthropology, 14(1): 77–108,
1992.
Merrill Singer, AIDS and the Health Crisis of the U.S. Urban Poor: The Perspective of Critical Medical
Anthropology, Social Science and Medicine, 39(7):931–948, 1994.
Merrill Singer, Beyond the Ivory Tower: Critical Praxis in Medical Anthropology, Medical
Anthropology Quarterly, 9(1), 1995.
TABLE OF CONTENTS
SECTION A: Orientation
Introduction
Chapter 1
Medical Anthropology and its Transformation
Chapter 2
The Critical Gaze
Chapter 3
Postmodernism Medical Anthropology: A Critique
SECTION B: The Macro-Social Level
Chapter 4
Health-Related Issues in Socialist-Oriented Societies: Ideals,
Contradictions, and Realities
Chapter 5
Studying Up: The Political Economy of Nuclear Regulation
SECTION C: The Intermediate-Social Level
Chapter 6
The American Dominative Medical System as a Reflection of Social
Relations in the Larger Society
Chapter 7
AIDS and the Health Crisis of the U.S. Urban Poor
Chapter 8
The Drive for Professionalization in British Osteopathy
SECTION D: The Micro-Social Level
Chapter 9
Medical Hegemony, Biomedical Magic, and Folk Medicine: Reproductive
Illness among Haitian Women
Chapter 10
Prophets and Advisors in African-American Spiritual Churches: Therapy,
Palliative, or Opiate?
SECTION E: The Individual Level
Chapter 11
Confronting Juan Garcia’s Drinking Problem: The Demedicalization of
Alcoholism
Chapter 12
Cure, Care and Control: Agency and Structure in the Clinical Encounter
SECTION F: Directions
Chapter 13
How Critical Can Clinical Anthropology Be?
Chapter 14
Critical Praxis in Medical Anthropology
Topic Index
Name Index