Description
In this fully revised and updated second edition of An Anthropology of Biomedicine, authors Lock and Nguyen introduce biomedicine from an anthropological perspective, exploring the entanglement of material bodies with history, environment, culture, and politics. Drawing on historical and ethnographic work, the book critiques the assumption made by the biological sciences of a universal human body that can be uniformly standardized. It focuses on the ways in which the application of biomedical technologies brings about radical changes to societies at large based on socioeconomic inequalities and ethical disputes, and develops and integrates the theory that the human body in health and illness is not an ontological given but a moveable, malleable entity.
This second edition includes new chapters on: microbiology and the microbiome; global health; and, the self as a socio-technical system. In addition, all chapters have been comprehensively revised to take account of developments from within this fast-paced field, in the intervening years between publications. References and figures have also been updated throughout.
This highly-regarded and award-winning textbook (Winner of the 2010 Prose Award for Archaeology and Anthropology) retains the character and features of the previous edition. Its coverage remains broad, including discussion of: biomedical technologies in practice; anthropologies of medicine; biology and human experiments; infertility and assisted reproduction; genomics, epigenomics, and uncertain futures; and molecularizing racial difference, ensuring it remains the essential text for students of anthropology, medical anthropology as well as public and global health.
Table of Contents
Acknowledgements xiii
Introduction 1
The Argument 1
Interwoven Themes 2
Improving Global Health: The Challenge 4
Biomedicine as Technology 5
Does Culture Exist? 7
A word About Ethnography 10
Section 1
1 Biomedical Technologies in Practice 15
Technological Mastery of the Natural world and Human Development 16
Technology and Boundary Crossings 17
Biomedicine as Technology: Some Implications 19
Technologies of Bodily Governance 21
Technologies of the Self 24
The Power of Biological Reductionism 25
Techno/Biologicals 26
2 The Normal Body 29
Cholera in the Nineteenth Century 30
Representing the Natural Order 31
Truth to Nature 32
The Natural Body 34
A Numerical Approach 35
Other Natures 36
Interpreting the Body 38
How Normal Became Possible 39
When Normal Does not Exist 42
Problems with Assessing Normal 43
Pathologizing the ‘Normal’ 46
Limitations to Biomedical ‘Objectivity’ 48
Better than Well? 49
3 Anthropologies of Medicine 51
The Body Social 51
Contextualizing Medical Knowledge 53
Medical Pluralism 55
The Modernization of ‘Traditional’ Medicine 56
Medical Hybridization 57
Biodiversity and Indigenous Medical Knowledge 58
Self‐medication 59
A Short History of Medicalization 60
Opposition to Medicalization 62
The Social Construction of Illness and Disease and Beyond 64
The Politics of Medicalization 68
Beyond Medicalization? 71
In Pursuit of Health 71
In Summary 74
Section 2
4 Colonial Disease and Biological Commensurability 79
An Anthropological Perspective on Global Biomedicine 79
Biomedicine as a Tool of Empire 81
Acclimatization and Racial Difference 82
Colonial Epidemics: Microbial Theories Prove their Worth 83
Fear of Biomedicine 85
Microbiology as a Global Standard 87
Infertility and Childbirth as Critical Events 89
Birthing in the Belgian Congo 90
A Global Practice of Fertility Control 91
Intimate Colonialism: The Biomedicalization of Domesticity 92
Biomedicine, Evangelism and Consciousness 93
The Biological Standardization of Hunger 94
The Colonial Discovery of Malnutrition 95
Albumin as Surplus 97
The Biologization of Salvation 98
In Summary 100
5 Grounds for Comparison: Biology and Human Experiments 103
The Laboratory as the Site of Comparison 103
The Colonial Laboratory 104
Experimental Bodies 106
Rise of the Clinical Trial 107
Taming Chance 109
The Alchemy of the Randomized Controlled Trial 110
The Problem of Generalizability 110
Medical Standardization and Contested Evidence 112
Anthropological Perspectives on Clinical Trials: The West African Ebola Epidemic 114
‘Jiki’: A Clinical trial Amidst the Ebola Epidemic 116
Context of the Clinical Trial 117
Globalizing Clinical Research 118
What Should Count as Evidence? 120
Economies of Blood 121
Experimental Communities: Social Relations 122
In Summary 124
6 The Right Population 127
The Origins of Population as a ‘Problem’ 129
Addressing the ‘Problem’ of Population 130
Improving the Stock of Nations 131
Contraceptive Technologies and Family Planning 133
Indian Family Planning – meeting Quotas 135
Increasing Fertility with Contraceptive use 139
The One‐child Policy 140
Biomedical Technology and sex Selection 145
Contextualizing Sex Selection: India and ‘Family Balancing’ 146
Contextualizing Sex Selection: Disappeared Girls in China 148
Sex Selection in a Global Context 151
Ghost Children, Little Emperors, Burgeoning Elders 153
Reproducing Nationalism 155
In Summary 157
Section 3
7 Who Owns the Body? 161
Commodification of Human Biological Material 162
Objects of Worth and their Alienation 164
The Wealth of Inalienable Goods 164
A Bioeconomy of Human Biological Materials 165
Who Owns the Body? 167
Gifting Life 168
Commodification of Eggs and Sperm 169
Medical Tourism 171
Immortalized Cell Lines 171
The Exotic Other 174
Biological Databases 177
Concluding Comments 182
8 The Social Life of Human Organs 185
Bioavailability – Who Becomes a Donor? 186
The Biopolitics of Organ Transplants 187
A Shortage of Organs 190
Inventing a New Death 192
The Good‐as‐dead 194
Struggling for National Consensus 197
A Rapacious Need for Organs 199
The Social Life of Human Organs 200
When Resources are in short Supply 204
Liminal Lives 206
Does the Body Belong to God? 207
Altruism, Entitlement and Commodification 209
9 Making Kinship: Infertility and Assisted Reproduction 213
Assisted Reproductive Technologies 214
Problematizing Infertility Figures 215
From Underfertility to Overfertility 216
Reproducing Culture 222
Assisted Reproduction in the United States 224
Assisted Reproduction in Egypt 227
Assisted Reproduction in Israel 230
ART and the Reproduction of Normalcy 234
Global Hubs of Conception 237
Section 4
10 The Sociotechnical Self 241
The Biological Boundary Between Self and Other 241
The Sociotechnical Self 242
Technologies of the Self 243
Technologies of the Self in Biomedicine 244
The Unconscious as Technology of the Self 245
The Discovery of an Unconscious Self 246
Unlocking the Pathogenic Secret 247
The Pathogenic Secret as a Mode of Subjection 248
The Making of Posttraumatic Stress Disorder 248
The Practitioner‐self 251
Producing the Self Through Talking Technologies: Technologies of Health Promotion 252
Technologies of Empowerment 253
Technologies of Self‐help 254
Confessional Technologies 255
The Globalization of the Unconscious 257
Beyond Freud to the Neurosciences 259
The Psychiatric Self 259
Psychopharmaceuticals 260
Addiction and the Lie 263
Conclusion 264
11 Genes as Embodied Risk 265
From Hazard to Embodied Risk 266
From Generation to Rewriting Life 267
Genomic Hype 269
Geneticization 271
Genetic Testing and Human Contingency 272
Genetic Citizenship and Future Promise in America 275
Biosociality and the Affiliation of Genes 276
Community‐based Participatory Research 277
Genetic Information and Hybrid Causality 277
Genetic Testing in the Era of Personalized Medicine 279
Genetic Screening 280
Screening as a Collective Endeavour 282
Race and Genetic Testing 284
Preimplantation Genetic Diagnosis 286
Is a Neo‐Eugenics Looming on the Horizon? 287
12 Global Health 291
What is Global Health, and How is it Different from International Health? 292
Metrics and the Global Clinic 296
Botswana’s Cancer Ward 297
Leukaemia in the Indian Ocean 298
Value in Global Health: A Global Market for Diagnostics and Drugs 300
When Markets don’t Work 301
Medical Humanitarianism and ‘Philanthrocapitalism’ 303
Regimes of Anticipation in Global Health: Epidemics Fast and Slow 304
An Anthropology of Preparedness 305
The Politics of Anticipation 307
Conclusion 309
Section 5
13 From Local to Situated Biologies 313
The End of Menstruation 314
Local Biologies 319
Kuru and Endocannibalism 320
Racism and Birth Weight 323
Agent Orange and Foetal Abnormalities in Vietnam 324
An Abundance of Local Biologies 326
Local Biology and the Erosion of Universal Bodies 328
Rethinking Biology in the Midst of Life’s Complexity 329
Is Biology Real? 330
In Summary 332
14 Of Microbes and Humans 335
The Microbial Arms Race 337
Warfare and Iraqibacter 339
Debates About the Origin of HIV 340
From Versus to Commensals: Microbiomes and Metagenomes 345
The Human Ecosystem 346
15 Genomics, Epigenomics and Uncertain Futures 349
Divining the Contemporary 349
Amassing and Systematizing DNA 350
The APOE Gene and Alzheimer’s Disease 351
Genetic Testing for Late‐onset Alzheimer’s Disease 353
Interpretations of Risk Estimates 355
Dethroning the Gene? 356
Eclipse of the Genotype–phenotype Dogma 357
Does a Programme for Life Exist? 358
Learning (Again) to Live with Uncertainty 359
Epigenetics: Overtaking Genetic Determinism 360
From Epigenesis to Epigenetics 361
Molecular Epigenetics and the Reactive Genome 362
Miniaturization of the Environment 364
Embedded Bodies 365
Epigenetics and the Womb 366
Food as Environment 367
Social Deprivation 367
Ageing and Epigenetics 368
From Causality to Contingency 368
16 Molecularizing Racial Difference 371
Molecular Biology and Racial Politics 375
The Molecularization of Race 377
Bioethnic Conscription 377
Racialized Allelic Variation 379
Mexican Genomics 380
Discordant Genomic Knowledge 381
Commodifying ‘Race’ and Ancestry 382
Looping Effects 383
Epilogue 385
Notes 389
Bibliography 467
Index 529
