Graduate Courses

ANTH 898-073: Problems in the Ethnography of Medicine and Health (Rivkin-Fish)

Course description: This graduate seminar will examine some of the key themes and questions that have animated anthropological concerns with medicine, health, and society over the last 15 years. Through the careful scrutiny of selected, acclaimed ethnographic monographs, we will explore issues such as: the historical construction of the body and self, of life, illness, death and the boundaries between them; comparative meanings and uses of technology as material, symbolic, and political resources; the contested interpretation of appropriate public health policies; the impact of symbolic violence, including racism, on health; the connections between reproduction, sexuality, commodification, and politics; and the impacts of politics, culture, bureaucracy, and profit-making on scientific knowledge, medical decisions, and patient suffering. In addition to these empirical topics, we will devote attention to understanding the ways ethnographers conceptualize their units and scope of analysis, and work to redefine the theoretical directions of anthropological inquiry.

Students from Anthropology, Public Health, Social Medicine, and related disciplines are welcome!

Required texts:
Biehl, Joao. VITA: Life in a Zone of Social Abandonment
Briggs, Charles. Stories in a Time of Cholera: Racial Profiling during a Medical Nightmare
Fassin, Didier. When Bodies Remember: Experiences and Politics of AIDS in South Africa
Kaufman, Sharon R. …And a Time to Die: How the American Hospital Shapes the End of Life
Lock, Margaret. Twice Dead: Organ Transplants and the Reinvention of Death
Petryna, Adriana. When experiments travel: clinical trials and the global search for human subjects
Rouse, Carolyn. Uncertain Suffering: Racial Health Care Disparities and Sickle Cell Disease
Taylor, Janelle. The Public Life of the Fetal Sonogram
Young, Allan. The Harmony of Illusions: Inventing Post-Traumatic Stress Disorder

For more information, please contact Michele Rivkin-Fish, mrfish@unc.edu

Anth 898/ Reli 890/ Comm 857: Detection & Rhetorics of Evidence (Barry F. Saunders)

Course description: This is a limited-enrollment graduate seminar (8 students). Places will be offered preferentially to graduate students in anthropology, communication studies, and religious studies, though all graduate students are welcome—literature, sociology, history, etc. Detection engages the problem of the hidden—criminal disguises, buried treasure, coded meaning, invisible particles—and thus involves modes of conjectural, hypothetical knowing, and histories of curiosity. It also involves rhetorics of evidence and practices of proof. These problems and practices are as ancient as reading—e.g. of animal tracks, and signs of divine intentions.

Detective stories as such arose in the nineteenth century, in metropolitan settings that connected police work (and its limitations) with new popular enthusiasms for comparative anatomy, Egyptology, cryptography, and other projects of reconstructive knowing. These developments were contemporaneous with the consolidation of important new modes of medical diagnosis. This course develops these historical contexts along with some critical dimensions of detective literature and films—and of medical/scientific modes of finding, knowing, and showing. Half the course hours will be shared with 8 second-year UNC medical students.

Texts may include selections from:
stories by Poe, Doyle, Dennis Potter; Benedict, Curiosity; Detienne & Vernant, Cunning Intelligence in Greek Culture and Society; Ginzburg, Clues, Myths, and the Historical Method; Gall, On the Functions of the Brain…; Foucault, The Birth of the Clinic, & The Order of Things; Benjamin and others on the flâneur; Bennett, The Birth of the Museum; Sekula, “The Body and the Archive”; Rosenheim, The Cryptographic Imagination; Muller & Richardson, The Purloined Poe; Taylor, Hiding; Peirce on abduction; Freud, The Interpretation of Dreams; Zizek, Looking Awry; Montgomery, How Doctors Think; Burney, Bodies of Evidence. (List is partial & provisional…)

For more information, please contact Barry Saunders at 843-8272 or bfsaunde@email.unc.edu. Prospective students are requested to be in touch as soon as possible: permission required to enroll.

Anth 898-054: The Anthropology of Global Pharmaceuticals (Peter Redfield)

Course description: In recent years the dramatic reworking of biomedical possibility through biotechnology suggests potential transformations of both capital and person. At the same time “global” health has emerged as a privileged site for ethical imagination and intervention seeking to remake the world. Amid the assertion of rights to life and health care, drugs increasingly play a central role in continuing contestation over illness and poverty. On the one hand we see a heightened corporate focus on developing and marketing products for newly defined disorders, as well as political contests over patents and profits. On the other we have dramatic (if uneven) responses to HIV-AIDS, the recasting of tragedy as trauma and the varied efforts of entities such as Doctors Without Borders and the Gates Foundation to ameliorate suffering. The products of pharmaceutical research thus signal a range of futures, their presence or absence indicating new human boundaries.

A strand of anthropology has ventured into this area, partly emerging from science and technology studies. This seminar seeks to follow part of that strand; first situating some of the background concerns about material culture, and then exploring how materia medica now intersects with a range of concerns stretching from world trade and research ethics to what constitutes health, citizenship and self in a world where one can now be “better than well.”

In addition to some background texts in science studies, readings will include works by João Biehl, Joe Dumit, Stefan Ecks, Didier Fassin, Cori Hayden, Andrew Lakoff, Vinh-Kim Nguyen, Adriana Petryna, Paul Rabinow, Kaushik Sunder Rajan, Nikolas Rose, Sjaak van der Geest and Susan R. Whyte among others.

I am planning this seminar as a partial workshop, shaped by my own interests but not limited to them. Therefore part of the course will be open to individual definition for those who might have established projects. Requirements will include regular discussion participation and a term research paper.

ANTH 898: Health Consequences of Culture Change (Sorensen)

Course Description: The processes of globalization and modernization have had profound impacts on the health status of individuals throughout the world. These health effects operate through a variety of mechanisms: through acculturation and culture and lifestyle change, through increased socioeconomic disparities, and through changes in the structure of health care systems and the costs of providing health care and new medications. We will use both evolutionary and political economic perspectives to explore the health consequences of culture change.

We will explore health status as an indicator of socioeconomic inequality and examine the associations between poverty and illness. We will also investigate the health consequences of rapid culture change among indigenous societies from the perspective of individual adaptations to changing lifestyles. The goals of the course are to elucidate broad scale patterns of health and global change, and to understand the role of local context, individual behavior, and human biology in shaping health status.

Required Texts:
Setel, Philip W. 1999. A Plague of Paradoxes: AIDS, Culture and Demography in Northern Tanzania. U Chicago Press.
Marmot M, & Wilkinson RG. 2005. Social Determinants of Health. London: Oxford. 2nd Ed.
Kunitz S. 1996. Disease and Social Diversity: The European Impact on the Health of Non-Europeans. London: Oxford UP.
Alchon, SA. 2006. A Pest in the Land: New World Epidemics in a Global Perspective. University of New Mexico Press.
Goodman A. & Leatherman, T. 1998. Building a New Biocultural Synthesis: Political-Economic Perspectives on Human Biology. University of Michigan Press.
Wilkinson, RG. 1996. Unhealthy Societies: Afflictions of Inequality. New York: Routledge.

ANTH 898: Human Disease Ecology (Sorensen)

Course Description: In this seminar we will consider cultural ecologies of disease by examining how social, cultural and historical factors have shaped and continue to shape disease patterns and affect pathogen-host evolution. We will pay particular attention to the role of humans in shaping pathogen-host coevolution. Through readings and discussions we will examine how ecosystems are shaped by disease, how disease shapes ecosystems, and how cultural processes (e.g., population movements, transportation networks, economic shifts, landscape modifications and other built environments) contribute to dynamic epidemiological environments. Among the topics we will address are pathogen-host coevolution, virulence and pathogen evolution, spatial and temporal trends in global health and disease, epidemiological transition theory, and emerging diseases.

Required Texts:
Infectious Disease Ecology: Effects of Ecosystems on Disease and of Disease on Ecosystems, R.S. Ostfeld, F. Keesing, V.T. Eviner. 2008. Princeton University Press
The Evolution of Infectious Disease, P.W. Ewald. 1996. Oxford University Press
The Burdens of Disease: Epidemics and Human Response in Western History. R.N. Hays. 1998. Rutgers University Press
Plagues and Peoples, W.H. McNeill. Anchor.

ANTH [?] Moral Economies of Medicine (Rivkin-Fish)

Course Description: The concept of moral economy refers to social understandings of the ethics of resource production, distribution, and exchange, including notions of obligation and norms of reciprocity. When applied to the sphere of medicine, the study of moral economies examines cultural ideas regarding who deserves health care, who should provide care, and what kinds of production, distribution, and exchange systems are considered fair and appropriate to establish for the provision of health services and healing practices. This course considers the concept of moral economies as a point of departure for analyzing claims about entitlement, virtue, and difference in various health care systems and the use of expert knowledge in medicine, science, and healing. We also explore connections and distinctions between the concepts of a “moral economy” and “political economy.” Case studies will examine anthropological approaches to the ethics of scientific, medical, and ethnographic research, the political and ethical implications of representations of suffering, and the role of language, including narrative, metaphor, and rhetoric, in moral economies of medicine. We will also examine disciplinary difference and convergences between medical anthropology, public health, bioethics, and medical humanities.

ANTH 585: Anthropology of Science (Redfield)

ANTH 750: Seminar in Medical Anthropology (Lachicotte)

Course Description: This course is meant to serve as an advanced introduction to the sub-discipline of medical anthropology. It is not organized topically, as most surveys of the field are, but by theoretical approach. We will sample three predominant ways—“interpretive,” “critical” and “biocultural”—medical anthropologists have tried to make sense of and account for health, disease and treatment in diverse social, cultural and natural settings. With the exception of the historical schools considered initially, these modes of investigation and explanation are roughly contemporaneous. We will be concerned throughout the course with the linkages among approaches–the dialogues and diatribes, collaborations and separations, which color our anthropological accounts of health and illness. None of these schools is “purified” of the others; in fact, they developed interactively, each in light of and in response to the others. Nor is any single account, monograph or ethnography ordinarily given over to one mode of explanation.

Ethnographers and analysts create “hybrids”—mixes of these ideal types—to portray and explain the variety of human experience with health, illness and treatment. For this, if no other, reason, each “school” is itself a collation of variations on a theme—rather an ongoing conversation among scholars who identify themselves with the tradition. Hence the schools still have real effects, both in shaping research questions and methods and in producing knowledge from the data collected. The course seeks to plunge us into the life of a discipline: the medley of discussions and the choreography of interactions that together comprise theory and practice in medical anthropology.

Required texts: (readings may vary by year and instructor)
Byron J. Good. Medicine, rationality and experience: An anthropological perspective. London & New York: Cambridge University Press, 1994.
Margaret Lock. Encounters with aging: Mythologies of menopause in Japan and North America. Berkeley: University of California Press, 1993.
Charis Thompson. Making parents: The ontological choreography of reproductive technologies. Cambridge, Mass.: MIT Press, 2005.
Additional readings are posted online.

ANTH 897-052: Managing Medical Work: Technologies, Instrumentalities and Institutional Contexts (Lachicotte)

Course description: This course explores the anthropology of biomedicine from the standpoint of social practice. It examines the production of medical care—that is, medical work—by sampling a variety of ethnographic, historical, social and cultural studies. We will focus particularly on two theoretical approaches— the “actor-network” theories articulated in studies of science and technology and the “practice theory” of Pierre Bourdieu–in order to frame the interplay of medical technologies, instrumentalities (routinized modes of activity) and discourses. The course follows a telescoping order of scale in which social practices combine forms of imagination and material relations to create the cultural settings—work worlds—that affect the meaning and experience of medicine.

Besides the theoretical groundwork, readings and discussion will pay special attention to an aspect of medicalization which medical anthropology has historically neglected: the changing face of “late capitalism.” Biomedical work is informed by such innovations as flexible means of production and distribution, new managerial techniques and strategies, forms of professional “self-regulation” and new public / private relationships. The course looks to place and thus to understand biomedicine within its larger institutional frame, the bureaucracies and economies of human services.

Required texts:
Marc Berg. Rationalizing medical work: Decision-support techniques and medical practices. Cambridge, Mass.: MIT press, 1997.
John Clarke. Changing welfare, changing states: New directions in social policy. London: Sage Publications, 2004.
Margaret Lock, Allan Young, and Alberto Cambrosio (eds.). Living and working with the new medical technologies: Intersections of inquiry. New York: Cambridge University Press, 2000.
Additional readings are posted online.

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