An Anthropology of Biomedicine

562 Pages·2018·3.224 MB·English

by  Margaret Lock,  Vinh-Kim Nguyen

An Anthropology of Biomedicine

An Anthropology of Biomedicine
Second Edition
Margaret Lock and Vinh‐Kim Nguyen
This edition first published 2018
© 2018 John Wiley & Sons, Inc.
Edition History: Margaret Lock and Vinh‐Kim Nguyen (1e, 2010) published by Blackwell Ltd.
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Library of Congress Cataloging‐in‐Publication Data
Names: Lock, Margaret M., author. | Nguyen, Vinh-Kim, author.
Title: An anthropology of biomedicine / by Margaret Lock, McGill University,
Vinh-Kim Nguyen, University of Montreal.
Description: Second Edition. | Hoboken, New Jersey : Wiley, 2018. | “Edition History:
Margaret Lock and Vinh-Kim Nguyen (1e, 2010) published by Blackwell Ltd.”–T.p. verso. |
Includes bibliographical references and index. |
Identifiers: LCCN 2017033416 (print) | LCCN 2017034377 (ebook) | ISBN 9781119069140 (pdf) |
ISBN 9781119069157 (epub) | ISBN 9781119069133 (paper)
Subjects: LCSH: Medical anthropology. | Public health–Anthropological aspects. | Human body–Social aspects.
Classification: LCC GN296 (ebook) | LCC GN296 .L63 2018 (print) | DDC 306.4/61–dc23
LC record available at https://lccn.loc.gov/2017033416
Cover image: © Leila Alaoui, No Pasara, untitled
Cover design by Wiley
Set in 10/12pt Warnock by SPi Global, Pondicherry, India
10 9 8 7 6 5 4 3 2 1
To Richard, Adam, Gudrun and Denis

vii
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
viii Contents
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