This text explores the border between medical and social problems, the boundary between health and social change. The book studies the body as the mediator between individual and collective experience, finding that many health problems, for example the trauma of violence or depression in the course of chronic pain, are less individual medical problems than interpersonal experiences of social suffering. It argues for an ethnographic approach to moral practice in medicine, one that embraces the infrapolitical context of illness, responses to (...) it, the social institutions relating to it and the way it is configured in medical ethics. (shrink)

Through arresting narratives we meet a woman aiding refugees in sub-Saharan Africa, facing the chaos of a meaningless society and a doctor trying to stay alive during Mao's cultural revolution - individuals challenged by their societies and in existential moral experiences that define what it means to be human.

This innovative volume is an extended intellectual conversation about the ways personal lives are being undone and remade today. Examining the ethnography of the modern subject, this preeminent group of scholars probes the continuity and diversity of modes of personhood across a range of Western and non-Western societies. Contributors consider what happens to individual subjectivity when stable or imagined environments such as nations and communities are transformed or displaced by free trade economics, terrorism, and war; how new information and medical (...) technologies reshape the relation one has to oneself; and which forms of subjectivity and life possibilities are produced against a world in pieces. The transdisciplinary conversation includes anthropologists, historians of science, psychologists, a literary critic, a philosopher, physicians, and an economist. The authors touch on how we think and write about contingency, human agency, and ethics today. (shrink)

Trust is indispensable not only for interpersonal relationships and social life, but for good quality healthcare. As manifested in the increasing violence and tension in patient-physician relationships, China has been experiencing a widespread and profound crisis of patient–physician trust. And globally, the crisis of trust is an issue that every society, either developing or developed, has to face in one way or another. Yet, in spite of some pioneering works, the subject of patient-physician trust and mistrust – a crucial matter (...) in healthcare especially because there are numerous ethical implications – has largely been marginalized in bioethics as a global discourse. Drawing lessons as well as inspirations from China, this paper demonstrates the necessity of a trust-oriented bioethics and presents some key theoretical, methodological and philosophical elements of such a bioethics. A trust-oriented bioethics moves beyond the current dominant bioethical paradigms through putting the subject of trust and mistrust in the central agenda of the field, learning from the social sciences, and reviving indigenous moral resources. In order for global bioethics to claim its relevance to the things that truly matter in social life and healthcare, trust should be as vital as such central norms like autonomy and justice and can serve as a potent theoretical framework. (shrink)

To investigate the phenomenon of patient–physician mistrust in China, a qualitative study involving 107 physicians, nurses and health officials in Guangdong Province, southern China, was conducted through semi-structured interviews and focus groups. In this paper we report the key findings of the empirical study and argue for the essential role of medical professionalism in rebuilding patient-physician trust. Health professionals are trapped in a vicious circle of mistrust. Mistrust leads to increased levels of fear and self-protection by doctors which exacerbate difficulties (...) in communication; in turn, this increases physician workloads, adding to a strong sense of injustice and victimization. These factors produce poorer healthcare outcomes and increasingly discontented and angry patients, escalate conflicts and disputes, and result in negative media coverage, all these ultimately contributing to even greater levels of mistrust. The vicious circle indicates not only the crisis of patient-physician relationship but the crisis of medicine as a profession and institution. Underlying the circle is the inherent conflict of interest in the healthcare system by which health professionals and hospitals have become profit-driven. This institutional conflict of interest seriously compromises the fundamental principle of medical professionalism—the primacy of patient welfare—as well as the traditional Chinese ideal of “medicine as the art of humanity”. Patient trust can be restored through rectifying this institutional conflict of interest and promoting medical professionalism via a series of recommended practical measures. (shrink)

Modern socio?cultural studies of medicine demonstrate the symbolic character of much of medical reality. This symbolic reality can be appreciated as mediating the traditional division of medicine into biophysical and human sciences. Comparative studies of medical systems offer a general model for medicine as a human science. These studies document that medicine, from an historical and cross?cultural perspective, is constituted as a cultural system in which symbolic meanings take an active part in disease formation, the classification and cognitive management of (...) illness, and in therapy. Medicine's symbolic reality also forms a bridge between cultural and psychophysiological phenomena; the basis for psychosomatic and socioso?matic pathology and therapy. This in turn becomes a central problem for medical theory and for a philosophical reinvestigation of medicine. (shrink)

The guiding inspiration of this book is the attraction and distance that mark the relation between anthropology and philosophy. This theme is explored through encounters between individual anthropologists and particular regions of philosophy. Several of the most basic concepts of the discipline—including notions of ethics, politics, temporality, self and other, and the nature of human life—are products of a dialogue, both implicit and explicit, between anthropology and philosophy. These philosophical undercurrents in anthropology also speak to the question of what it (...) is to experience our being in a world marked by radical difference and otherness. In The Ground Between, twelve leading anthropologists offer intimate reflections on the influence of particular philosophers on their way of seeing the world, and on what ethnography has taught them about philosophy. Ethnographies of the mundane and the everyday raise fundamental issues that the contributors grapple with in both their lives and their thinking. With directness and honesty, they relate particular philosophers to matters such as how to respond to the suffering of the other, how concepts arise in the give and take of everyday life, and how to be attuned to the world through the senses. Their essays challenge the idea that philosophy is solely the province of professional philosophers, and suggest that certain modalities of being in the world might be construed as ways of doing philosophy. Contributors. João Biehl, Steven C. Caton, Vincent Crapanzano, Veena Das, Didier Fassin, Michael M. J. Fischer, Ghassan Hage, Clara Han, Michael Jackson, Arthur Kleinman, Michael Puett, Bhrigupati Singh. (shrink)

Thomas Ogden, writing as a practicing psychoanalyst for other practicing analysts, distinguishes between epistemological psychoanalysis and ontological psychoanalysis, while recognizing that the two approaches often overlap. Epistemological psychoanalysis has to do with assisting patients with the interpretation of significant meanings in their psyches, which in turn has an effect on their symptoms, other problems they may be facing, and their understanding of their own lives. Ontological psychoanalysis is about helping individuals transform themselves so that they are, whatever meanings they may (...) eke out, more present to themselves and to others: a change in being and becoming. Ogden associates... (shrink)