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Anth 475 Janelle Taylor Fall 2002 Office: Denny M39


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ANTH 475 Janelle Taylor

Fall 2002 Office: Denny M39

University of Washington Phone: 543-4793

Tue & Thu 10:30 – 12:20 pm Office hours: Thu 3:30-5:00

Denny 309 jstaylor@u.washington.edu

Perspectives in Medical Anthropology

Course Syllabus

About the Course

This course is an introduction to some aspects of the field of medical anthropology. We shall focus especially on theoretical questions of how one frames “illness,” “health,” “healing” or “medicine” as an object of study.

The course is organized into three thematic sections (and one brief interlude). The first section of the course considers issues involved in interpretation, with an emphasis on illness narratives. Next comes a brief theoretical interlude, in which we consider several different scholars’ takes on where the field of medical anthropology is at, where it has come from, and where it ought to go from here. The second thematic section focuses on critical perspectives, and the connections among power, knowledge, and practice in medicine. The third and final section explores questions raised by technologies upon which so much of the practice of contemporary medicine depends, with particular attention to questions concerning the status of “the body.” Much of the course material concerns illness experience and medical practice in the United States.

My goals for students in this course are: 1) to gain a working knowledge of theoretical issues in the field of medical anthropology; 2) to practice applying this knowledge to specific topics; 3) to gain some understanding of current issues in US and world medical systems; and more generally 4) to develop analytical skills that will help us think critically about issues of health, illness, and medicine as we encounter them in our lives and in our world.



Requirements





  1. Class participation and attendance: Your classmates are a community of people with whom and from whom you will learn; collegiality is both a requirement and a primary goal of the class. You are expected to come to each class session having prepared the day's assignments in advance, and to participate actively. Repeated absences will adversely affect your grade. Be there, be prepared, be engaged, be respectful. Lately it is coming to seem necessary to say that cellphones should be turned off during class.

  2. Analytic papers: You will be asked to write two short papers, due at the beginning of class on Tuesday Oct. 22 and Tuesday Nov. 27, in response to questions which will be distributed one week in advance. These papers ask you to analyze and critically reflect upon the course readings. Evaluation: I care primarily about discovering whether you understand the materials well and have interesting things to say about them. Clarity, care, and creativity are encouraged. Your understanding and insights can best shine through, of course, only if you also attend to details of grammar, punctuation, spelling, format, and so forth. If you need help with writing, please make use of the anthropology writing center, 415 Smith Hall (wrcenter@u...) Papers must be typed, double-spaced, in 12-point font, with 1-inch margins, and stapled; include a bibliography with full citations of all works and sources that you reference in your paper, and please proofread carefully.

  3. Reflection papers: Description: The first written assignment for the course is a description of some episode of illness, diagnosis, and/or treatment, that you have either experienced, participated in, or witnessed at first hand. Bearing in mind how we will subsequently be using these descriptions, please select an episode to write about that you feel merits sustained reflection, and that you will feel comfortable sharing with others in class. Write a description, roughly 2-3 double-spaced pages in length, before you have read anything at all – just try to clearly and accurately convey the episode in question. This is due at the beginning of class on the second class meeting. Analyses: You will be asked to revisit your original description twice, taking your account as a primary text and analyzing it in light of some of the ideas, perspectives, questions, and comparative examples encountered in the course of our readings. The first analysis focuses on questions of meaning and narrative explored in the first section of the course, and is due on Tuesday Oct. 29. The second analysis focuses on questions of inequality and power, and is due on Tuesday Dec. 4. Detailed guidelines for this revision process will be distributed early on in the quarter. Evaluation: The description paper and analyses will not be graded, except to note that each was completed (and of 2.8 quality work or better). What is important is how well you demonstrate an understanding of concepts, questions, and approaches from the course readings, and how creatively and carefully you use them to think through the descriptive account that you have provided.

Policies: Writing assignments are due when they are due. If truly extraordinary circumstances make it impossible for you to meet a deadline, talk to me beforehand. Otherwise, assignments handed in late will be graded down accordingly, in fairness to students who have met the deadline. All written work must be completed in order to receive a passing grade for the course.
Grading: The two analytic paper assignments will count for 65% of your grade for the course; 35% of your grade will come from completion of the reflection paper assignments and participation in class, including completion of any writing exercises that may be assigned in class. Please note that incompletes will be given only in accordance with UW policy as set forth in the catalogue.
Texts: A course packet of photocopied articles containing all required readings has been prepared specifically for this class, and is available for purchase at RAMS on University Ave. In addition, a number of books from which some course readings are excerpted have been placed on order at the University Bookstore; these are not required, but simply made available for those who might wish to pursue in greater depth some of the topics explored in class.
Class Schedule and Assignments



Week 1 Introductions


10/1 Introduction (no readings assigned)

10/3 Stacy Leigh Pigg, “The Credible and the Credulous”


Reflection Paper Descriptive Account due


PART I: MAKING CULTURAL SENSE OF ILLNESS: POWERS OF NARRATIVE


Week 2 Imposing Narrative Order on Disordered Experience

10/8 Arthur Kleinman, “The Vulnerability of Pain and the Pain of Vulnerability”

Byron Good, “The Heart of What’s the Matter”

10/10 Laurence Kirmayer, “The Body’s Insistence on Meaning”

Gay Becker, “Order and Chaos”

Week 3 Struggling with Narratives in Medical Practice


10/15 Linda Layne, “ ‘How’s the Baby Doing?’”

Allan Young, “The Technology of Diagnosis”

Rayna Rapp, “Refusing Prenatal Diagnosis”

10/17 Instructor attending conference



Film: “Breathing Lessons,” on reserve at Odegaard

Week 4 Narratives in -- and of -- Medical Science

10/22 Emily Martin, “The Woman in the Flexible Body”
Deborah Heath, “Locating Genetic Knowledge”

First Analytic Paper due


10/24 Niranjan Karnik, “Locating HIV/AIDS in India”

Sharon Traweek, “Warning Signs”


INTERLUDE: THEORETICAL OVERVIEWS

Week 5 Staking Out the Field of Medical Anthropology


10/29 Lorna Rhodes, “Studying Biomedicine as a Cultural System”

Noel Chrisman and Thomas Johnson “Clinically Applied Anthropology”



First Reflection Paper due (~4 pages)

10/31 Nancy Scheper-Hughes and Margaret Lock, “The Mindful Body”


PART II: REFOCUSING UPSTREAM: POWER, KNOWLEDGE, AND PRACTICE


Week 6 Power/Knowledge I: The Second Sickness


11/5 Nancy Scheper-Hughes, “Nervoso: Medicine, Sickness, and Human Needs”

11/7 Michael Taussig, “Reification and the Consciousness of the Patient”

Diana Forsythe, “New Bottles, Old Wine”

Week 7 Power/Knowledge II: Biopower


11/12 Michel Foucault, “The Examination” and “Lecture One”

11/14 Lorna Rhodes, “The Game of Hot Shit”

Deborah Lupton, “Bodies, Pleasures and the Practices of the Self”

Week 8 The “Subject” of Anatomy

11/19 Frederic Hafferty, “Anatomy Lab”
Kaplan “First Cut”

Byron Good, “How Medicine Constructs Its Objects”

11/21 Instructor attending conference



Film: “Blue End”
PART III: TECHNOLOGIES IN MEDICINE, THE BODY IN QUESTION
Week 9 Medical Images, Cultural Visions

11/26 Joseph Dumit, “A Digital Image of the Category of the Person”

Anne Balsamo, “On the Cutting Edge”

Second Analytic Paper due

11/28 Thanksgiving break




Week 10 Unresolved Endings


12/3 Thomas Csordas, “Computerized Cadavers”

Robert Nelson, “The Ventilator/Baby as Cyborg”



Second Reflection Paper due (~4 pages)

12/5 Margaret Lock, “Japan and the Brain-Death ‘Problem’”

Lesley Sharp, “Commodified Kin”


Week 11 Not-Necessarily-Conclusive Conclusion


12/10 Final discussion (where everything magically comes together – maybe)

ANTH 475 “Perspectives in Medical Anthropology”



Course Reader Contents & Bibliographic Information
Stacy Leigh Pigg, “The Credible and the Credulous: The Question of ‘Villagers’ Beliefs’ in Nepal” Cultural Anthropology 11(2):160-201, 1996.
Arthur Kleinman, “The Vulnerability of Pain and the Pain of Vulnerability,” The Illness Narratives: Suffering, Healing, and the Human Condition (New York: Basic Books, 1988).
Byron Good, “The Heart of What’s the Matter: The Semantics of Illness in Iran,” Culture, Medicine, and Psychiatry 1:25-28, 1977.
Laurence J. Kirmayer, “The Body’s Insistence on Meaning: Metaphor as Presentation and Representation in Illness Experience,” Medical Anthropology Quarterly 6(4):323-346, 1992.
Gay Becker, “Order and Chaos,” Disrupted Lives: How People Create Meaning in a Chaotic World (Berkeley: University of California Press, 1997).
“ ‘How’s the Baby Doing?’: Struggling with Narratives of Progress in a Neonatal Intensive Care Unit,” Medical Anthropology Quarterly 10(4):624-656, 1996.
Allan Young, “The Technology of Diagnosis,” The Harmony of Illusions: Inventing Post-Traumatic Stress Disorder (Princeton: Princeton University Press, 1995).
Rayna Rapp, “Refusing Prenatal Diagnosis: The Meanings of Bioscience in a Multicultural World,” Science, Technology & Human Values 23(1):45-70, 1998.
Emily Martin, “The Woman in the Flexible Body,” in Adele E. Clarke and Virginia L. Olesen, eds., Revisioning Women, Health and Healing: Feminist, Cultural, and Technoscience Perspectives (New York: Routledge, 1999).
Deborah Heath, “Locating Genetic Knowledge: Picturing Marfan Syndrome and Its Traveling Constituencies,” Science, Technology & Human Values 23(1):71-97, 1998.
Niranjan S. Karnik, “Locating HIV/AIDS in India: Cautionary Notes on the Globalization of Categories,” Science, Technology & Human Values 26(3):322-348, 2001.
Sharon Traweek, “Warning Signs: Acting on Images,” in Adele E. Clarke and Virginia L. Olesen, eds., Revisioning Women, Health and Healing: Feminist, Cultural, and Technoscience Perspectives (New York: Routledge, 1999)
Lorna A. Rhodes, “Studying Biomedicine as a Cultural System,” in Thomas Johnson and Carolyn Sargent, eds., Medical Anthropology: Handbook of Theory and Method (New York: Greenwood Press, 1990).
Noel Chrisman and Thomas Johnson, “Clinically Applied Anthropology,” in Thomas Johnson and Carolyn Sargent, eds., Medical Anthropology: Handbook of Theory and Method (New York: Greenwood Press, 1990).
Nancy Scheper-Hughes and Margaret Lock, “The Mindful Body: A Prolegomenon to Future Work in Medical Anthropology,” in Peter Brown, ed., Understanding and Applying Medical Anthropology (Mountain View: Mayfield Publishing Company, 1998).
Nancy Scheper-Hughes, “Nervoso: Medicine, Sickness, and Human Needs,” Death Without Weeping: The Violence of Everyday Life in Brazil (Berkeley: University of California Press, 1992).
Michael Taussig, “Reification and the Consciousness of the Patient,” The Nervous System (New York: Routledge, 1992).
Diana E. Forsythe, “New Bottles, Old Wine: Hidden Cultural Assumptions in a Computerized Explanation System for Migraine Sufferers,” Medical Anthropology Quarterly 10(4):551-574, 1996.
Michel Foucault, “The Examination,” Discipline and Punish: The Birth of the Prison (New York: Vintage, 1979).
Michel Foucault, “Lecture One,” Power/Knowledge: Selected Interviews and Other Writings, 1972-1977 (New York: Pantheon, 1980).
Lorna A. Rhodes, “The Game of Hot Shit,” Emptying Beds: The Work of an Emergency Psychiatric Unit (Berkeley: University of California Press, 1990).
Deborah Lupton, “Bodies, Pleasures, and the Practices of the Self,” The Imperative of Health: Public Health and the Regulated Body (London: Sage Publications, 1995).
Frederic Hafferty, “Anatomy Lab,” Into the Valley: Death and the Socialization of Medical Students (New Haven: Yale University Press, 1991).
Jonathan Kaplan, “First Cut: Learning to Be a Surgeon Under Apartheid.” Granta 68 (Winter 1999).
Byron Good, “How Medicine Constructs Its Objects,” Medicine, Rationality, and Experience: An Anthropological Perspective (Cambridge: Cambridge University Press, 1994).
Joseph Dumit, “A Digital Image of the Category of the Person: PET Scanning and Objective Self-Fashioning,” in Gary Lee Downey and Joseph Dumit, eds., Cyborgs & Citadels: Anthropological Interventions in Emerging Sciences and Technologies (Albuquerque: SAR Press, 1997).
Anne Balsamo, “On the Cutting Edge: Cosmetic Surgery and New Imaging Technologies,” Technologies of the Gendered Body: Reading Cyborg Women (Durham: Duke University Press, 1996).
Thomas J. Csordas, “Computerized Cadavers: Shades of Being and Representation in Virtual Reality,” in Paul Brodwin, ed., Biotechnology and Culture: Bodies, Anxieties, Ethics (Bloomington: Indiana University Press, 2000).
Robert M. Nelson, “The Ventilator/Baby as Cyborg: A Case Study in Technology and Medical Ethics,” in Paul Brodwin, ed., Biotechnology and Culture: Bodies, Anxieties, Ethics (Bloomington: Indiana University Press, 2000).
Margaret Lock, “Japan and the Brain-Death Problem,” Twice Dead: Organ Transplants and the Reinvention of Death (California: University of California Press, 2001).
Lesley A. Sharp, “Commodified Kin: Death, Mourning, and Competing Claims on the Bodies of Organ Donors in the United States,” American Anthropologist 103(1):112-133, 2001.





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