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CHAPTER 1 Re/inventing Medical Anthropology: Definitional Struggles and Key Debates (Or: Answering the Cri Du Coeur)

       Elisa J. Sobo

      INTRODUCTION

      The distinct subfield called “medical anthropology” emerged in the 1970s as the outcome of many lines of intertwined inquiry. Interest in diverse health practices and understandings goes back centuries, pre-dating anthropology’s establishment as an academic discipline. However, after World War II, a notable subset within the field began to consider health a topic worthy of focused specialization. Anglophone anthropology’s participation in post-World War II international and public health efforts fueled this impulse: Data collected in earlier times for simple descriptive purposes proved invaluable as these scholars worked to help said health programs succeed. That is, medical anthropology’s concretized emergence was driven by ethnology’s newly valuable, directly “technical” (Scotch 1963) relevance. Indeed, the first review of the nascent field, William Caudill’s “Applied Anthropology in Medicine” (1953), emphasized its practical utility.

The shorter phrase “medical anthropology” seems first to have been used by P.T. Regester (1956) and then by Khwaja Hasan and B.G. Prasad (1959), while an article by James Roney carried the phrase in its title (1959). But what did this label describe? What tensions did it encompass? Did these tensions exhibit different characteristics in different global settings?

      Building on previous historical reviews (including Anderson 2018; Browner 1997; Claudill 1953; Colson and Selby 1974; Fabrega 1971; Foster 1974; Foster and Anderson 1978; Good 1994; Hasan 1975; Lock and Nichter 2002; McElroy 1986; Polgar 1962; Scotch 1963; Sobo 2004; Todd and Ruffini 1979; Weidman 1986), I examine medical anthology’s rise as a named subfield. This process unfolded initially in the USA, where the great majority of medical anthropologists were, and still are, concentrated. However, anthropology is an international discipline: The subfield’s emergence depended on inputs from anthropologists of a variety of nationalities, as well as from related disciplines. Global variation and concerns that emerged as the subdiscipline matured also are key to the story. To foreshadow: In medical anthropology’s early days as a distinct subfield, debate centered on the applied–theoretical divide, the generalist–specialist distinction, and the contrast between physical (now “biological”) and cultural perspectives. Later developments related to the evolving definition of culture, the influence of various instantiations of critical theory, the role of extra-disciplinary interaction, and concern for social justice and for decolonizing the field.

      MEDICAL ANTHROPOLOGY TAKES SHAPE

      Application or Theory?

      When medical anthropology coalesced in the 1960s, it was as a “practice discipline” (Good 1994, p. 4) dedicated to the service of improving public health in economically poor nations. Indeed, initial effort at organizing a medical anthropology interest group in the USA – diligently fostered by Hazel Weidman – resulted in a 1968 invitation from the Society for Applied Anthropology (SfAA) to affiliate (Weidman 1986). The fledgling community, then called the Group for Medical Anthropology (GMA), accepted this invitation as a practical solution to the challenges of maintaining cohesion, but it was “something of an embarrassment” to many (Good 1994, p. 4). Even George Foster, a key founding figure, reported having to work through ambivalences: “We were trained to despise applied anthropology” (Foster 2000, quoted in Kemper 2006).

      As Scotch reported, at the time many felt that because of its practical bent “the quality of literature in [medical anthropology] is not always impressive… It is superficial, impressionistic, and nontheoretical” (1963, p. 32): wholly infra dig. Some felt that its practitioners were “less rigorous than their more traditional-minded contemporaries” (p. 33) and denigrated them as mere “technicians” (p. 42). In the UK, this stigma was worse (Kaufert and Kaufert 1978): a British Medical Anthropology Society did form in 1976, but it served mostly medical doctors (Dingwall 1980).

      Generalists or Specialists?

      Anthropologists who did consider assembling worried whether formally organizing as medical anthropologists would reinforce an “artificial area of study”; in support of this claim some pointed to “the lack of systematic growth and the failure to produce a body of theory” (Scotch 1963). Some feared that formal organizing might “prove detrimental to the development of theory in anthropology” as it would force the fragmentation of the field (Browner 1997, p. 62), a growing concern at that time.

The American Anthropological Association (AAA) was itself then in “organizational disarray,” according to the Committee on Organization, which noted that while anthropologists in general desired to “retain an integrated professional identity” the profession also faced strong “fissiparous tendencies” (Anthropology Newsletter 9[7], as cited in Weidman 1986, p. 116). Some US medical anthropologists felt, accordingly, that simply maintaining a newsletter would be better than assembling as if a faction (Weidman СКАЧАТЬ