The authors present the relevance of the anthropological study of biomedicine. To do so, they describe some characteristics of biomedicine without going into much detail. What interests them is the anthropological analysis of biomedicine. They give several reasons to consider biomedicine as ethnomedicine and give some characteristics of biomedicine. They show that biomedicine has a very defined anthropological content, such as the division of labor as seen in medical specialties, the rules of practice, different roles, and means of socialization, to name a few. Among their conclusions, they insist that biomedicine is more than a pseudoscience than we can imagine.
“The central concern of Biomedicine is not general well-being, nor individual persons, nor simply their bodies, but their bodies in disease” (p. 312).
Overview
I would say that this is an article where the authors want to express their opinion on a particular topic and use the structure of a review to do so. This means that they justify each of their thoughts with background literature. This is one way of doing reviews, and I find it interesting. I have done it myself. I think there are some advantages, for example: you know what the authors think about a certain topic. Even if they quote or refer to previous publications, reading the article is a way of getting to know the author’s thinking. Another good thing is that in a very short article you can find an incredible amount of research, they referenced 197 articles, which I think is a lot. Another advantage is that the text is fluent and not difficult to read. It could be that these authors had the ability to write a good article, but I also think that this type of review is easy to read because you are following the authors’ thoughts and not just a summary of a review of 197 articles.
The main possible disadvantage is that the selection of articles is arbitrary, depending on what the authors want to say. They can talk about contrary opinions, that they could even choose the articles from the opposite argument as they wish. So, in that sense it is not a systematic review. But their aim was not to write a systematic review, and the reader has to be aware of that. Another disadvantage is that the reader can get lost in a sea of articles without having a clear idea of how the authors plan to proceed.
Structure
As mentioned before, in this kind of review you can understand what the authors think about a particular topic, but also how they organize their ideas. And I think this is a very well-structured article. They made a short introduction explaining what biomedicine is and immediately they described the importance of an anthropological analysis of biomedicine. In this analysis they covered several topics that were separated by subtitles. When they characterized biomedicine, they did it in two different ways, with their respective subtitles, and they always use numbers or letters to separate ideas or thoughts. So, I think in that sense the article is well structured. The conclusion is not so clear, but I think it was enough to understand her final thoughts on the subject. The lack of an abstract is something I really miss. This is an old article, from 1983, so abstracts were not very popular back then.
The authors’ approach
It was evident from the very beginning of the article that the authors did not want to go deep in the discussion of the misconceptions of biomedicine, something that I want to deal with in my final paper for our course. What they wanted to do is to show that anthropology has a lot to say about biomedicine and that biomedicine is more than just a technical discipline without any or just a little human component. It was clear that they wanted to be explicit about the value of medical anthropology and how the disciplines could be nurtured together.
Reviewers’ position
I think that the reviewers have a reconciling point of view. They mentioned the drawbacks of biomedicine and possible misconceptions or misunderstandings, but I did not have the feeling of rejecting biomedicine. The authors smoothly presented their point of view with abundant support of literature. It is evident that they have to choose a position and they strongly defend the role of anthropology and the value of an anthropological analysis. They mentioned several times some philosophical theories, such as Marxism or finalism. They could have mentioned others, but that was their position.
Strengths
The article shows the position of the authors. This position is very well documented. Their thoughts are recognizable. They added literal quotes when they found necessary and appropriate. They covered a topic that it is of great importance even today. They wrote their article with a critique position but not with criticism. They promoted the value of anthropology without making from the article an ode of anthropology.
“We propose that the development of anthropological ways of thought in Biomedical settings will enhance the science of Biomedicine and anthropology at the same time as it fosters a common humanity” (p. 327)
Reference
Hahn, R. A., & Kleinman, A. (1983). Biomedical Practice and Anthropological Theory: Frameworks and Directions. Annual review of anthropology., 12(1), 305-333. https://doi.org/10.1146/annurev.an.12.100183.001513
2 Replies to “Biomedicine and Anthropology”
Carlos –
Things are clearer in my mind … Western / scientific medicine is well served by the definition in this review; it is concerned with a body in disease. Disease is a defined pathology, but its locus is solely the human body. Medicine looks at the cells, or the tissues, or the organs, but does so within the scope of the body.
Traditional medicine is concerned with the interactions with dis-ease. That is a purposeful break. A human is optimally “at ease” with the world, tuned and ready to interact with the mortal and non-mortal parts of the world around them. When they are not at ease, dis-ease, then there is something wrong. Not necessarily a medical condition. It could be a feeling, a sense … anything that interacts with full and complete communication with the world around them.
Disease vs. dis-ease.
“easy to read because you are following the authors’ thoughts and not just a summary of a review of 197 articles”
I think this is such a great insight. The more readable the article is, the more it will be used by others to situate their work. However, if one includes a bunch (197 articles!) that support the opinions one has, and does not include literature which refutes the opinions, it is still unclear where these opinions are situated in anthropological evaluation of biomedicine. Of course, there is no obligation to tell the whole story (if indeed there is more to the story), but is there not some kind of *fallacy* that is enacted when you gravitate towards evidence of what you think to be true? hmm
Carlos –
Things are clearer in my mind … Western / scientific medicine is well served by the definition in this review; it is concerned with a body in disease. Disease is a defined pathology, but its locus is solely the human body. Medicine looks at the cells, or the tissues, or the organs, but does so within the scope of the body.
Traditional medicine is concerned with the interactions with dis-ease. That is a purposeful break. A human is optimally “at ease” with the world, tuned and ready to interact with the mortal and non-mortal parts of the world around them. When they are not at ease, dis-ease, then there is something wrong. Not necessarily a medical condition. It could be a feeling, a sense … anything that interacts with full and complete communication with the world around them.
Disease vs. dis-ease.
“easy to read because you are following the authors’ thoughts and not just a summary of a review of 197 articles”
I think this is such a great insight. The more readable the article is, the more it will be used by others to situate their work. However, if one includes a bunch (197 articles!) that support the opinions one has, and does not include literature which refutes the opinions, it is still unclear where these opinions are situated in anthropological evaluation of biomedicine. Of course, there is no obligation to tell the whole story (if indeed there is more to the story), but is there not some kind of *fallacy* that is enacted when you gravitate towards evidence of what you think to be true? hmm