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Basic Concepts of Medical Anthropology

Basic Concepts of Medical Anthropology. Sjaak van der Geest Medical Anthropology University of Amsterdam. Overview lecture. Anthropological perspective Anthropology of illness and of healthcare Three sectors of health care Disease vs illness Cult. anthrop. vs medical anthropology

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Basic Concepts of Medical Anthropology

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  1. Basic Concepts of Medical Anthropology Sjaak van der Geest Medical Anthropology University of Amsterdam

  2. Overview lecture • Anthropological perspective • Anthropology of illness and of healthcare • Three sectors of health care • Disease vs illness • Cult. anthrop. vs medical anthropology • Explanatory model • Two ‘types’ of explanations • Therapy management group • Anthropology of / in medicine

  3. Anthropological perspective on medical issues • Context • Interpretation • Emic /etic • Respect • Comparative • Participant observation • Conversation • Introspection

  4. Rational Objectifying Etic Measuring (quant.) Individual-oriented Explanatory “Laws” Associative Subjectifying Emic (and etic) Descriptive (qualit.) Contextualising Interpretive Unpredictable medical vs anthropological

  5. Anthropology of health/illness and of healthcare

  6. Anthropology of health / illness Origin = socio/cultural Expression = socio/cultural Label = socio/cultural Explanation = socio/cultural Experience = socio/cultural Illness = socio/cultural

  7. PREVENTION Ideas practices CURATIVE Ideas / etiology Practices Medical pluralism Therapy choice Practitioners Practitioner-patient relationship Anthropology of health care

  8. Three sectors of health care

  9. Outsider Objective Ahistorical Universal Science “True” “Rational” Insider Subjective Historical Cultural Lay knowledge “Untrue” “Irrational” DISEASE VS ILLNESS

  10. Healthy body Body as instrument Body: being in the world Locus of production of meaning Body as subject Ally in times of peace Sick body Body as enemy Body: rupture with the world Locus of crisis, chaos, danger, suffering Body as object Weapon of resistance Cultural anthropology - Medical anthropology

  11. Explanatory model • 1. etiology (why? because of what?) • 2. onset of symptoms • 3. pathofysiology • 4. course of sickness • Treatment (whatto do?) (Kleinman 1980:105; Helman 2000:85-86)

  12. Personalistic explanation: Illness is attributed to the work of a person or conscious agent; someone is blamed (examples) Naturalistic explanation: Illness is not attributed to a person or conscious agent: it just happens, like a natural phenomenon (examples) Illness explanations

  13. Illness explanations are not just cultural; they can also have a (hidden) social or political meaning • Personalistic ….. • Naturalistic …..

  14. Personalistic explanation • Is it satisfactory? • When? • For whom? • Does it provide a starting point for action?

  15. Naturalistic explanation • Is it satisfactory? • When? • For whom? • Does it provide a starting point for action?

  16. Illness explanations express social and other interests of those who produce them(personalistic or naturalistic) • Patient: • Environment: • Doctor: • Anthropologist:

  17. Personalistic and naturalistic: • Personalistic is not a more “primitive” view of illness causes than naturalistic. • Personalistic is not more “cultural” and less “scientific” than naturalistic. • Personalistic and naturalistic views do not exclude one another: they often occur together.

  18. Therapy management group

  19. Anthropology of / in medicine • Anthropology of medicine: outside perspective / theoretical / critical… • Anthropology in medicine: ‘embedded’, applied, ‘useful’… • Cannot be separated however

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