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Anthropology 295: Medical Anthropology

(Spring 2001)

Professor: Jeanne Shea, Ph.D, 515 Williams Hall, (802) 656-3181

Class meetings: MWF 1:25-2:25, Williams Hall, Room 403

Prof. office hours: Mon. 10:00-10:30 am, 2:15-2:45 pm.

Wed. 10:00-10:30 am, 2:15-2:45 pm.

Fri. 10:00-10:30 am.

Prof. email: jlshea@zoo.uvm.edu

Teaching assistant: Sarai Schulz

Course website: http://webct.uvm.edu:8900

Prerequisites: Anthropology 21 and one 100-level course in Anthropology

Course Description:

This advanced seminar applies social and cultural perspectives to the exploration of health and illness experiences, doctor-patient interactions, healing traditions and therapeutic practices, and the political economy of health and health care. Central issues explored include the influence of culture on people’s views and experiences of health and illness, how sociocultural factors involved in doctor-patient interactions can affect treatment efficacy and client satisfaction, the cultural assumptions underlying various healing traditions and therapeutic practices, and the ways in which politics and economics can affect people’s access to health and health care.

This course will provide an opportunity for students to read, analyze, discuss, and write about an extensive selection of scholarly literature in medical anthropology. In the spirit of an advanced seminar, class meetings will center primarily around interactive class discussion, and course work will involve not only mastery of assigned readings and in-class material, but also the completion of independent reading and research connected with each student’s semester project.

This semester, readings, lecture material, and class discussions in this course will focus on Asian conceptions of health and Asian healing practices across the world and on health, healing, and health care in Asian societies. In the spirit of cross-cultural comparison, however, professor and students alike will be free to draw into class discussion examples from non-Asian societies and healing traditions. In addition, students are encouraged to conduct their semester projects on sociocultural aspects of health, healing, and/or health care in any society or culture, Asian or non-Asian, in which they have an interest.

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Anthropology 295: Medical Anthropology Professor Shea, Spring 2001

Introduction to the course:

Wed. Jan. 17 Introduction: Medical Anthropology: A Focus on Asian Health and Healing

Experiences of Health and Illness:

Fri. Jan. 19 Experiences of Health and Illness: Introduction

Readings due: Strathern, ch. 1: Introduction. Leslie, ch. 1: Introduction

[Interdisciplinary Health Colloquium today]

Mon. Jan. 22 Experiences of Health and Illness: Health Across the Lifecycle

Readings due: Lock, Encounters with Aging, xiv-77

Wed. Jan. 24 Gender, the Lifecycle, and Health: Discourse and Experience in Japan

Readings due: Lock, Encounters with Aging, 78-106

Fri. Jan. 26 Gender, the Lifecycle, and Health: Discourse and Experience in Japan

Readings due: Lock, Encounters with Aging, 107-170

*** Essay #1 due

Mon. Jan. 29 Gender, the Lifecycle, and Health: Comparisons with the US and Canada

Readings due: Lock, Encounters with Aging, 171-255

Wed. Jan. 31 Gender, the Lifecycle, and Health: Comparisons with China

Readings due: Lock, Encounters with Aging, 256-300

Fri. Feb. 2 Experiences of Health and Illness: Science, Culture, and Experience

Readings due: Lock, Encounters with Aging, 301-387

Doctor-Patient Interactions:

Mon. Feb. 5 Doctor-Patient Interactions: Belief, Trust, and Authority

Readings due: Strathern, ch. 12: Communication: Doctors and Patients

Wed. Feb. 7 Doctor-Patient Interactions: Hmong Patient, Biomedical Doctor

Readings due: Fadiman, The Spirit Catches You, vii-37

Fri. Feb. 9 Doctor-Patient Interactions: The Issue of Compliance

Readings due: Fadiman, The Spirit Catches You, 38-77

*** Essay #2 due

[Interdisciplinary Health Colloquium today]

Mon. Feb. 12 Doctor-Patient Interactions: The Placebo and Nocebo Effects

Readings due: Fadiman, The Spirit Catches You, 78-118

Wed. Feb. 14 Doctor-Patient Interactions: The Quest for “Culturally Competent” Care

Readings due: Fadiman, The Spirit Catches You, 119-170

Fri. Feb. 16 Doctor-Patient Interactions: The Culture of Biomedicine

Readings due: Fadiman, The Spirit Catches You, 171-224

Mon. Feb. 19 (UVM holiday - no classes)

Wed. Feb. 21 Doctor-Patient Interactions: Medically-Induced Health Problems

Readings due: Fadiman, The Spirit Catches You, 225-288

Alternative Healing Traditions:

Fri. Feb. 23 Biomedicine vs. Alternative Healing Traditions

Readings due: Strathern, ch. 2: Regimens of Treatment

*** Essay #3 due

Mon. Feb. 26 Humoral Systems in Papua New Guinea

Readings due: Strathern, ch. 3, 4, 5

Wed. Feb. 28 Ayurvedic Medicine

Readings due:

Trawick in Leslie, Death and Nurturance in Indian Systems of Healing

Obeyesekere in Leslie, Science, Experimentation, Clinical Practice in Ayurveda

Zimmerman in Leslie, The Flower Power of Ayurveda

Fri. Mar. 2 Islamic Humoral Medical Traditions

Readings due:

Good in Leslie, Greco-Islamic Medicine

Laderman in Leslie, Islamic Humoralism

Mon. Mar. 5 Traditional Chinese Medicine: Relation to Chinese Folk Beliefs and Customs

Readings due: Zhang, Who Can Ride the Dragon? pp. xii-78

Wed. Mar. 7 Traditional Chinese Medicine: Ties to Chinese Philosophy, Religion, Literature

Readings due: Zhang, Who Can Ride the Dragon? pp. 79-136

Fri. Mar. 9 Traditional Chinese Medicine: Relation to the Chinese Scientific Tradition

Readings due: Zhang, Who Can Ride the Dragon? pp. 137-168

*** Essay #4 due

Mon. Mar. 12 Traditional Chinese Medicine: Sexual Practices, Health, and Longevity

Readings due: Zhang, Who Can Ride the Dragon? pp. 169-194, 195-256

Wed. Mar. 14 Traditional Chinese Medicine: Pragmatics of Practice in the Clinic and in Society

Readings due:

Farquhar in Leslie, Approaching Chinese Medicine Practice ... a Published Case

Unschuld in Leslie, Traditional Chinese Medicine in the Twentieth Century

[Interdisciplinary Health Colloquium today]

Fri. Mar. 16 Combinations of Healing Traditions: Medical Syncretism, Medical Pluralism

Readings due:

Strathern, ch. 6: Medical Pluralism among the Huli

Leslie in Leslie, Syncretism in Modern Ayurveda

March 19-23 (UVM holiday - no classes)

Political Economy of Health and Health care:

Mon. Mar. 26 Political Economy of Health and Health Care: Critical Medical Anthropology

Readings due:

Strathern, ch. 13: Critical Medical Anthropology

Farmer in Kim, Foreword

Millen in Kim, ch. 1: Introduction: What is Growing? Who is Dying?

Wed. Mar. 28 Political Economy of Health and Health Care: The Global Economy

Readings due: Gershman in Kim, ch. 2: Getting a Grip on the Global Economy

Fri. Mar. 30 Political Economy of Health and Health Care: Development Discourse and Health

Readings due:

Shakow in Kim, ch. 3: Decoding Development Discourse

Farmer in Kim, ch. 4: Hypocrisies of Development and Health of the Haitian Poor

*** Rough drafts of paper and presentation on semester project due

Mon. Apr. 2 Political Economy of Health and Health Care: Corporate Power and Health

Readings due:

Millen in Kim, ch. 8: Transnational Corporations and the Health of the Poor

Millen in Kim, ch. 9, Political Influence of National, Transnational Corporations

Wed. Apr. 4 Political Economy of Health and Health Care: 1984 Bhopal Gas Disaster in India

Readings due: Holtz in Kim, ch. 10: The 1984 Bhopal Gas Disaster

Fri. Apr. 6 Political Economy of Health and Health Care: Health Care System in Russia

Readings due:

Field in Kim, ch. 7, Neolib. Econ. Policy, “State Desert.,” Russian Health Crisis

Mon. Apr. 9 Political Economy of Health and Health Care: Health Care System in China

Readings due: World Bank, Financing Health Care in China

Wed. Apr. 11 Political Economy of Health and Health Care: Health Care System in China

Readings due: World Bank, Financing Health Care in China

Fri. Apr. 13 Political Economy of Health and Health Care: Strategies for Action

Readings due:

Millen in Kim, ch. 15: Pessimism of the Intellect, Optimism of the Will

Patel in Kim, ch. 16: Pragmatic Solidarity

*** Essay #5 due

[Interdisciplinary Health Colloquium today]

Oral Presentations of Semester Projects:

Mon. Apr. 16 ** Presentations on semester projects **

Wed. Apr. 18 ** Presentations on semester projects **

Fri. Apr. 20 (UVM holiday -no classes)

April 21-22 [Symposium on Asian Health and Healing: Saturday and Sunday, 9 am - 5 pm]

Mon. Apr. 23 ** Presentations on semester projects **

Wed. Apr. 25 ** Presentations on semester projects **

Fri. Apr. 27 ** Presentations on semester projects **

Mon. Apr. 30 ** Presentations on semester projects **

Conclusion of the Course:

Wed. May 2 Final remarks (and course evaluation)

Tues. May 8, *** Term papers on semester project due

12:00 noon, 515 Williams Hall (slide under door)

May 11 [Interdisciplinary Health Colloquium today]

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Anthropology 295: Medical Anthropology Professor Shea, Spring 2001

UVM Special Events Related to Medical Anthropology

Friday, January 19, 12:15-1:15

Interdisciplinary Health Colloquium

Laura Solomon, Research on Smoking and Health

Old Mill, 3^rd floor: John Dewey Lounge

Friday, February 9, 12:15-1:15

Interdisciplinary Health Colloquium

Beth Mintz, The Role of Capital in Health Care

Old Mill, 3^rd floor: John Dewey Lounge

Friday, March 9, 12:15-1:15

Interdisciplinary Health Colloquium

Richard White, Cultural Diversity and Patient Care

Old Mill, 3^rd floor: John Dewey Lounge

Friday, April 13, 12:15-1:15

Interdisciplinary Health Colloquium

Jeanne Shea, Careseeking of Montreal Chinese

Old Mill, 3^rd floor: John Dewey Lounge

Saturday, April 21 and Sunday, April 22, 9 am - 5 pm

Symposium on Asian Health and Healing

Talks by researchers and practitioners on Asian conceptions of health and

forms of healing across the world, and on health, healing, and health care in Asia

Rowell Hall, UVM

Friday, May 11, 12:15-1:15

Interdisciplinary Health Colloquium

Nana Owusudarkwa, Drug Dependency in Ghana

Old Mill, 3^rd floor: John Dewey Lounge

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Anthropology 295: Medical Anthropology Professor Shea, Spring 2001

Required Coursework:

Assigned readings (in UVM bookstore):

1. Strathern/Stewart, Curing and Healing.

2. Leslie/Young, Paths to Asian Medical Knowledge.

3. Zhang/Rose, Who Can Ride the Dragon? Cultural Roots of Traditional Chinese Medicine.

4. Fadiman, The Spirit Catches You and You Fall Down.

5. Lock, Encounters With Aging: Mythologies of Menopause in Japan and North America.

6. Kim/Millen/Irwin/Gershman,Dying For Growth:Global Inequality and the Health of the Poor.

7. World Bank, Issues and Options for China: Financing Health Care.

8. Course website: http://webct.uvm.edu:8900 (check and participate regularly)

Class participation: 20%

Completion of all required readings before class.

Attendance and prompt arrival at all class meetings (MWF 1:25-2:15).

Active oral participation in class discussions with informed analysis and specific examples.

Listening to and acknowledging each other’s points of view.

Encouraging others to participate by drawing them into the discussion.

Thoughtful, diplomatic responses to differences of opinion.

Complete, on-time delivery of rough drafts of semester project presentation and paper.

Extra credit for participation in UVM special events related to medical anthropology.

Analytical essays on course readings, lectures, films, and discussions: 50%

Essay #1 4-5 pages, DS, 12 pt., 1-in. margins due Fri. Jan. 26, 1:25 pm (10%)

Essay #2 4-5 pages, DS, 12 pt., 1-in. margins due Fri. Feb. 9, 1:25 pm (10%)

Essay #3 4-5 pages, DS, 12 pt., 1-in. margins due Fri. Feb. 23, 1:25 pm (10%)

Essay #4 4-5 pages, DS, 12 pt., 1-in. margins due Fri. Mar. 9, 1:25 pm (10%)

Essay #5 4-5 pages, DS, 12 pt., 1-in. margins due Fri. Apr. 13, 1:25 pm (10%)

Guidelines for the evaluation of essays to be distributed in class

Presentation on semester project: 10%

One 10-minute in-class oral presentation on semester project

Rough draft due Fri. Mar. 30, 1:25 pm

In-class presentation on April 16, 18, 23, 25, 27, or 30 as scheduled by lottery

Guidelines for the evaluation of presentations to be distributed in class

Term paper on semester project: 20%

15-20 pages, DS, 12 pt., 1-inch margins, plus outline, thesis, and annotated bibliography

Independent research on any aspect of health, illness, healing, and/or health care.

Analysis of research materials from a cultural, social, economic, and/or political perspective.

Engage issues and theoretical debates from the field of medical anthropology.

Can deal with any culture(s) or societi(es). Cross-cultural comparison is recommended.

Must analyze and cite material from assigned readings, lectures, and class discussions.

Must analyze and cite material from at least six outside books or scholarly articles.

Rough draft due Fri. Mar. 30, 1:25 pm

Final version due Tues. May 8, 12:00 noon, 515 Williams Hall (slide under door)

Guidelines for the evaluation of papers to be distributed in class

Students with special needs: Please confirm that I have received a letter from the ACCESS office, and contact me during the first week of class to discuss accommodations arrangements.

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Anthropology 295: Medical Anthropology Professor Shea, Spring 2001

Course Policies:

This section addresses course policies to ensure a positive and fair learning environment and to make sure that everyone has a clear understanding of the expectations in this course.

Preparation: Assigned readings must be completed prior to each class meeting. Inadequate preparation will impair your ability to participate effectively in class discussion and perform well in your written work. Class discussions will assume completion of assigned readings. It is your responsibility to make sure to complete all of the readings in a timely fashion.

Attendance: Attendance at each class meeting is crucial to your ability to do well in this course. Classes will start promptly at 1:25 pm on Mondays, Wednesdays, and Fridays. Students are expected to arrive in the classroom by 1:25 pm and to remain in the classroom until the end of the class at 2:15 pm. No absences and no tardiness can be permitted without documentation of a serious health problem, family emergency, religious obligation, or other excused reason. Unexcused absences, tardiness, or early departures will bring down the student’s class participation grade. If you do need to be absent, with or without an excused reason, please touch base with the professor and TA via a brief note or email as soon as you can. If, during class, you need to arrive late or leave early, you should do so quietly and considerately, giving a brief note with your name, the date, and an explanation to the lecturer. It is your responsibility to make up any content that you miss due to absence from class.

Conduct: All members of the class are expected to be attentive and considerate, to work together to create a positive and invigorating learning environment, and to treat each other with respect and compassion. In the classroom, students are expected to actively participate in course discussions, to ask questions and express their analyses of issues raised in readings, to encourage others to participate in discussion, to listen respectfully to others’ points of view, and to respond diplomatically to differences of opinion. On the course website, participants should take full advantage of the possibilities offered by online interactivity, while making sure to observe web etiquette and refrain from flaming, spamming, and other inconsiderate online practices. Inappropriate conduct whether in the classroom or on the course website will bring down the student’s class participation grade.

Late papers and makeups: Late papers cannot be accepted, extensions cannot be granted, and makeups cannot be given without documentation of a serious health problem, family emergency, religious obligation, or other excused reason. Please mark your calendars and set your alarm clocks carefully. Unexcused absence on the day that a presentation is scheduled will result in a zero on the presentation in question. Unexcused late papers will be marked down by a full letter grade per day late (e.g., one to twenty-four hours late, an A- becomes a B-).

Plagiarism and cheating: Not only do these practices hamper a person’s ability to learn and create and a group’s ability to maintain fairness and trust , plagiarism and cheating are both serious violations of the honor code at the University of Vermont. Violations will result in severe consequences, including a zero on the essay, paper, or presentation in question. Please familiarize yourself with proper citation practices. If you have any questions concerning the line between doing your own work and copying the work of others, please do not hesitate to ask.

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Anthropology 295: Medical Anthropology Professor Shea, Spring 2001

Overview of Course Readings

Experiences of health and illness:

Lock, Encounters with Aging, xiv-77, 78-106, 107-170, 171-255, 256-300, 301-387

Strathern, ch. 11: Fertility

Strathern, ch. 8: Ethnopsychiatry: Aboriginal Australia

Doctor-patient interaction:

Strathern, ch. 12: Communication: Doctors and Patients

Fadiman, The Spirit Catches You, vii-37, 38-77, 78-118, 119-170, 171-224, 225-288

Alternative healing traditions:

Overview

Strathern, ch. 2: Regimens of Treatment

Western Biomedicine

Kleinman, What is Specific to Biomedicine (on reserve)

Humoral Systems in Papua New Guinea

Strathern, ch. 3: Humoral Systems: Papua New Guinea

Strathern, ch. 4, Curers and Healers: The Melpa

Strathern, ch. 5, Duna Ritual Practices and Healing

Traditional Chinese Medicine

Zhang, Who Can Ride the Dragon? xii-40, 41-78, 79-98, 99-136, 137-168, 169-194, 195-256

Farquhar in Leslie, Approaching Chinese Medicine Practice ... a Published Case

Unschuld in Leslie, Traditional Chinese Medicine in the Twentieth Century

Ayurvedic Medicine

Trawick in Leslie, Death and Nurturance in Indian Systems of Healing

Obeyesekere in Leslie, Science, Experimentation, and Clinical Practice in Ayurveda

Zimmerman, The Flower Power of Ayurveda

Islamic Humoral Medical Traditions

Good in Leslie, Greco-Islamic Medicine

Laderman in Leslie, Islamic Humoralism

Medical Syncretism, Medical Pluralism

Strathern, ch. 6: Medical Pluralism among the Huli

Leslie, Syncretism in Modern Ayurveda

Political economy of health and health care:

Strathern, ch. 13: Critical Medical Anthropology

Kim, Dying for Growth

Farmer in Kim, Foreword

Millen in Kim, ch. 1: Introduction: What is Growing? Who is Dying?

Gershman in Kim, ch. 2: Getting a Grip on the Global Economy

Shakow in Kim, ch. 3: Decoding Development Discourse

Farmer in Kim, ch. 4: Hypocrisies of Development and Health of the Haitian Poor

Field in Kim, ch. 7, Neoliberal Econ. Policy, “State Desertion,” Russion Health Crisis

Millen in Kim, ch. 8: Transnational Corporations and the Health of the Poor

Millen in Kim, ch. 9, Political Influence of National and Transnational Corporations

Holtz in Kim, ch. 10: The 1984 Bhopal Gas Disaster

Millen in Kim, ch. 15: Pessimism of the Intellect, Optimism of the Will

Patel in Kim, ch. 16: Pragmatic Solidarity