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In the field of medical anthropology, the body is the object of constant attention. This is on the one hand, because the status of patient implies alterations to one’s bodily state which people try to modify or master, and many attempts to modify the body, even when there is no illness, necessarily involves calling upon healthcare professionals. On the other hand this is, because ill-being employs corporal metaphors to express itself, and because uses of the body and the related symptoms tell us something about our societies and their evolution. Yet we are now seeing new phenomena which are giving medical anthropology food for thought and interrogation. Contemporary societies are marked by the general public’s increased familiarity with medical terminology, easier access to information via new information technologies, the spreading of diagnostic criteria, the propagation of behavioural (sexual, food-related) norms etc. So in relation to stakes of varying types (economic, therapeutic, ideological, cultural, aesthetic, commercial, technical...) the question of the social treatment of the body and its transformations emerges.
Medical anthropology has shown that a certain number of nosological entities are related to body management or to the expression of ill-being within a specific social context. This is true of burn out, chronic fatigue, French spasmophilia, fibromyalgia, etc.
What becomes of these entities (identified within a given social or national environment) in different contexts? Pharmaceutical laboratories seize upon these entities, or act beforehand, taking part in the construction of illnesses which correspond to the effects of molecules born of recent pharmacological research. The practice commonly known as disease mongering (which, as far as the pharmaceutical industry is concerned, involves identifying or inventing new pathologies which correspond to the products that they wish to sell) applies to numerous areas. Various phenomena (menopause, sexual dysfunction, social phobia, shyness, etc.) are thus medicalised to this end.
How are healthcare professionals and lay people reacting to these “new” illnesses?
Temporalities and identity
Whilst the passing of time in terms of the physical deterioration that it entails has always been a problem for humanity, people nowadays turn to surgery and medicine to postpone the said deterioration. Plastic surgery and a whole range of prostheses can give us new faces, new bodies, sometimes even bionic bodies.
With the increase in life expectancy and new prognostic techniques we must also face such issues as time spent living with a chronic illness, or the prolonging of life to avoid so-called “premature” death. Although medicine’s acceptance or avoidance of “risky” behaviour involves projecting oneself into the future (by refusing or denying said risk), a new relationship with the future is developing with the breach in the future that predictive medicine allows. Knowing oneself to be “at risk” due to the revelation of predisposing genetic factors, does violence to this gentle passage of time and projects one into a state which has been analysed as being a state of liminality.
What becomes of identity in an era where medicine can change the body by transplanting organs and where human organisms can be thought of in this manner (“engineered babies”, for example)?
What place do symptoms or the fact of knowing ones genetic status take in people’s lives, in the construction of their status as sufferers, and of their identity?
“Nomad” bodies and techniques
Globalism tends to erase frontiers and allows ways of life which used to be linked to societies or to specific cultural areas to spread. For example, people all over the world are being offered access to a technology (mobile phones, Internet) whose use must be considered as one of a range of therapeutic solutions. Internet space is taking over from local space.
What are the interpretations of technical terms found on the Internet and how are they related to pathologies and the body?
What contribution might anthropology make with regard to discourses on the body and symptoms made available on the Internet (via medical sites, discussion forums, etc.)? Furthermore, increasing recourse to foreign medicines, which demonstrates that there is no longer an exclusive relation between a given cultural area and a particular way of treating people, is a new challenge for medical anthropology which tends to define its field of investigation in terms of local arenas or cultural areas. We thus find a reconstruction and redefinition of both local disorders and global categories, and also a recourse to non-western practices or alternative practices which involve the body in a different manner.
To what bricolage do these forms of reconstruction give rise? Of course, despite the fact that existing models are spreading, local specificities remain, whether they be linked to national health systems (with the existence, in some countries, of a Welfare System), or to cultural practices, the result of an ancient heritage or of contemporary innovations. But the boundaries between these areas are constantly transforming and being redefined. The comparative approach so dear to anthropology should be used in this regard to pose new questions. Indeed, these new arenas and these new boundaries (when they are not totally erased) must offer themselves up to a renewed comparative examination.
In this new context, the notion of anthropology “at home” should be re-examined.
Bioethics and applied anthropology
Interventions on the human body constitute a subject of predilection for bioethical reflection. Although, as a social science, medical anthropology does not aim at defining ethical norms, it is a necessary counterpoint to bioethics as it engages in the empirical studying of the meaning and values underlying medical practices (in relation to procreation, genetic engineering, surgery, experimentation, end of life, etc.) and of the related moral and political stakes. This is not just a question of medical anthropology’s usefulness in terms of “applied” or of “involved” research, but also of thinking about the evolution of its role within the modern social arena, faced with the emergence of new values, new practices and new public policies relating to healthcare.
What is anthropology’s role in relation to issues put forward by bioethics? How can we, or should we, take up the critical position as social scientists?