An Anthropology of Biomedicine

The strength of this re-edited volume is that its analysis and criticism of biomedical practice can be transferred to comparable (and contemporary) negotiations over space and time. - Curare - Journal for Medical Anthropology, VOL 44 (2021) 1-4

MARGARET LOCK is Professor Emerita at McGill University, Montreal, Canada, Dept. of Social Studies of Medicine and Dept. of Anthropology. She is a Fellow of the Royal Society of Canada, Officier de L'Ordre national du Qubec, Officer of the Order of Canada, and an elected Member of the American Academy of Arts and Sciences. Author and/or co-editor of 18 books and over 220 articles, Lock is a medical anthropologist whose work focuses on embodiment, comparative epistemologies of medical knowledge, and the global impact of biomedical technologies. VINH-KIM NGUYEN is Professor at the Graduate Institute of International and Development Studies in Geneva, Switzerland and at the University of Montreal, Canada. He is also Chair of Anthropology and Global Health at the Collge d'tudes mondiales in Paris. He is a medical anthropologist and practicing physician who practices in infectious diseases and emergency care and has worked on the frontlines of global health efforts particularly in West Africa since 1994.

Acknowledgements xiii Introduction 1 The Argument 1 Interwoven Themes 2 Improving Global Health: The Challenge 4 Biomedicine as Technology 5 Does Culture Exist? 7 A word About Ethnography 10 Section 1 1 Biomedical Technologies in Practice 15 Technological Mastery of the Natural world and Human Development 16 Technology and Boundary Crossings 17 Biomedicine as Technology: Some Implications 19 Technologies of Bodily Governance 21 Technologies of the Self 24 The Power of Biological Reductionism 25 Techno/Biologicals 26 2 The Normal Body 29 Cholera in the Nineteenth Century 30 Representing the Natural Order 31 Truth to Nature 32 The Natural Body 34 A Numerical Approach 35 Other Natures 36 Interpreting the Body 38 How Normal Became Possible 39 When Normal Does not Exist 42 Problems with Assessing Normal 43 Pathologizing the Normal 46 Limitations to Biomedical Objectivity 48 Better than Well? 49 3 Anthropologies of Medicine 51 The Body Social 51 Contextualizing Medical Knowledge 53 Medical Pluralism 55 The Modernization of Traditional Medicine 56 Medical Hybridization 57 Biodiversity and Indigenous Medical Knowledge 58 Selfmedication 59 A Short History of Medicalization 60 Opposition to Medicalization 62 The Social Construction of Illness and Disease and Beyond 64 The Politics of Medicalization 68 Beyond Medicalization? 71 In Pursuit of Health 71 In Summary 74 Section 2 4 Colonial Disease and Biological Commensurability 79 An Anthropological Perspective on Global Biomedicine 79 Biomedicine as a Tool of Empire 81 Acclimatization and Racial Difference 82 Colonial Epidemics: Microbial Theories Prove their Worth 83 Fear of Biomedicine 85 Microbiology as a Global Standard 87 Infertility and Childbirth as Critical Events 89 Birthing in the Belgian Congo 90 A Global Practice of Fertility Control 91 Intimate Colonialism: The Biomedicalization of Domesticity 92 Biomedicine, Evangelism and Consciousness 93 The Biological Standardization of Hunger 94 The Colonial Discovery of Malnutrition 95 Albumin as Surplus 97 The Biologization of Salvation 98 In Summary 100 5 Grounds for Comparison: Biology and Human Experiments 103 The Laboratory as the Site of Comparison 103 The Colonial Laboratory 104 Experimental Bodies 106 Rise of the Clinical Trial 107 Taming Chance 109 The Alchemy of the Randomized Controlled Trial 110 The Problem of Generalizability 110 Medical Standardization and Contested Evidence 112 Anthropological Perspectives on Clinical Trials: The West African Ebola Epidemic 114 Jiki: A Clinical trial Amidst the Ebola Epidemic 116 Context of the Clinical Trial 117 Globalizing Clinical Research 118 What Should Count as Evidence? 120 Economies of Blood 121 Experimental Communities: Social Relations 122 In Summary 124 6 The Right Population 127 The Origins of Population as a Problem 129 Addressing the Problem of Population 130 Improving the Stock of Nations 131 Contraceptive Technologies and Family Planning 133 Indian Family Planning meeting Quotas 135 Increasing Fertility with Contraceptive use 139 The Onechild Policy 140 Biomedical Technology and sex Selection 145 Contextualizing Sex Selection: India and Family Balancing 146 Contextualizing Sex Selection: Disappeared Girls in China 148 Sex Selection in a Global Context 151 Ghost Children, Little Emperors, Burgeoning Elders 153 Reproducing Nationalism 155 In Summary 157 Section 3 7 Who Owns the Body? 161 Commodification of Human Biological Material 162 Objects of Worth and their Alienation 164 The Wealth of Inalienable Goods 164 A Bioeconomy of Human Biological Materials 165 Who Owns the Body? 167 Gifting Life 168 Commodification of Eggs and Sperm 169 Medical Tourism 171 Immortalized Cell Lines 171 The Exotic Other 174 Biological