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Diagnostic procedures are emblematic of medical work. Scholars in the field of social studies of medicine identify diverse dimensions of diagnosis that point to controversies, processual qualities and contested evidence. In this anthology, diagnostic fluidity is seen to permeate diagnostic work in a wide range of contexts, from medical interactions in the clinic, domestic settings and other relations of affective work, to organizational structures, and in historical developments. The contributors demonstrate, each in their own way, how different agents ‘do diagnosis’, highlighting the multi-faceted elements of uncertainty and mutability integral to diagnostic work. At the same time, the contributors also show how in ‘doing diagnosis’ enactments of subjectivities, representations of cultural imaginaries, bodily processes, and socio-cultural changes contribute to configuring diagnostic fluidity in significant ways.
By portraying the circumstances of people living with chronic conditions in radically different contexts, from Alzheimer’s patients in the UK to homeless people with psychiatric disorders in India, Managing Chronicity in Unequal States offers glimpses of what dealing with medically complex conditions in stratified societies means. While in some places the state regulates and intrudes on the most intimate aspects of chronic living, in others it is utterly and criminally absent. Either way, it is a present/absent actor that deeply conditions people’s opportunities and strategies of care. This book explores how individuals, groups and communities navigate uncertain and unequal healthcare systems, in which inherent moral judgements on human worth have long-lasting effects on people’s wellbeing. This is key reading for anyone wishing to deconstruct the issues at stake when analysing how care and chronicity are entangled with multiple institutional, economic, and other circumstantial factors. How people access the available informal and formal resources as well as how they react to official diagnoses and decisions are important facets of the management of chronicity. In the arena of care, people with chronic conditions find themselves negotiating restrictions and handling issues of power and (inter)dependency in relationships of inequality and proximity. This is particularly relevant in current times, when care has given in to the lure of the market, and the possibility of living a long and fulfilling life has been drastically reduced, transformed into a ‘reward’ for the few who have been deemed worthy of it.
Worldwide, there have been consistently high or even rising incidences of people classified as mentally ill, paired with increasing mental healthcare service utilization over the last decades. While psychiatric institutions have been consistently expanding, psychiatric knowledge has become increasingly dispersed and globalized, making psychiatric vocabularies and classificatory systems widely available, shaping increasing areas of life, creating powerful markets for therapeutic services of all kinds, and impacting how we understand ourselves and others. This process can be described as the psychiatrization of society. Psychiatrization is highly complex, diverse, and global, although it takes different forms in different contexts, involves various actors with largely diverging motives, and is part of a wider assemblage of the psy-disciplines.
In this groundbreaking study based on five years of in-depth ethnographic and interdisciplinary research, Troubled in the Land of Enchantment explores the well-being of adolescents hospitalized for psychiatric care in New Mexico. Anthropologists Janis H. Jenkins and Thomas J. Csordas present a gripping picture of psychic distress, familial turmoil, and treatment under the regime of managed care that dominates the mental health care system. The authors make the case for the centrality of struggle in the lives of youth across an array of extraordinary conditions, characterized by personal anguish and structural violence. Critical to the analysis is the cultural phenomenology of existence disclosed through shifting narrative accounts by youth and their families as they grapple with psychiatric diagnosis, poverty, misogyny, and stigma in their trajectories through multiple forms of harm and sites of care. Jenkins and Csordas compellingly direct our attention to the conjunction of lived experience, institutional power, and the very possibility of having a life.
This book addresses the principle that successful treatment incorporates a remarkably broad range of clinical variables. Clinicians must identify the extent to which each factor contributes to the success of the treatment process, and how to utilize this information strategically so that their combination enhances outcome. Complex clinical situations involve numerous macroscopic and microscopic components and their interactions. This book describes clinical practices and variables, that should be weighted according to their relevance for achieving treatment precision and improved results. The book is divided into sections, each containing topically organized chapters. Sections build from identifying discrete components of the clinical field to combined variables as they impact treatment progression. The clinical narratives that make up the latter part of the book elaborate on the course of care and the challenges involved in managing complex clinical situations. Cases range from primary care patients with systemic medical and psychiatric co-morbidity to more complex cases requiring the involvement of medical specialists, allied health professionals, and multiple health care systems. Scholarly, practical, and comprehensive, Complexity in Health Care enables clinicians to incorporate previously underappreciated health-related factors into their thinking and practice.
In health and medicine, imagining the future is essential in giving meaning to the past and the present and for propelling people into action. This is true not only at the level of individuals as they envision and carry out everyday activities and long-term plans but also for institutional practices framed by and unfolding within various socio-political ecologies and transfigurations. Hope and uncertainty are critical affective and knowledge-related modalities of such imaginations and assume vital meanings in policing, managing, and experiencing health, illness, and well-being. This volume brings together contributions from medical anthropologists who address this theme across various medical spheres, including the pragmatics of hope and uncertainty, the techno-sphere, health management, and individual and socially distributed emotions.
Cancer Entangled explores the shifts that took place in Denmark around the millennium, when health promoters set out to minimize delays in cancer diagnoses in hope of improving cancer survival. The authors suggest a temporal reframing of cancer control that emphasizes the importance of focusing on how people – potential patients as well as health care professionals – experience and anticipate cancer before a diagnosis or a prediction has been made. This argument compellingly challenges and augments anthropological work on cancer control that has privileged attention to the productive role of science and technology and to life with cancer or cancer risk. By offering rich ethnographic insights into the introduction of the first cancer vaccine, cancer signs and symptoms, public discourses on delays, social class and care seeking, cancer suspicion in the clinic, as well as the work on fast-track referral – the book convincingly situates cancer control in an ethical registrar involving attention to acceleration and time, showing how cancer waiting times become an index of the "state of the nation".
Volume IV of The Handbook of Systemic Family Therapy considers family-level interventions for issues of global public health. Information on the effectiveness of relational treatment is included along with consideration of the most appropriate modality for treatment. Developed in partnership with the American Association for Marriage and Family Therapy (AAMFT), it will appeal to clinicians, such as couple, marital, and family therapists, counselors, psychologists, social workers, and psychiatrists. It will also benefit researchers, educators, and graduate students involved in CMFT.
Drawing on ethnographic studies of the lived experiences of people with rare diseases, this volume critically examines rare, chronic diseases in the context of care, kinship, and technologies, providing in-depth analyses of local worlds that usually remain at the peripheries of medical anthropological inquiry.