3.21.2006
Medicine as Culture (History and Theory of the Body)
Title
Lupton, Deborah. Medicine as Culture: Illness, Disease, and the Body in Western Societies. London: SAGE Publications, 1994.
Field
History and Theory of the Body
Summary
"This book examines th socio-historical dimensions of medicine in western societies, seeking to cast light upon the reasons why medicine is characterized by such strong paradoxes, why issues of health and illness are surrounded with controversy, conflict and emotion." (2) Wow, tall order. But Lupton gives a great overview. This book is kinda like a history of the theory of the body. The first chapter outlines the major schools of thought/theory on the body. In the sociology of health and illness, "there have been three dominant htoretical perspectives...functionalism, the political economy approach, and social constructionism." (6) Functionalism considers illness an unnatural state of the body that is alleviated by medical institutions as "necessary institution[s] of social control." (7) The political econominist also believe that medicine exerts social control, but not for the good of society. Here capitalism and health care are in a symbiotic relationship, illness is produced, medicine is consummed, etc. Social Constructionism (coming out of Foucauldian thought) does not put the blame so squarely on the medical institutions, but rather recongizes multiple sites for the production of medical power and seeks to understand the ways in which this power is normalized and contested. Medical Anthropologists are concerned with the lived experiences of those with illnesses. History of Medicine has recently moved away from a teleological success story of medical technology to take into account the movements in medical sociology and anthropology. Cultural studies looks at the confluence of illness and representation. And finally, one must note the influence of poststructuralist concerns with discourse and language on the ways in which the construction and deployment of the body and medicine is conceived. The second chapter looks at the ways the body as a bounded entity has come into being as a reference point, object, subject, etc. There is the Foucauldian notion of the body coming into being as a site for surveillance and control. The coming into being of the gendered/sexualized body. The public health discourse of the body as dangerous. The body as beseiged by germs, therefore the body as im/pervious. And of course, the body and food, the commodified body, and the dead body. "By far the most important insight is that which views the body and its ills not as universal biological realities byt as a combination of discursive processes, practices and physical matter which have a symbiotic and symbolic relationship with the discourses and ideologies governing societal regulation." (49) The next chapter deals with the ways in which the body is represented through out history. "Two important and pervasive ways of conceptualizing illness and disease are the use of metaphor and visual imagery." (51) "The linguistic and visual representations of medicine, illness, disease and the body in elite and popular culture and medico-scientific texts are influential in the construction of both lay and medical knowledges and experiences of these phenomena. The metaphorical systems describing illness, disease and the body are important linguistic choices which are revealing of deeper societal anxieties about the control and health of the body politic as well as that of the body corporeal." (78) The next chapter looks at the way illness was and is conceived by the lay person. While prior to the Enlightenment, divine providence might be seen as the source of illness, there after, the doctor and medical establishment rose to prominence in mediating the way the public conceived and remedied illness. "Such empirically based investigations have demonstrated the ways in which bodies become inscribed by dominant discourses in the public sphere, how relations of power are excercised and reproduced in everyday activities as well as by and through medical practices, and how medical and public health ideologies are incorporated into lay knowledges of health and illness." (104) The fifith chapter analyses power in the medical encounter, concluding that "power relations in the medical encounter [can be seen] as simply abusive and oppressive of patient's rights and agency, or by contrast as universally beneficient and mutually co-operative, [it is] too simplistic an understanding of the complex nature of this social interaction. Power in the medical encounter may be both productive and oppressive; both patients and doctors have expectations and needs related to the encounter which may at times demand the doctor take an authoritative stance. While there is limited scope for patient resistance, to challenge this authority calls into question the whole nature and rationale of the medical encounter." (130) The final chapter reads like a case study of paradox as it examines feminist interventions in the field of power and medicine, discussing debates on abortion, menstruation, contraception, and menopause - and example of the ambivalence on medical discourse.
Keywords
Health, Disease, Paradox, Illness, Socio-Cultural, Power.
Other Thoughts
This would make a great intro book for a class on the body.
"For the populations of western societies, serious illness and death are strange, mysterious, frightening, and unexpected events, except perhaps for the very old. Medicine, or faith in medicine, is a creed." (1)
"Within the mind/body dualism predicated by scientific medicine is a series of essentialist binary oppositions: mind is contrasted with body, spirit with soul, active with passive, form with matter, rational with irrational, reason with emotion, free with determined, objective with subjective, voluntary with involuntary, master with slave, adult with child, male with female, immortal with mortal, right with left, culture with nature, purity with coarseness." (87)
"The phenomenological approach to understanding the social world places importance upon the everyday activities in which people engage and the meanings invested in these activities. It rejects the assumptions of positivist research that human behavior can be observed in the same manner as the natural sciences. Phenomenology employs techniques of ethnomethodology - particularly observation, depth interviewing and the construction of case studies - to understand the human lived experience. Hermenuetics, or the interpretation of the meaning of human experience, is part of the research methodology of phenomenology." (92)
"Health becomes a simulacrum, a floating signifier with manifold and changing meanings, reified as an end in itself, symbolic of morality, subject to continued anxious measurement and scanning." (100)
Other QE Works Cited
Fiske, J. Channels of Discourse Reassembled. (Film and Media Studies)
Foucault, M. History of Sexuality (History and Theory of the Body)
Harawy, D. A Manifesto for Cyborgs (History and Theory of the Body)
Martin, E. Flexible Bodies (History and Theory of the Body)
Sontag, S. Illness as a Metaphor / AIDS as a Metaphor (History and Theory of the Body)
Lupton, Deborah. Medicine as Culture: Illness, Disease, and the Body in Western Societies. London: SAGE Publications, 1994.
Field
History and Theory of the Body
Summary
"This book examines th socio-historical dimensions of medicine in western societies, seeking to cast light upon the reasons why medicine is characterized by such strong paradoxes, why issues of health and illness are surrounded with controversy, conflict and emotion." (2) Wow, tall order. But Lupton gives a great overview. This book is kinda like a history of the theory of the body. The first chapter outlines the major schools of thought/theory on the body. In the sociology of health and illness, "there have been three dominant htoretical perspectives...functionalism, the political economy approach, and social constructionism." (6) Functionalism considers illness an unnatural state of the body that is alleviated by medical institutions as "necessary institution[s] of social control." (7) The political econominist also believe that medicine exerts social control, but not for the good of society. Here capitalism and health care are in a symbiotic relationship, illness is produced, medicine is consummed, etc. Social Constructionism (coming out of Foucauldian thought) does not put the blame so squarely on the medical institutions, but rather recongizes multiple sites for the production of medical power and seeks to understand the ways in which this power is normalized and contested. Medical Anthropologists are concerned with the lived experiences of those with illnesses. History of Medicine has recently moved away from a teleological success story of medical technology to take into account the movements in medical sociology and anthropology. Cultural studies looks at the confluence of illness and representation. And finally, one must note the influence of poststructuralist concerns with discourse and language on the ways in which the construction and deployment of the body and medicine is conceived. The second chapter looks at the ways the body as a bounded entity has come into being as a reference point, object, subject, etc. There is the Foucauldian notion of the body coming into being as a site for surveillance and control. The coming into being of the gendered/sexualized body. The public health discourse of the body as dangerous. The body as beseiged by germs, therefore the body as im/pervious. And of course, the body and food, the commodified body, and the dead body. "By far the most important insight is that which views the body and its ills not as universal biological realities byt as a combination of discursive processes, practices and physical matter which have a symbiotic and symbolic relationship with the discourses and ideologies governing societal regulation." (49) The next chapter deals with the ways in which the body is represented through out history. "Two important and pervasive ways of conceptualizing illness and disease are the use of metaphor and visual imagery." (51) "The linguistic and visual representations of medicine, illness, disease and the body in elite and popular culture and medico-scientific texts are influential in the construction of both lay and medical knowledges and experiences of these phenomena. The metaphorical systems describing illness, disease and the body are important linguistic choices which are revealing of deeper societal anxieties about the control and health of the body politic as well as that of the body corporeal." (78) The next chapter looks at the way illness was and is conceived by the lay person. While prior to the Enlightenment, divine providence might be seen as the source of illness, there after, the doctor and medical establishment rose to prominence in mediating the way the public conceived and remedied illness. "Such empirically based investigations have demonstrated the ways in which bodies become inscribed by dominant discourses in the public sphere, how relations of power are excercised and reproduced in everyday activities as well as by and through medical practices, and how medical and public health ideologies are incorporated into lay knowledges of health and illness." (104) The fifith chapter analyses power in the medical encounter, concluding that "power relations in the medical encounter [can be seen] as simply abusive and oppressive of patient's rights and agency, or by contrast as universally beneficient and mutually co-operative, [it is] too simplistic an understanding of the complex nature of this social interaction. Power in the medical encounter may be both productive and oppressive; both patients and doctors have expectations and needs related to the encounter which may at times demand the doctor take an authoritative stance. While there is limited scope for patient resistance, to challenge this authority calls into question the whole nature and rationale of the medical encounter." (130) The final chapter reads like a case study of paradox as it examines feminist interventions in the field of power and medicine, discussing debates on abortion, menstruation, contraception, and menopause - and example of the ambivalence on medical discourse.
Keywords
Health, Disease, Paradox, Illness, Socio-Cultural, Power.
Other Thoughts
This would make a great intro book for a class on the body.
"For the populations of western societies, serious illness and death are strange, mysterious, frightening, and unexpected events, except perhaps for the very old. Medicine, or faith in medicine, is a creed." (1)
"Within the mind/body dualism predicated by scientific medicine is a series of essentialist binary oppositions: mind is contrasted with body, spirit with soul, active with passive, form with matter, rational with irrational, reason with emotion, free with determined, objective with subjective, voluntary with involuntary, master with slave, adult with child, male with female, immortal with mortal, right with left, culture with nature, purity with coarseness." (87)
"The phenomenological approach to understanding the social world places importance upon the everyday activities in which people engage and the meanings invested in these activities. It rejects the assumptions of positivist research that human behavior can be observed in the same manner as the natural sciences. Phenomenology employs techniques of ethnomethodology - particularly observation, depth interviewing and the construction of case studies - to understand the human lived experience. Hermenuetics, or the interpretation of the meaning of human experience, is part of the research methodology of phenomenology." (92)
"Health becomes a simulacrum, a floating signifier with manifold and changing meanings, reified as an end in itself, symbolic of morality, subject to continued anxious measurement and scanning." (100)
Other QE Works Cited
Fiske, J. Channels of Discourse Reassembled. (Film and Media Studies)
Foucault, M. History of Sexuality (History and Theory of the Body)
Harawy, D. A Manifesto for Cyborgs (History and Theory of the Body)
Martin, E. Flexible Bodies (History and Theory of the Body)
Sontag, S. Illness as a Metaphor / AIDS as a Metaphor (History and Theory of the Body)
# posted by SMRT : 6:25 PM
