Attending to the Dark Side of Medicine

Decades of medical anthropological work have helped disrupt notions of biomedicine’s soteriological basis, its unquestioning moral rightness, and its fundamental commitment of doing no harm. In our cross-border research on public health systems in Indian and Pakistan-controlled Kashmir, respectively—two of the most militarized places on earth—we try to trouble and even undo the assumed good or neutrality of medicine by evaluating its darker, shadow side. As medical anthropologists, we are interested in how long-term conflict leaves traces in public health infrastructures, and how medicine’s soteriological foundations are manipulated, twisted, or mangled in everyday clinical practices, such that the lines between practice and malpractice can become exceptionally blurred.

Promoting the Anthropological Perspective in Global Health Systems Scholarship

A small sub-field within medical anthropology has focused on the social organization, power relations, and politics of health policy and systems. This scholarship takes policymakers and health staff—at various levels of the health system—as points of ethnographic entry. This requires a somewhat different epistemological orientation than anthropologists’ usual focus on recipient populations, one which works through the multiple individuals and bureaucracies that produce a culture—such as the culture of biomedicine. High-quality ethnographic work is perhaps the best way of understanding the complex systems that may impede progress in fighting disease or enable the promotion of good health.