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Medical Anthropology Project
Transcript of Medical Anthropology Project
She has also identified some practical and ethical issues that are unique to conducting medical anthropological research. They are:
-How is access to the setting obtained?
-How is data recorded?
-What is the role of the researcher?
-What special issues are there in researching elite groups? Getting In: Access to Medical Settings
This is the process of getting permission to conduct ethnography in places such as operating rooms.
Ms. Pope used a “gatekeeper” that is she was introduced by someone already in the organization. Having a legitimate entry is vital since “before entering the field there is a substantial hurdle to be surmounted, mainly, gaining ethical approval” (Pope 1). This process involves continuous negotiation and renegotiations as to the goal and the role of the researcher. With regard to Ms. Pope’s experience in getting access to operating rooms in the USA she was “briefed on occupational safety and health administration guidelines and informed about what to do, for example, in the event of contact with blood or bodily fluids.” This is certainly unique to the practice of medical anthropology (Pope 2). http://www.globalnewspointer.net/negotiation-in-theory-practice-why-it-pays-to-build-relationships Since ethical issues are so important in medical settings the researcher must obtain the unqualified consent of the participants. This is accomplished not only by the introduction by the “gatekeeper” but by “meetings to describe the study to all the staff involved and explain that they could decline to take part or ask us to leave at any point during the fieldwork” (Pope 2). Recording Data
Ms. Pope says “lengthy periods of observation require hours of copious notes. It is not always appropriate to take notes contemporaneously, such as conversation over lunch, may have to be remembered and written down later. Sometimes it is necessary to focus on watching the action without writing” (Pope 2) Tape recording conversations is a useful tool although some subjects may object to this. And others may alter their responses if their remarks are being recorded. Of course it is essential to get honest responses so the subjects must be at ease to be forthcoming (Pope 3).
The term “participant observation” is often used as a synonym for ethnography, describing the researcher who actively takes part in the life of the group being studied Pope 3). Ms. Pope quotes a classic typology of research roles which has participants on a continuum from “complete participant” to complete observer”. Medical ethnographers are never complete participants (Pope 4). Research roles are not static, they may change over time and with different circumstances. Ms. Pope reports “as my relationship with these surgeons developed, I felt that I became more integrated into the group and moved closer to the participant role”(Pope 4) Researching Elite Groups
In much research, the researcher occupies a more powerful position than the subjects. Medical anthropologists often find a reverse of this hierarchy of power and balance. The researcher may be the more junior party in terms of professional and occupational status as the research involves senior managers, clinicians and professional elites(Pope 5). Paul Farmer Paul Farmer is a medical anthropologist and physician whose specialized work focuses on different ways in which to treat families and individuals in the poorest communities (The Quest of Dr. Paul Farmer). http://www.myhero.com/go/hero.asp?hero=Paul_Farmer He strives to treat patients, who may not have the financial resources to cover their medical expenses, with the same respect and care as those who reside in the upper class and posses a broader range of financial freedom (The Quest of Dr. Paul Farmer). http://www.npr.org/templates/story/story.php?storyId=1472188 Farmer's studies of how the inequalities of society and financial distribution among the different social classes have led him to create many highly successful programs in which to bring relief to those who would not normally be able to afford such luxury (The Quest of Dr. Paul Farmer ). One such program is Partners in Health of PIH. PIH is a non-profit organization whose main goal is to provide medical care to financially unstable communities in the United States as well as in countries around the world (Paul Farmer MD, PHD). http://clubs.calvin.edu/chimes/article.php?id=546 Farmer refers to his method of providing healthcare to poor communities as Community-Based, Health Center-Enriched and Hospital-Linked. Communities work with one another to provide professional medical care in a hospital setting to those who would normally not receive routine or even emergency services due to their financial situations (Paul Farmer MD. PHD). http://hscweb3.hsc.usf.edu/health/publichealth/news/?attachment_id=4229 PIH is responsible for many health operations that have saved the lives of millions. Currently they are battling epidemics in such areas as Haiti and Africa. Currently, volunteers of PIH are fighting day and night to combat the cholera epidemic that has been rampant through Haiti for 2 years (Paul Farmer MD, PHD). http://www.myhero.com/go/hero.asp?hero=P_Farmer_dnhs_US_2010 They continue their work not only by treating those who are sick and providing vaccinations, but they provide educational programs as well in the hopes that increasing Haiti's public knowledge of proper sanitation practices will decrease the chances of the disease spreading further (Paul Farmer MD, PHD). Currently, Farmer is the head of humanitarian projects in Russia and Peru, as well as Rwanda and Lesotho. Through his program, PIH, people of these poor nations receive free healthcare including drugs that treat tuberculosis and AIDS (The Quest of Dr. Paul Farmer). Such people as Paul Farmer have made a lasting and continuing affect on the world. Millions of lives have been saved due to his careful consideration of individuals located in the poorest of communities and his quick action to provide for those whom no one else will provide for (Paul Farmer MD PHD). http://www.kplu.org/post/does-global-health-have-first-focus-poverty Holistic Perspective Holism is one of the approaches used by anthropologists in the field of medical anthropology. To see something as holistic, you must view it from a broad angle such as looking at the “total range of human activity”(Nanda et al. 6). In terms of medical anthropology, researching something holistically is to view it from every angle possible and to take into consideration every aspect of culture (“Holistic Medicine,”2010). For example a doctor who practices holism seeks to answer these questions:
•Why has the patient decided to consult?
•What does the patient think is the problem?
•What does the patient fear may be the problem?
•What is the patient hoping to achieve from the consultation? Holistic medicine seeks to encourage patient participation. Doctors try to empower their patients by practicing good listening and communication skills during the consultation. By using this method, doctors are able to get a good sense of the patient as a whole instead of just focusing on one area such as the pain. The holistic approach seeks to look at the smallest details in individual’s lives. “This also involves study of the macro-level forces and structures that are acting on people that cause them to behave the way they do…It is important to utilize a holistic approach to illness in order to identify all pertinent factors that contribute to a given pandemic (Anthropology’s Contribution to Public Health Policy Development). John Porter, an epidemiologist, has said of anthropology: "The discipline concentrates on what is actually happening and looks to 'the root' of where things come from" (Porter). Whether this 'root' at the level of social interactions between individuals, a cultural nuance or the macrocosmic structures that impact a given population, anthropological methods of investigation have proven reliable in identifying it.”(Anthropology’s Contribution to Public Health Policy Development,”2011) Hippocrates: He is one of the first anthropologists who practiced holistic medicine http://personal.georgiasouthern.edu/~rdanie12/index6.html Percival: He published the first textbook of medical ethics in 1803 and stated that, "The feeling and emotions of the patients require to be known and to be attended to, no less than the symptoms of their diseases” (Anthropology’s Contribution to Public Health Policy Development). http://en.wikipedia.org/wiki/Percival_Lowell John Macleod: He published a book that encourages the practice of holism in healthcare called, “Clinical Examination” http://www.nndb.com/people/871/000126493/ Michael Balint: He wrote, “The Doctor, the patient and his illness.” He focused on seeing the patient as a whole rather than as an isolated pathology. He stated: “llness is not just an isolated physical disorder or random event. Perhaps bad habits start in medical school, referring to a patient as "the mitral stenosis in bed 7" or "the lobar pneumonia in bed 13". (“Holistic Medicine,”2010) There are many benefits to practicing holistic medicine because it recognizes the person as a whole in the prevention and treatment of disease. Studies have shown that the patient tends to be more satisfied with a doctor who practices the holism because they feel that the doctor genuinely cares about them and doesn’t treat them like a number. Many doctors make patients feel rushed by just giving them ten minutes of their time, which makes the holistic approach difficult to achieve due to time constraints. Douglas Feldman Dr. Feldman is a researcher in the field of HIV/AIDS. He focuses on the informing people on the spread of infectious diseases in poverty stricken countries, and providing orphan support to disadvantaged communities. Douglas A. Feldman, Ph.D. is a Professor of Anthropology at The College at Brockport, State University of New York near Rochester, New York, and President-Elect of the Society for Medical Anthropology – an international organization with over 1,300 members. As a leader in AIDS and anthropology, and more broadly medical anthropology, he was the first anthropologist to develop a research study on HIV/AIDS in the United States in 1982 . He also was the first anthropologist to do a research study on AIDS in Africa in 1985 (Dr. Douglas Feldman to Speaks at Conference on Child Rights &Sight). He started the AIDS and Anthropology Research Group in 1986, which had rapidly grown under his leadership. In 1988, he influenced AIDS policy in Bangladesh after meeting with government officials and the media. That same year, he founded the American Anthropological Association Task Force on AIDS. Feldman's project was aimed at HIV/ AIDS prevention through a culturally sensitive educational approach aimed at changing normative behavior among Zambian adolescents(Nanda & Warms et al. 346). Works Cited
Nanda, S., & Warms, R. L. "Culture Counts: A Concise Introduction to Cultural Anthropology" Second Edition. Wadsworth, Cengage Learning
Wright, Michelle. "Holistic Medicine." Patient.co.uk. N.p., n.d. Web. 13 Dec. 2012
"Dr. Douglas Feldman to Speak at Conference on Child Rights & Sight." Distressed Children Infants International RSS. N.p., n.d. Web. 13 Dec. 2012.
"Society for Medical Anthropology." . N.p., n.d. Web. 13 Dec. 2012.
"Paul Farmer, MD, PhD." The Department of Global Health and Social Medicine. N.p., n.d. Web. 13 Dec. 2012.
Pope, Catherine. "Conducting Ethnography in Medical Settings” N.p., n.d. Web 13 Dec. 2012
Campbell, Dave. "RECENT EVOLUTION IN MEDICAL ANTROPOLOGY." National Center for Biotechnology Information. U.S. National Library of Medicine, 30 Nov. 0005. Web. 13 Dec. 2012.