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Worlds Beyond Us: SoMA Symposium on the Human & Non-Human in Medical Anthropology

soma symposium poster

Image may contain: 9 people, including Niamh Woodier, Cormac Cleary and Maythe S. Han, people smiling

PROGRAMME

Welcome:  10.00 - 10.20 am

Professor Ian Harper (Director of Edinburgh Centre for Medical Anthropology)

Ritti Soncco (Representative of Students of Medical Anthropology and Symposium organiser) 

Group 1:  Practises of Care Beyond Personhood (10.20 - 11.20 am)

Image may contain: 4 people, including Niamh Woodier, people sitting and indoor

Material objects and art & design-based methodologies for research with people with dementia - by Valeria Lembo (Edinburgh Centre for Research on the Experience of Dementia, University of Edinburgh)

In recent years there has been a growing interest in arts and design for dementia care. This attention has been also manifested in a growing body of studies that have used innovative research methods in order to understand more effectively the experiential dimension of living with dementia (Bellass 2019). Dementia studies are increasingly looking at innovative visual, kinaesthetic and sensory approaches to methodology; some examples include: ‘walking interviews’; poetry, drama, participatory film-making, journaling (Bellas 2019); ‘wardrobe interviews’ and usage of material objects during one-to-one discussions, focus and reminiscence groups, including: photograph albums; prompt cards; visual images; fabric; clothing and accessories (Buse, Twigg 2014). Outside the specific field of dementia studies, social scientists Goopy and Assan (2019) have proposed an arts-based engagement ethnography (ABEE) for research with underrepresented communities. In their work, they have shown how the use of ‘cultural probes’ can relocate traditional power hierarchies between researcher and research participants and foster a collaborative process in which participants’ own hierarchies of importance can emerge and shape research. By examining these novel methodological trends, I intend to reflect on the potential of including material objects and ‘cultural probes’ within my PhD research design on arts and dementia care in Scotland. I further intend to reflect on the following questions: How can the research process within the social sciences be more inclusive towards people with dementia and let emerge their own questions? Can art-based/design-based methodologies be useful not only for ‘gathering data’, but also for creating meaningful research communities?

General Practice Receptionists: undervalued guardians of care? - by Niamh Woodier (University of Edinburgh)

There are few people who do not interact with a general practice receptionist. Receptionists make decisions everyday about who can see a GP, and when. In the everyday lives of patients these are significant decisions that cost time and sometimes upset. Yet for a figure that apparently has a controlling influence on the population, there is a paucity of literature that studies their work and larger role in delivering care services. Key literature surmises that, ‘the relational practice of receptionists seemed to me in some way inappropriate’ (Hewitt 2006, 279), and portrays receptionists as unable to handle ‘high-level procedural operations’(Spencer 2018, 2). This negative image in academic literature is compounded by their negative public image, and their unspoken role as a scape-goat for structural problems in primary healthcare. This paper attempts to reflect on some of the literature from personal experience in the work place. The paper reviews the role, knowledge and training and receptionists, and contemplates if the informal power of receptionists impacts the quality of care.

Niamh Woodier

Generational differences in perceptions of medical student experiences of clinical attachments in surgery - by Debbie Aitken (University of Cambridge)

In the UK, medical students spend a large proportion of their training in the medical workplace; learning clinical skills, being enculturated into the profession and having the opportunity to see, hear and experience expert behaviour. These clinical experiences (known as clinical attachments or placements in the UK) provide students with the opportunity to learn in a ‘real world’ workplace environment with real patients. Studies have shown that students’ experiences can have an impact on what specialties they choose as careers, and in busy and high-pressure specialties such as surgery, negative experiences on clinical attachments have been linked to recruitment crises in these specialties. It is therefore imperative that we understand what the key players in clinical attachments (students and teachers) think contribute to students’ negative (and positive) experiences. Gauging this can be quite challenging, and as a result, changes or improvements are often made based on surveys of medical students’ opinions, or sometimes based on no evidence at all. It is important to go beyond surveys to explore the cultural issues that may exist in surgery. This study will use an ethnographic approach in order to explore generational differences and similarities between what medical students and their teachers (consultant surgeons) think about clinical attachment experiences. Preliminary results of the ethnographic study will be presented at the symposium.

Slide

Entangled stories: Emergence of personhood in dementia care during Animal-Assisted Therapy (AAT) - by Cristina Douglas (University of Aberdeen)

Medical and public health narratives of dementia are dominated by ideas of erosion and loss of personhood, cognitive abilities, self-awareness and agency. People with dementia are portrayed as living in liminal zones between living and dying (Kaufman 2006; 2015), challenging the differentiation between life/death, body/mind, person/non-person. In this debate, personhood, though occupying a central role, remains heavily associated with human exceptionalism. I propose an exploration of sociality in both dementia and human-animal relations, by looking at the entanglements of what it means to be alive at these margins. I propose a discussion of: ethical/legal aspects; Western normative definitions and narratives of personhood of both people with dementia and animals and their consequences (political and economic); and the imperative of challenging and potentially reframing these current definitions by taking into account the point of view of the body and senses involved on both sides, human and non-human therapy animals, in Animal-Assisted Therapy. Further, I explore what subject/self/person types emerge, shaped by new opportunities of being and becoming with each other. Finally, I explore how a multi-species moral community might alter knowledge about dementia and redefine the status that non-human animals play in the wider medical, public health and social community, targeting ‘marginal’ relations as potentially challenging hegemonic assumptions about what it means to be alive, human or animal.

Coffee Break:  11.20 - 11.40 am

Group 2:  Life and Work With Non-Humans (11.40am - 12.30 pm)

Image may contain: 3 people, including Cormac Cleary and Maythe S. Han, people sitting and indoor

Beyond Resistance: Microbial worlds, military metaphors and the post-antibiotic era - by Iona Walker (BEYOND RESISTANCE Network)

Microbes are here to stay. Antimicrobial resistance is recognised as an “urgent global threat” (Hancock 2019) centred in militaristic metaphors and approaches. Yet as conventional therapies to ‘kill bugs’ decline in effectiveness, research increasingly asserts the integral role of microbiome in human health. I argue that this tension offers a unique opportunity to interrogate human-microbe relationships at a critical juncture, asking: what is the impact of the military metaphor on this relationship and how might it be imagined differently? Fisher states that “Freud’s unheimlich is about the strange within familiar” and that being in the presence of the ‘weird’ often means we are encountering the new and must adjust accordingly. The return of the microbe we cannot control I suggest, invokes this. To reimagine our relationship with the microbial world (the majority of which are either directly beneficial or neutral towards humans) we must confront this. Art has dealt with similar questions of the body through the abject, which reveals tangibly the ‘uncanny’ truths about the ecological nature of the ‘human’ body (such as the revulsion we may feel seeing cultures of bacteria sampled from human bodies). Combining art with multispecies ethnography to investigate human and non-human ecologies, what does it mean to be microbially entangled?

Iona Walker

Experimenting on Animals: Taking animals seriously in social science ethics - by Cormac Cleary (University of Edinburgh)

There is a significant body of work across the social sciences which includes the nonhuman in its definition of the social. However little has been done to take seriously the challenges this kind of work presents to the practice of the discipline as a whole. Rather the nonhuman turn is generally acknowledged to have theoretical potential but on a practical level it is given essentially meaningless lip service. For example, the Association of Social Anthropologists’ Ethical Guidelines mention animals twice. The preamble states that the guidelines “apply to anthropological work whether studying ‘up’ and/or ‘down,’ with persons and/or animals.” Substantively, the document’s only piece of practical advice that mentions nonhumans advises against “economic exploitation of individual informants, translators, groups, animals and research participants.” The rest of the code focuses on generally accepted ethical principles for social scientific research, e.g. informed consent, few of which (with the exception of anticipating harm), are particularly relevant to nonhuman research subjects. In the natural sciences, on the other hand, it is common practice to incorporate nonhuman bodies in experiments, and there are well-developed ethics codes governing the interspecies encounter between researcher and subject. By examining the points of tension and confluence between social science ethical guidelines and natural science ethics codes about the use of animals in experimentation, I will explore the potential practical implications of nonhuman research subjects for research ethics codes in the social sciences.

Cormac Cleary

Kibbles of love and chicken: an interspecies story about dog food - by Maythe Han (University of Edinburgh) 

This auto-ethnography tells the story of how I came to choose the ‘best’ food for Frank, my 4-year-old rescue border collie, who has been an integral part of my family since April 2017. With the premise that responsible dog ownership requires commitment not only of emotional and physical labour but also of economic capital, this essay explores the themes of love and care through examining the materiality of the kibbles that I feed Frank, and by contemplating the role that food plays in the maintenance of my more-than-human family. I show that dog food is a material site of interaction between and overlap of the emotional, physical, and economic elements involved in caring for a dog – that dog food is where the translation of the immaterial (love and care) into the material (kibbles) happens. In turn, I argue that the concept of materiality itself is quite multifaceted and fluid.

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LUNCH BREAK:  12.20 - 1.30pm

Group 3:  Follow, Enter, Unravel the Thing (1.30 - 2.20 pm)

panel discussion

The social life of abortion pills in Britain and Ireland - by Leah Eades (University of Edinburgh)

A growing number of British and Irish women are using mifepristone and misoprostol, commonly referred to as “abortion pills”, to terminate their pregnancies through early medical abortion (EMA). In this paper, I present an overview of the licit and illicit social life of abortion pills in Britain and Ireland – specifically, as they move within and between England, Scotland, Wales, Northern Ireland, the Republic of Ireland, and the Isle of Man. In this region, differing laws and healthcare delivery systems have resulted in diverse and highly interconnected distribution and consumption practices, with pregnant people accessing EMA legally through regulated health services in countries where it is available and illegally via unregulated online distributors. This range of official and unofficial distribution channels contributes to the mobility of bodies, medications, and information within and between countries. I conclude by reflecting on some of the strengths and limitations of employing a biographical approach to explore the ways in which these pharmaceuticals intersect with borders and bodies in the context of this rapidly changing regulatory landscape.

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People, Products and Power: Constructing the Moral Economy between Self and Product in Boycott Campaigns - by Sophia Celeste Hoffinger (University of Edinburgh)

This paper seeks to investigate the moral economy of the relationship between people and products in boycott movements by tracing how products have been made complicit in systems of oppression by humans and more-than-human institutions alike. Boycott movements take on a specific role in “the production, circulation, and use of values and sentiments” (Fassin 2012: 441) of products, companies and their position in the world. They mobilise an affective narrative that traces the connections between personal consumption, the state, the corporation with systems of oppression and marginalised groups. Thus, boycott campaigns move between the domestic, the national, and the international; between people, products, and companies. While situating boycott campaigns historically, this paper will focus on the moral economy of the Palestinian-led Boycott, Divestment, and Sanction (BDS) movement. This moral economy, I argue, is accentuated and revitalised by the production of ‘Brand Israel’, a national rebranding campaign initiated and co-designed by the Israel Ministry of Foreign Affairs in 2006. This talk thus explores some of the contingencies between BDS-led boycott mobilisations and Brand Israel.

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A Geography of Tolerance: The Making or Unmaking of the Lyme Disease Epidemic in the Scottish Highlands - by Ritti Soncco (University of Edinburgh)

This paper discusses the role that historical and modern-day social constructions of Scottish landscapes play in making Lyme disease invisible as it becomes endemic to the country. Lyme disease is notoriously difficult to identity and diagnose in patients - yet beyond the human, this problem has extended to landscape bodies. My focus is on the Scottish Highlands, whose glens, crags, and cairns are both a habitat for ticks carrying Lyme disease and a geography of loss, healing, memory and tourist performances of beauty. I offer a brief historical excursion to the 18th century, when the Highland Clearances saw the expulsion of thousands of Highlanders from their lands and the systematic dismantling of a way of life, and the introduction of sheep and deer, as well as their romanticisation and construction of authenticity in poetry, novels, films, and the tourist industry. What were once historically violent landscapes are today performed by tourists, residents and hillwalkers as safe and peaceful spaces, with British children brought up under the mantra: “nothing here can kill you”. Offering my theory of ‘geographies of tolerance’, I discuss how constructions of landscapes as authentically remote, safe spaces has played on transforming humans into undesirable Others, and the space this construction leaves for a growing epidemic such as Lyme disease, giving both the tick and the bacteria multiple hiding spaces in the folds of historical healing, non-human kinship, and peaceful countryside.

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Edinburgh Students