ASA15: Symbiotic anthropologies: theoretical commensalities and methodological mutualisms

(P08)
Medical evidence beyond epistemology
Location Room 2
Date and Start Time 15 April, 2015 at 09:15
Sessions 2

Convenors

  • Christos Lynteris (University of Cambridge) email
  • Lukas Engelmann (University of Cambridge) email
  • Branwyn Poleykett (University of Cambridge) email
  • Nicholas Evans (University of Cambridge) email

Mail All Convenors

Short Abstract

Asking how anthropologists can think about medical evidence other than through a consideration of its social and suasive power, this panel seeks to explore medical evidence beyond epistemology.

Long Abstract

Interdisciplinary experiments with medical evidence practices have allowed anthropologists to trace conflicts and ruptures in knowledge and to re-examine evidentiary practices in anthropology (Ecks, 2008). These approaches have primarily considered medical evidence as a problem of knowing. However, across anthropology and the medical and exact sciences, evidence is not only an epistemological question. The handling and assembling of evidence makes selves and worlds and evidence-ing is an unstable practice that not only transgresses intellectual and disciplinary boundaries and modes of reasoning but also creates new moral and ethical problems, new subjectivities, and new alliances.

This panel asks how anthropologists can think about medical evidence other than through a consideration of its social and suasive power; in other words, we seek to explore medical evidence beyond epistemology.

Some of the questions we are interested in addressing are the following:

• How is the medical evidence of the past curated and encountered in the present?

• What events or crises incite a call for more evidence? How does an absence of evidence galvanise new categories and new knowledges?

• How do people interact with evidence and its objects in order to evidence an ideal medical or scientific self?

• When does evidence become proof?

• How is medical evidence commensurated between different regimes of value?

This panel is closed to new paper proposals.

Papers

Mapping plagues, containing epidemic threats

Author: Lukas Engelmann (University of Cambridge)  email

Short Abstract

The paper engages with mapping practices and will draw on examples reaching from Bubonic Plague to AIDS and Ebola to present mapping as a unique way of making epidemics evident.

Long Abstract

Practices of mapping have contributed to knowledge about epidemics throughout history. Mappings allowed to distinguish affected areas, they were crucial for installing and defending quarantines, and they helped to understand the dynamics and structures of disease which affected a number of people constrained by time and space. As such the history of epidemics and the history of their mapping could be understood as inseparable. In many ways plague can be understood as the historical archetype of disease mapping. As early as the 16th century mappings of plague crafted the original paradigm, which became a crucial tool in the 19th century history of medical geography. The paper will approach this history of geographical mapping of epidemics as yet another history of medical science, establishing medical evidence beyond the paradigms of a scientific medicine. As such, practices of mapping remained a key instrument in the making, distribution and popularization of (visual) knowledge about epidemic threats, reaching from Plague to AIDS and to the recent outbreaks of Ebola. The paper will draw on these examples to carve out the unique features of mapping practices in order to understand what kind of disease model is implied when mapped onto spatial and temporal data.

The plague on trial: witnessing, speech, and judgment in the making of a disease.

Author: Nicholas Evans (University of Cambridge)  email

Short Abstract

None provided.

Long Abstract

Shortly after plague broke out in India in 1896, a commission of inquiry was established to investigate the disease. This commission sought to examine both government responses to plague, and the true nature of the disease itself. In doing this, it followed a historical precedent set by other commissions of inquiry in India, particularly those concerning cholera, famine, and leprosy. This paper examines how plague came to be the kind of object that could be evidenced through the particular methods of the commission. How is it that the commission operated so as to constitute plague as something that might have its truth told through the performative enactments of professional 'witnesses' called to testify in front of a panel of questioners? What kind of epistemological processes were necessary for plague to become an object whose reality could be elucidated through the methodology of the trial and judgment? Ultimately, how did the commission help to establish this disease as something about which judgments of responsibility and accountability could be made? The broader scope of this paper is to probe the commission of inquiry - still an important part of British political life and an oft-uncontested producer of 'truth' - by examining how it constructs particular forms of witnessing as evidentiary of objects that might be placed on trial.

Pestis minor: evidential strategies and the colonial scramble for plague

Author: Christos Lynteris (University of Cambridge)  email

Short Abstract

The paper will examine the notion of pestis minor as an evidential strategy developed in the context of colonial medical science during the third plague pandemic (1855-1959).

Long Abstract

Pestis minor is a little used medical category today. Until one hundred years ago, however, at the height of the third plague pandemic, this was a notion that fuelled extensive debate and speculation amongst scientists. Referring to an attenuated or benign for plague, evidence of pestis minor was gleaned from medical reports across the world so as to raise the question of whether the disease could survive measures against it by means of temporary transformation. Afflicting its victims only by the slightest swellings, the disease could thus lurk in the human body until conditions allowed it to break out again in its true, malignant form. This paper will for the first time draw a history of this notion and the questions raised by it. More than that, however, it will ask how pestis minor was itself evidentialised; how, being based on the systematisation of loose and scattered evidence, it was rendered itself evidence of the true nature of plague, in other cases, a mechanism for disputing evidence about plague. The paper will examine these strategies of epidemiological reasoning within the context of inter-imperial antagonism regarding the truth of plague in the time of high colonialism.

Medical evidence in public

Author: Branwyn Poleykett (University of Cambridge)  email

Short Abstract

This paper follows African scientists as they attempt to trace lively ecologies and to keep open fraught political questions about disease control and eradication.

Long Abstract

Medical and scientific evidence emerges between universal claims and particular experiences. This paper follows African scientists as they attempt to trace lively ecologies and to keep open fraught political questions about disease control and eradication. These scientists live with and query the fluctuating indices produced by the monitoring of NTDs; calculations which mobilise an idea of debility shaped not just by the experiences of vulnerable bodies but also by complex imaginations of poverty, market participation and socio-economic fitness. Ugandan scientists blend the political and epistemic, the pragmatic and the philosophical, in their critique of public health programmes and draw acute contrasts between their scientific skill and their attenuated capacity for effective political action. I will argue that their stories can guide us towards new ways of producing collaborative, responsible and effective cultural critiques of global health.

Zeroes and millions, paleos and primitives: evidencing bodily biodiversity in the era of the microbiome

Author: Alex Nading (University of Edinburgh)  email

Short Abstract

I suggest some ways that evidence about the presence or absence of microbes in bodies might enrich critical analysis of medical subjectivity.

Long Abstract

Numerical evidence is central to the everyday operations of biomedicine. As scholars have shown, "target" quantities, from CD4 to cholesterol to body mass, are not just powerful indicators of well-being. They are also powerful tools of governance. By calculating these numbers, people "count themselves" as parts of populations at risk.

Attention to the role of microbes in regulating human health might alter this understanding of medical subjectivity. The human microbiome—the population of bacteria, viruses, fungi, and other creatures that live in and around the human body—is frequently described as a population of indeterminate "millions." Research in animals with microbial populations of "zero" has helped show how microbes operate symbiotically with their hosts, aiding in digestion, immunity, and even mood stabilization. Some experts are starting to advocate maintenance of a diversity of species, rather than adherence to strict numerical targets, as a pathway to good health.

The search for historical and contemporary evidence of the benefits of "bodily biodiversity" has made a set of bodies formerly marginal to biomedicine—namely, those of ancient and so-called "primitive" people—newly relevant. Drawing a comparison with work in historical ecology and environmental anthropology, I suggest that attention to how biodiversity has been evidenced (and politicized) in the context of environmental conservation—where ideas about the ancient and the "primitive" are also salient—can provide clues for rethinking medical subjectivity in the era of the microbiome.

Medical evidence, expectation and hope as techno-collective ethics: the case of gene therapy and thalassaemia in Cyprus

Author: Theodoros Kyriakides (University of Manchester)  email

Short Abstract

The paper explores medical evidence on gene therapy as means of politicizing patient expectations and hopes regarding therapeutic finality. By being disseminated into an infrastructure of institutional heterogeneity (techno-collectivities), medical evidence acquires political relevance and potency.

Long Abstract

This paper focuses on gene therapy and explores its connection to the politics of thalassaemia in Cyprus. Gene therapy utilizes the manipulation and insertion of viral vectors in the human organism as means to transmit and replace pathological genes with therapeutic ones. The medical technology in question is still in an experimental stage yet, if successful, carries the potential of providing a permanent cure for thalassaemia patients around the world. Gene therapy has an ambivalent relationship with medical evidence. First speculated in the early 70s, and after several clinical trials met by dead ends, gene therapy's originally messianic promise subsided in the 1990s through the early 2000s, only to recently resurface as imminent "reality". Using ethnographic research conducted with a thalassaemia patients association, and thinking through anthropological literature on expectation, imagination and hope, the paper situates the intensifying medical evidence surrounding the potential actualization of gene therapy in the wider political context of governmental decision making and patient activism in Cyprus. I make the case that medical evidence acquires political relevance and potency insofar it is disseminated into an institutional infrastructure of heterogeneous actors (techno-collectivities), capable of upholding patient expectations and hopes of techno-therapeutic finality as issues of collective concern, to be deliberated and contested by many.

Experience as Evidence: The Scientification of Homeopathy in Germany

Author: Eva Jansen (University of Tübingen)  email

Short Abstract

This paper analyses the gradual integration of homeopathy into biomedical institutions and science in Germany and the public discourse that comes along with it.

Long Abstract

Homeopathy in Germany is currently on the rise. Due to increased demand from patients as well as practitioners, the University of Magdeburg is planning to offer the first postgraduate course in scientific research methods for homeopathy. This can be interpreted as a step in the gradual integration of homeopathy into biomedical institutions and science. Although homeopathy was founded in Germany and is widely practiced by physicians and non-university trained naturopathic practitioners, the announcement of the course's establishment sparked an immediate counter-reaction: a number of natural scientists labeled the course "institutionalized quackery" and undertook an online campaign to lobby against it. At the same time, the course has attracted the increasing interest of physicians and medical students. Using data from ethnographic fieldwork and document analysis, this paper examines the public discourse on the scientification of homeopathy and the process of legitimizing experience as evidence.

This panel is closed to new paper proposals.