Contemporary approaches to the study of suicide tend to examine suicide as a medical or public health problem rather than a moral problem, avoiding the kinds of judgements that have historically characterised discussions of the phenomenon. But morality entails more than judgement about action or behaviour, and our understanding of suicide can be enhanced by attending to its cultural, social, and linguistic connotations. In this work, I offer a theoretical reconstruction of suicide as a form of moral experience that delineates (...) five distinct, yet interrelated domains of understanding: the temporal, the relational, the existential, the ontological, and the linguistic. Attention to each of these domains, I argue, not only enriches our understanding of the moral realm but also provides a heuristic for examining the moral traditions and practices that constitute contemporary understandings of suicide. (shrink)

Social analysis of transplant organ demand often focuses on either small-scale (familial) tyrannies of the gift or large-scale (global) markets. Media accounts of the scandalous in transplant medicine stress the latter, a homogeneous model of flows of biovalue down gradients of economic and social capital. This article examines particular globalizations of tissue demand organized as much around claims of social similarity as gradients of social difference. To engage apparent ‘diasporic’ networks of organ purchase — Non-Resident Indians traveling to India and (...) Overseas Chinese to China — I elaborate a concept of bodily supplementarity. Supplementarity in this account is the ability of an individual or population to secure longevity through the mobilization or acquisition of the organic form of others. Diasporic tissue circuits are analyzed in the context of ‘experiments’ in supplementarity that proliferate with the transformation of the molecular conditions for supplementarity. The emergence of powerful immunosuppressants renders the scale of tissue recruitment flexible and contingent, and allows clinics to develop alternatives to brain death. These circuits emerge as situations that reorder the relation of the familial and the global in transplantation, in the service not only of migrant supplementarity but also efforts to reimagine the challenges of emigrant belonging within particular configurations of racialized life and its government. (shrink)

If there is any endeavor so demanding of human creativity, it is the remaking of lives and property after disaster. However, post-disaster recovery is considered the greatest failure in disaster management, and within this field, post-disaster housing reconstruction is the most insufficiently investigated practice. Furthermore, studies of disaster management attribute failure to top-down and technocratic approaches that often overlook the agency, capacities, and moral priorities of those directly affected. In contrast, this paper attends to those displaced by disaster as creative (...) and moral agents who manage to carry on with life despite their socio-economic and political vulnerabilities by drawing from theory in anthropology, disaster studies, and cognitive psychology. Through examining how inhabitants of a post-Typhoon Yolanda reset­tlement site transform their housing to negotiate multiple and vague rules and regulations, I entangle myself with literature that assumes that the creativity of design lies in the capacity of individuals to improvise according to their values and in response to those of others, within a world that is continually unfolding. I also assume that improvisation is contingent upon processes of cognitive innovation in which social relations operate as indispensable intellectual resources for grasping and mobilizing knowledge that would give inhabitants of resettlement housing the best possible chance of attaining their hopes, dreams, and ambitions. Consequently, I propose that viewing creativity as an improvisational process highlights the agentic potential of design in even the bleakest and most quotidian of settings. My own hope is to extend the possibilities for correspondence between built environment practitioners and those who, because of their subaltern positionalities, tend to be overlooked by the field of post-disaster housing reconstruction and yet must live through the consequences of its practice. (shrink)

The model of mind and body in Tibetan medical practice is based on Buddhist theory, and is neither dualistic in a Cartesian sense, nor monistic. Rather, it represents a genuine alternative to these positions by presenting mind/body interaction as a dynamic process that is situated within the context of the individual’s relationships with others and the environment. Due to the distinctiveness, yet interdependence, of mind and body, the physician’s task is to heal the patient’s mind (blo-gso) as well as body. (...) This in turn emphasizes the central importance of ‘compassion’ in the physician/patient relationship. This article investigates how Tibetan medical practitioners understand and enact the mind/ body and physician/patient relationships, and how this relates to theoretical explications of these relationships in Tibetan medical and Buddhist teachings. Furthermore, Tibetan medicine provides an interesting model for comparison with embodied theories of cognition, which see consciousness, the body and its environment as integral parts of a complex, dynamical cognitive system. (shrink)

The application of human right frameworks is an increasingly important part of efforts to accelerate progress in global mental health. Much of this has been driven by several influential legal and policy instruments, most notably the United Nations’ Convention on the Rights of Persons with Disabilities, as well as the World Health Organization’s QualityRights Tool Kit and Mental Health Action Plan. Despite these significant developments, however, much more needs to be done to prevent human rights violations. This chapter focuses on (...) a critical component of this broader challenge, which is the question of how best to regulate and reduce the use of coercive measures. The recent literature on coercion in psychiatry – which addresses involuntary commitment, seclusion, restraint, and forced medication – represents a useful resource that can help guide tractable solutions in global mental health. These issues are evaluated from the perspective of global health governance, and several general recommendations are made in order to improve monitoring and enforcement, provide guidance for domestic legislative reform, and strengthen health systems. (shrink)

Health care services increasingly face patient populations with high levels of ethnic and cultural diversity. Cultures are associated with distinctive ways of life; concepts of personhood; value systems; and visions of the good that affect illness experience, help seeking, and clinical decision-making. Cultural differences may impede access to health care, accurate diagnosis, and effective treatment. The clinical encounter, therefore, must recognize relevant cultural differences, negotiate common ground in terms of problem definition and potential solutions, accommodate differences that are associated with (...) good clinical outcomes, and manage irresolvable differences. Clinical attention to and respect for cultural difference (a) can provide experiences of recognition that increase trust in and commitment to the institutions of the larger society, (b) can help sustain a cultural community through recognition of its distinct language, knowledge, values, and healing practices, and (c) to the extent that it is institutionalized, can contribute to building a pluralistic civil society. (shrink)

This paper is about the ontology of a cancer diagnosis at high-end hospitals in Colombia. Drawing on a seventeen-month ethnographic fieldwork study in this country, it pays attention to how dermatologists, pathologists, and oncologists looked at my partner’s skin during a routine medical checkup and enacted two seemingly contradictory diagnoses: a lethal melanoma and a benign dysplastic nevus—commonly known as mole. Because their differences under the microscope or through dermatology goggles may be subtle, physicians often disagree on what they see. (...) When medical services are not unrelated to the economic possibilities of patients to pay for them, what emerges through a microscope might be different. With neoliberal medical reforms in Colombia as background, this paper focuses on the ontological indeterminacy of cancer and its relationship to high-end hospitals and a patient who could, albeit not without effort, pay for the treatment. Thus, I argue that how physicians saw was not unrelated to what they saw and therefore to their practices of medicine in neoliberal Colombia. How do medical practices and ways of seeing in Colombia enter into composition with the bodies they study? Could the same skin tissue simultaneously be cancerous and noncancerous? (shrink)

An enduring question in the cultural study of psychological experience concerns how emotion may play a role in shaping moral aspects of children’s lives as they are mentored into socially preferred ways of understanding and responding to the world at hand. This article brings together approaches from psychological and linguistic anthropology to explore how cultural schemas of normativity are communicated, embodied, and enacted as children participate in day-to-day family activities and routines. Illustrative examples emanate from a videotaped corpus of naturalistic (...) interactional data that document the daily lives of 32 ethnically diverse U.S. middle-class families who reside in the Los Angeles, California metropolitan region. The article employs discourse and narrative analysis to examine how children are apprenticed into perceiving, appraising, and reacting to the emotions of self and others as culturally shaped indicators for proper comportment. Data analysis emphasizes how implicit components of caregivers’ interactions with children (i.e., gesture, gaze, facial expression) intertwine with explicit, verbal communication to constitute intricately layered affective messages that shape the evaluative frames through which children interpret, display, and respond to emotions. The article identifies two culturally salient childrearing practices, “pep talks” and “time outs,” that apprentice children into moral accountable relationships with others by encouraging them to manage their emotions in culturally preferred ways. Study findings suggest that parental communications conveying praise and approval—or conversely indexing disapproval—towards children are emotionally resonant motivational practices in this cultural milieu as children are mentored into culturally meaningful emotional management techniques. The article highlights how children actively employ semiotic socio-communicative resources and it closely traces their sense-making processes in tandem with their discursive contributions to the moment-by-moment interaction. It argues that emotion, morality, and interpersonal relations are critical in shaping children’s acquisition of consensually validated ways of perceiving, feeling, and responding to the phenomena they encounter in their day-to-day lives. This perspective aims towards contextualized understandings that render plausible connections between local contexts of everyday action and broader macro-level discourses and master narratives, such as those associated with a neo-liberal emphasis on cultivating citizens who learn to regulate their emotions on behalf of self and others. (shrink)

Contemporary sociology mirrors Western society in its general aversion and sensitivity to pain, and in its view of pain as an unproductive threat to cultures and identities. This highlights the deconstructive capacities of pain, and marginalizes collectively authorized practices that embrace it as constitutive of cultural meanings and social relationships. After exploring the particularity of this Western orientation to pain — by situating it against processes of instrumentalization and medicalization, and within a broader context of other social developments conducive to (...) a heightening of affect control — this article builds on Mauss’s analysis of ‘body techniques’ in suggesting that the cultural, physiological and psychological dimensions of pain can be combined in various ways. In examining this point further, we then compare contrasting religious engagements with pain as a way of detailing how it can be positively productive of cultural meanings and identities, and conclude by using these comparisons to illuminate the relationship between the current Western approach to pain and the Christian traditions that shaped the West historically. (shrink)

When African migrants disappear on the Mediterranean going to Europe they often leave no trace—except for the occasional bodies that wash ashore on the beaches of southern Europe. In this essay, the urgent social and existential ramifications of migrant fatalities on the sea are explored. Drawing on ethnographic fieldwork in a small Ghanaian fishing village on the coast of the Gulf of Guinea, it is discussed how the bereaved struggle to make sense of these deaths to high-risk migration—how they struggle (...) to deal with devastating loss while retaining a sense of moral order. (shrink)