THE THICK SOCIAL MATRIX FOR BIOETHICS Anthropological Approaches

Abstract

Anthropologists working in the fields of health, illness, and medicine share a focus on norms, values and practice with scholars and practitioners of bioethics. Yet there is also a substantial anthropological mistrust of the field. This mistrust is based on what anthropologists often take to be the ahistoricity and ethnocentricity of much bioethical discourse. By “ahistoricity”, I intend to signal two concerns: first, the foundational premises of classical bioethics developed in relation to a specific moment in Anglo-American analytic philosophical traditions. Yet these premises are often incorporated into bioethical discussions in universalizing terms, without sufficient acknowledgement of their embeddedness in time and place (e.g. relevant critiques include Kleinman 1999; Lock 2001; Marshall 1992; Rosenberg 1999). Other perspectives and methods, for example, those drawn from the reflexive and phenomenological perspectives that are the trademark of Continental philosophy and critical social science, have held far less sway in US bioethics. Yet these are the discursive traditions with which many US anthropologists now work. Second, the social movements and institutional changes which spawned bioethics are rarely analyzed in relation to its accomplishments. Yet the field developed under the influence of health reform movements in the USA. In attempting to protect the subjects of medical interventions and experiments, activists made powerful regulatory claims which were rapidly institutionalized in American hospitals and the governmental research apparatus. Ironically, recognition of this activist success was quickly muted in relation to the more successful