Oral Presentation Session
Reviewed by: Society for Medical Anthropology
Of interest to: Students
Primary Theme: The Political
Secondary Theme: Health
Our panel investigates the clinic at its infrastructural and social borders, exploring the entanglements of care and politics, the changing relations between patients and providers, and the elusive limits of the clinical encounter. Writing against the grain of earlier representations of health inequality (the “social determinants of health,” “social suffering” etc.), medical anthropologists have already shed much light on how depoliticization actually makes clinical spaces political, through studies of addiction, disability, mental illness, and HIV/AIDS, among others. By attending to how clinics are like other institutions (insofar as they act as spaces for subjectivization), these studies have eroded the idea that there are any boundaries between the clinical and non-clinical space. And yet borders exist, and they are fundamental to how care is experienced, performed, and recognized.
We approach these questions through five papers exploring the re-bordering of clinical spaces and the tension inherent in the concept of “boundary” itself. We look how the spatial arrangements and structures of clinical space inform the ways we think about public decency or private techniques of the self. In this, Bianca Dahl, Morganne Blais-McPherson and Laura Beach take up the supposed entangled relationship between care and coercion and ask us to consider how this entanglement emerges or is changed by the structure or contingencies of space itself. Our panel also explores questions related to how clinical spaces become contested: Nicholas Abrams and Tomas Matza consider the changing roles of technology and “evidence-based medicine” in producing subjects and/or exacerbating conflicting interests or imaginaries of good clinical practice. In this, our conversation contributes to understanding a political reemergence and the therapeutic importance of the political in the clinical space—what we might call the clinically political.
We build on past research that held the clinic as a political space, but we do so by asking how and by whom are the boundaries of clinics created, enforced, negotiated and renegotiated in everyday practices. Both Beach and Abrams consider how tropes of “thoughtless doctors” and “unreasonable patients” are nuanced by investigating the ways that the clinic is itself imagined and contested. Conversely, Dahl and Blais-McPherson explore a reemergence of political narratives in the clinic, as they (along with Matza) investigate how the practice of care is informed by political ideologies—how they are brought into clinical practice and the significance of navigating an order of difference between clinical and non-clinical spaces. In doing so, our panel explores how attempts to democratize the clinic can inevitably build the boundaries that structure disciplinary regimes, give rise to new social divisions, operationalize care, as well as ultimately inspire new tactics and make new forms of democratic demands conceivable.