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doi: 10.1111/maq.12865pmid: 38860724
This article examines how militarized regimes of narcotics and price control sustain unpalliated cancer pain in Pakistan. It shows how these regimes of control—reimagined as “regimes of pain”—render morphine, a cheap, effective opiate analgesic, scarce in hospitals. Meanwhile, heroin, morphine's illegal derivative, proliferates in illicit circuits. The article highlights a devastating consequence of the global wars against drugs and “terror”: the consignment of cancer patients to agonizing end‐of‐life pain. Widening the analytic lens upon palliation beyond bodies and their clinical encounters, the article offers a geopolitics of palliation. It shows how narcovigilance targeting illicit drugs has the perverse effect of throttling morphine's licit supply. It shows further how unviably low price ceilings, purported to ensure a poor population's access to morphine, render it scarce on the official market. These mutually reinforcing regimes of control thus thwart their own purported objectives, consigning cancer patients to preventable, yet unpalliated, pain.
doi: 10.1111/maq.12868pmid: 38775702
Recent ethnographies have investigated self‐care as a socially driven configuration of care. This analysis engages theorizing on the imagination to expose new social dimensions of self‐care in cases of mental health as embodied and communal. Based on fieldwork across Canadian universities and in conversation with students, campus wellness providers, and a group of psychiatric epidemiologists seeking to understand the mental health treatment choices of students, this article examines how these different subjects activate what I call an imaginarium of self‐care. Among young adults in Canada, mounting social ills that go therapeutically unaccounted for have relocated forms of self‐care into the imagination through play and world‐building in ways that challenge the distinction between material and speculative healing. Attending to the imaginative dimensions of self‐care makes coherent the ways that young people are grasping for hope in a world that—when embodied—resists recovery.
Rubinstein, Ellen B.; Heinemann, Laura L.
doi: 10.1111/maq.12873pmid: 38847386
In November 2020, North Dakota reported a higher number of cases and deaths per capita from COVID‐19 than any other state in the United States. Several months later, it reported one of the country's highest rates of vaccine hesitancy, leading to the development and implementation of the state‐funded and physician‐led “Vaccine Champion” (“VaxChamp”) program. Glossing the primary problem as one of “provider confidence,” the VaxChamp program emphasized a standardized, scalable intervention that targeted healthcare providers directly, and patients only indirectly. Although the program hit its quantitative benchmarks, a qualitative inquiry into the program's history and context reveals multiple crises of confidence, many beyond the bioscientific domain of the program's focus. Drawing from work in medical and linguistic anthropology, we describe and analyze the “multiple levers of vaccine confidence” at play in the intervention and its surrounding context, as well as how these crises of confidence emerged.
Hasemann Lara, José Enrique; Díaz de León, Alejandra; Daser, Deniz; Doering‐White, John; Frank‐Vitale, Amelia
doi: 10.1111/maq.12866pmid: 38775701
We compare the social determinants of health (SDOH) and the social determination of health (SDET) from the school of Latin American Social Medicine/Collective Health. Whereas SDET acknowledges how capitalist rule continues to shape global structures and public health concerns, SDOH proffers neoliberal solutions that obscure much of the violence and dispossession that influence contemporary migration and health‐disease experiences. Working in simultaneous ethnographic teams, the researchers here interviewed Honduran migrants in their respective sites of Honduras, Mexico, and the United States. These interlocutors connected their experiences of disaster and health‐disease to lack of economic resources and political corruption. Accordingly, we provide an elucidation of the liberal and dehumanizing foundations of SDOH by relying on theorizations from Africana philosophy and argue that the social determination of health model better captures the intersecting historical inequalities that structure relationships between climate, health‐disease, and violence.
doi: 10.1111/maq.12867pmid: 38773774
Recent research has unveiled the pervasiveness with which Indigenous patients are subjected to racialized stereotypes within the Canadian health system. Because discrimination in health care is associated with poor health outcomes and undertreated illness, there is a need to better understand how racism is perpetuated systemically in order to rectify the policies, practices, and attitudes that enable it. This article outlines a moral economy of care in emergency departments in western Canada by exploring the discourses that medical professionals employ when discussing cases of medical racism. While these discourses respond to the everyday realities of working in hospitals, they are also rooted in the colonial genealogy of health care in Canada and perpetuated by neoliberal shifts in health care services. By exploring the moral economy of care, this article sheds light on the way pervasive discourses contribute to reproducing and circulating Indigenous‐specific racism and its role in decision‐making.
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