Patients, Pharmaceuticals, and Time: Reclaiming the Temporal Ambiguities of Illness and Healing through an Ethnographic Analysis of Asthma (original) (raw)

Health(care) and the temporal subject

The Ethics Forum, 2018

Defends “momentary sufficientarianism,” as being an important element of healthcare justice: it is a fundamental demand of justice that people are sufficiently well off not across their lives, but at all moments in their lives. Also considers how a pluralist approach, which engages both with people’s lives as a whole and with their states at particular moments, can reconcile the potentially competing claims in healthcare that emerge from these two perspectives.

Diagnostic refusals, temporality, and subjectivity among ''non-compliant'' sufferers of asthma

Subjectivity, 2017

Medical guidelines define asthma as a chronic lung disease usually treated with daily, preventative medication. A significant proportion of asthma sufferers, however, reject understandings of asthma as chronic, based on their experiences of bouts of breathlessness that are frightening but often episodic and short-lived. This paper considers the experiential aspects of asthma among New Zealanders and explores the interplays between pharmaceutical temporalities and the temporalities of respiratory distress. Focusing on asthma sufferers who eschew preventative medication, I argue that while standardized treatment programs assume a particular mode of reckoning time, sufferers can engage in radically different ways of temporalizing the symptom and the subject, indicating the need for a new con-ceptualization of what ''non-compliance'' may entail.

The Problem of Time in Ethnographic Health Care Research

Qualitative Health Research, 2010

Drawing on the ideas outlined by anthropologist Fabian and feminist scholars Halford, Savage, and Witz, in this article I make two arguments that challenge ethnography's claim to theoretical inference and empirical generalization, particularly for research examining contemporary health care practices. For Fabian the dilemma arose out of ethnography's origins in the secularization of time. Accounts of the subject's experiences using present tense assume no progress; accounts using past tense freeze the subjects in the past. For Halford and her colleagues, the methodological problem was reversed. Their respondents were engaged in a battle with health systems in constant change that resulted in the loss of memory of a corporate past. The problem now for the ethnographer, as in many other research approaches, is one of verification of observations and reliability of interpretations. The ethnographer now becomes frozen in time as is his or her account of events in the field. Drawing on ethnographic research in hospital workplace change, in this article I examine these time-based implications for truth claims.

Therapy, Remedy, Cure: Disorder and the Spatiotemporality of Medicine and Everyday Life

Increasingly, there is a temporal differentiation among kinds of treatments available through medicine. Cures offer one-time resolution of symptoms; that is, with the benefit of a cure, there is no longer a medical problem in need of treatment. Remedies offer temporary, situational relief of symptoms. Therapies offer temporary relief of symptoms, but promise the possibility of nonsituational fixes, offering universal cessation of symptoms but only for a limited time. Therapy has become increasingly integral to the rhythm of everyday life, particularly in the United States, where medical treatment and pharmaceutical consumption have become a means for normalizing oneself to social expectations. I draw on fieldwork with people who experience sleep disorders-narcolepsy, sleep apnea, and delayed and advance sleep phase syndrome-to explicate these models of treatment and consider how these medical spatiotemporalities formulate emergent everyday orders of life.

Unsettled Care: Temporality, Subjectivity, and the Uneasy Ethics of Care

Anthropology and Humanism, 2020

In this introduction, and indeed this special section, we explore care as a morally ambiguous and relationally unstable set of practices. By exploring care over longer temporal frames and across shifting subjectivities and intersubjectivities, we show how enactments of care are often unsettled by the transforming dynamics of relationships across time and often entail a multiplicity of competing affects and aspirations, such as hope and failure, love and resentment, pragmatism and utopianism, and connection and disconnection. We thus suggest an analytic approach to care that questions care as either morally suspect or morally virtuous and instead allows for the compromised, shifting, and ambiguous dimensions of care practices to take center stage. [care, anthropology, temporality, subjectivity] Caring for another and being cared for is often messy, both emotionally and physically. Informed by broader politico-economic conditions, mundane, longterm care relationships may involve daily labor and aspirations toward the "good life," but they are rarely, if ever, settled. This collection of seven short, ethnographically rich papers explores diverse contexts in which care is theorized as unsettled in three ways. First, diverse temporal perspectives inform daily care practices, including varied orientations to the past, present, and future. Second, care relationships unfold and transform over time and exploring this necessitates an understanding of the transforming ethics, politics, pragmatics, and socialities that shape the possibilities for care. Third, experiences of caring and being cared for ebb and flow across the life course, with individuals occupying shifting, often multiple, roles as both subjects and objects of care. Although care relationships are often enduring and mundane, they remain unpredictable, containing the possibility of both suffering and hope, and although such practices change over time, moments of felicity or catastrophe are rarely final. As such, we understand giving and receiving care to be in situ enactments of long-term transformations of human relationships, informed by fantasies of futurity and post hoc perceptions of experience. Ethnographically, our emphasis on unsettled care involves following people in and out of their encounters with care regimes and locating care within broader relationships and values. This vantage point reveals the ways in which people fulfil different and ever shifting therapeutic and relational roles of care in particular moments (e.g. Herring 2020). Unsettled Care thus seeks to problematize the boundaries implied by the roles of "care giver" and "care recipient," and explores the

The art of healing and the many worlds of time

Journal of Religion & Health, 1983

This essay is a contribution to the understanding of the difficulties involved in integrating biomedicine and holistic medicine. The phenomenology of the perception of time as described by Mann, Siegler, and Osmond is postulated as underlying the different orientations to the practice of medicine.

On Social Plasticity: The Transformative Power of Pharmaceuticals on Health, Nature and Identity

Dutch Crossing: Journal of Low Countries Studies, 2016

This article proposes a theoretical framework on the role of pharmaceuticals in transforming perspectives and shaping contemporary subjectivities. It outlines the significant role drugs play in three fundamental processes of social transformation in Western societies: medicalisation, molecularisation and biosocialisation. Indeed, drugs can be envisaged as major devices of a pharmaceutical regime, which is more akin to the notion of dispositif, as used by Foucault, than to the sole result of high-level scheming by powerful economic interests, a notion which informs a significant share of the literature. Medications serve as a key vector of the transformation of perspective (or gaze) that characterises medicalisation, molecularisation and biosocialisation, by shifting our view on health, nature and identity from a categorical to a dimensional framework. Hence, central to this thesis is that the same underlying mechanism is at work. Indeed, in all three processes there is an evolving polarity between two antinomic categories, the positions of which are constantly being redefined by the various uses of drugs. Due to their concreteness, the fluidity of their use and the plasticity of the identities they authorise, drugs colonise all areas of contemporary social experiences, far beyond the medical sphere.