Social and Cultural Perspectives on Health, Technology and Medicine

Old Concepts, New Problems

Ciara Kierans, Kirsten Bell, Carol Kingdon

• Publisher: Routledge
• Year: 2016
• Print ISBN:
  9781138941106
• eBook ISBN:
  9781317377498
• Topic: Social Sciences
• Subtopic: Anthropology
• Index: Social Sciences

Developments in health, science and technology have long provided fertile analytical ground for social science disciplines. This book focuses on the critical and enduring importance of core concepts in anthropology and sociology for interrogating and keeping pace with developments in the life sciences. The authors consider how transformations in medical and scientific knowledge serve to reanimate older controversies, giving new life to debates about relations between society, culture, knowledge and individuals. They reflect on the particular legacies and ongoing relevance of concepts such as 'culture', 'society', 'magic', 'production', 'kinship', 'exchange' and 'the body'. The chapters draw on the work of key historical and contemporary figures across the social sciences and include a range of illustrative case studies to explore topics such as transplant medicine, genetic counselling, cancer therapy, reproductive health and addiction. Of particular interest to students and scholars of anthropology, sociology, and science and technology studies, this volume will also be a valuable resource for those working in the fields of health and medicine.

1 CULTURE

Ciara Kierans

DOI: 10.4324/9781315673882-2

Culture is a deeply compromised idea I cannot yet do without.

James Clifford, The Predicament of Culture

Introduction

If we can agree on one thing within the discipline of anthropology today with regard to the vexed concept of culture, it is what culture is not. Culture is not the sort of concept that can be pressed into a prescriptive role, reduced to sets of traits or understood as a causative agent. Phenomena associated with culture, such as beliefs, practices, symbols and so on, are not free-floating, abstracted features of everyday life. Nor is culture simply the property of a group. What it does constitute, however, is a different story. Anthropologists, who use culture as their principal interpretive tool, readily admit its contested and changing character. It has been extensively critiqued within the discipline, most intensively over the past 30 years, with little resolution or consensus over its long-term durability or utility (Frankenberg, 2014). It is possibly best characterized by the shifting discourses that have underpinned various attempts to define it, definitions that pinball between its objectivist, symbolic, discursive and practised referents.

Michael Agar, borrowing from Roy D’Andrade, gets straight to the heart of the matter:

Culture is a mess, akin to ‘studying snow in the middle of an avalanche’. You can see why some argue that we should consider dropping the word from our vocabulary. This will never happen, though, since anthropology only gets one vote in the crowded marketplace of global discourse, and global discourse is enamoured of the term culture and isn’t about to give it up. For now let’s continue with culture, continue to redefine the concept so that we can say ‘culture means this’, even if we know what we say has the chance of the proverbial snowball in hell of ever influencing popular uses of the term.

(Agar, 2014: 5)

In the spirit of such refined resignation, this chapter attempts to do three things: (1) to provide an overview of the concept’s meandering career in anthropology; (2) to examine its position in the ‘crowded marketplace of global discourse’ by empirically demonstrating culture as a ‘topic of concern’ for health and medicine; and (3) to consider ways in which we might continue to work with the concept. Although far from offering any prescription for its use, I hope what follows will stand as a resource for students and researchers who are interested in the concept, one that might aid navigation of the anthropological terrain.

Reflections upon culture at the crash-points of disciplinary inquiry

There are, in anthropology, an abundance of reviews that have sought to map out trajectories of the culture concept over much of the twentieth century (see Elias, 1978 [2014]; Kroeber and Kluckhohn, 2014; Stocking, 2014; Harris, 2014; Ortner, 2014; Clifford and Marcus, 2014; Kuper, 2014). While there are benefits to tracing the progression of a concept, it’s equally important not to assume historical developments represent intellectual advancements. Adam Kuper’s treatment of the work of culture in anthropology cautions:

Modern arguments [over culture] do not precisely recapitulate earlier controversies… Each generation modernises the idiom of debate, usually adapting it to current scientific terminology; evolutionism in the late 19th century, organicism in the early 20th century, relativity in the 1920s.

(Kuper, 2014: 9)

As a consequence, explications of culture and the various definitional disputes that have accompanied them might best be thought of as a field of practice in Pierre Bourdieu’s sense of the term: an arena where different thinkers and groups of thinkers manoeuvre, interact and come to occupy positions relative to one another through the ways in which they mobilize culture to do certain things. Culture is a term that has been employed to denote national identities as much as disciplinary objects and boundaries. It has been at the very heart of anthropology as a discipline. If culture has been drawn on to understand distinctions, we also must recognize that it has emerged as a product of distinctions (Bourdieu, 2014). That is, the ways in which anthropologists have taken up the concept are themselves connected to wider uses and ways of marking difference. The following section presents an overview of key points in the concept’s career. They are drawn on only to anchor the changing and contested terrain of culture and are in no way comprehensive. Definitions of culture advanced by some of the authors cited in this next section can be found in Table 1.

TABLE 1 Definitions of culture

1.1 Edward Burnett Tylor (2014 [2014]: 1)	Culture, or civilization, taken in its broad, ethnographic sense, is that complex whole which includes knowledge, belief, art, morals, law, custom, and any other capabilities and habits acquired by man as a member of society.
1.2 Franz Boas (2014: 149)	Culture may be defined as the totality of the mental and physical reactions and activities that characterize the behavior of individuals composing a social group collectively and individually in relation to their natural environment, to other groups, to members of the group itself and of each individual to himself. It also includes the products of these activities and their role in the life of the groups. The mere enumerations of these various aspects of life, however, does not constitute culture. It is more, for its elements are not independent, they have a structure.
1.3 Margaret Mead (2014: 17)	Culture means the whole complex of traditional behavior which has been developed by the human race and is successively learned by each generation. A culture is less precise. It can mean the forms of traditional behavior which are characteristics of a given society, or of a group of societies, or of a certain race, or of a certain area, or of a certain period of time.
1.4 Bronisłw Malinowski (2014: 623)	Culture is a well-organized unity divided into two fundamental aspects – a body of artifacts and a system of customs.
1.5 Ruth Benedict (2014: 16)	What really binds men together is their culture, … the ideas and the standards they have in common.
1.6 A.R. Radcliffe-Brown (2014: 2)	We do not observe a ‘culture’, since that word denotes, not any concrete reality, but an abstraction, and as it is commonly used a vague abstraction. But direct observation does reveal to us that these human beings are connected by a complex network of social relations. I use the term ‘social structure’ to denote this network of actually existing relations.
1.7 Talcott Parsons (2014: 2)	Cultural objects are symbolic elements of the cultural tradition, ideas or beliefs, expressive symbols or value patterns.
1.8 Alfred Kroeber and Clyde Kluckhohn (2014: 357)	Culture consists of patterns, explicit and implicit, of and for behavior acquired and transmitted by symbols, constituting the distinctive achievements of human groups, including their embodiments in artifacts; the essential core of culture consists of traditional (i.e. historically derived and selected) ideas and especially their attached values; culture systems may, on the one hand, be considered as products of action, and on the other as conditioning elements of further action.
1.9 Clifford Geertz (2014: 5)	Man is an animal suspended in webs of significance he himself has spun. I take culture to be those webs, and the analysis of it to be therefore not an experimental science in search of law but an interpretative one in search of meaning.
1.10 Claude Lévi-Strauss (2014 [2014]: 4)	Man is a biological being as well as a social individual. Among the responses which he gives to external stimuli, some are the full product of his nature, and others of his condition… But it is not always easy to distinguish between the two… Culture is neither simply juxtaposed to nor simply superposed over life. In a way, culture substitutes itself to life, in another way culture uses and transforms life to realise a synthesis of a higher order.
1.11 James Clifford (2014: 19)	If culture is not an object to be described, neither is it a unified corpus of symbols and meanings that can be definitively interpreted. Culture is contested, temporal and emergent.
1.12 Paul Rabinow (2014: 241)	We do not need a theory of indigenous epistemologies or a new epistemology of the other. We should be attentive to our historical practice of projecting our cultural practices onto the other; at best, the task is to show how and when and through what cultural and institutional means other people started claiming epistemology for their own.

Culture: a modern construction

The contemporary anthropological use of culture emerged, post-Enlightenment, as an outcome of Europe’s complex project of modernization. The Enlightenment had given rise to new social processes, institutions and discourses, engendering, in turn, new modes for thinking about oneself and one’s place in a rapidly changing world (Porter, 2014). These new ways of thinking were, according to Norbert Elias, evident in the differences between what the French referred to as ‘Civilization’ and the Germans ‘Kultur’ (Elias, 1978 [2014]). ‘Civilization’, according to Elias, was explicitly an extension of the Enlightenment project. It manifested in pride in progress, in technological advancements, in the power of self-determining new societies and, in many respects, in the status of a newly modernized Europe as superior to other forms of society.

The German use of the term ‘Zivilisation’ similarly reflected these developments, but was ancillary to what they referred to as ‘Kultur’. In this reading, Kultur, by comparison, is the expression or spirit of ordinary people, the outcome of history and tradition, visible in spiritual, artistic and creative endeavours. It is Kultur that establishes and delineates the ground of difference. For Elias (2014 [2014]: 8), ‘it brought into focus those areas of the social life of humans which provided the politically excluded German middle classes with the main basis for their self-legitimization and the justification of their pride’. Kultur was, in fact, the bulwark against the immediate threats posed by Zivilisation: technological modernization and mass society (Gaughan and Lutzeier, 2014). Kultur, with its roots in the writing of the German philosopher Johann Gottfried Herder, is both political and social. In cohering a shared identity, it establishes a common and future path. The specific focus on the collective or ‘lifeways’ of a people, would have far-reaching consequences not only for German philosophers such as Friedrich Nietzsche and Wilhelm Dilthey, but also for Weber’s methodological standpoint of ‘verstehen’¹ and the rise of anthropology as a discipline (Kuper, 2014).

If conceptualizing culture became a way for the Germans to distinguish who they were in the changing economic and political landscape of nineteenth-century Europe, for many British thinkers it was a resource to enlarge understanding of an increasingly complex world, which included the expanding colonial territories and their place within them. That said, and echoing Grimshaw and Hart (2014: 21), we must be cautious not to ‘indulge a parochial nationalism equating anthropology’s development with specific histories’, and so remain mindful that anthropological thought is diffuse and embedded in wider international projects. Nevertheless, colonial nations not only presented administrative problems to solve for an expanding British Empire, but generated new questions for intellectuals with regard to the visible diversity in social organization, social practice and physical form across the globe (Greenfield, 2014). Victorian thinkers such as Herbert Spencer and Sir James Frazer assumed that social differences could be constructed as a result of socially organized hierarchies, evolving as a logical consequence of natural competition. This crude evolutionary rendering laid the framework for the work of English anthropologist Edward Burnett Tylor’s early fieldwork studies in Mexico and what would become anthropology’s first formal definition of culture (Table 1.1).

Tylor’s definition treated culture in unitary terms, with different societies progressing developmentally through time. Elaborated in Primitive Culture (1871), Tylor advocated that all cultures, past and present, must be studied as a part of a progressive history, moving from an animistic savage society to the modern civilized state. For many different reasons – political, commercial, intellectual and imperial – the idea of the Other was pushed into relief, and the concept of the ‘primitive’ took hold as a key organizational device in early anthropology (see Chapter 3), producing understandings of culture and naturalized orders of social division that, in turn, imposed classificatory arrangements that took the better part of the twentieth century to deconstruct.

It didn’t take long before anthropologists were caught up in the contest to wrestle the concept from the scientific racism and discriminatory policies that inevitably followed on from evolutionary thinking. Initial efforts to disentangle culture from evolutionism are linked to the work of Franz Boas and his advancement of the theory of cultural relativism. Motivated by the writings of Rudolf Virchow (Stocking, 2014) and working among the Inuit, Boas questioned the classification and categorization of peoples according to evolutionary standards set by Western society. According to Boas, culture must be understood in the plural ‘culture(s)’ and within context (Stocking, 2014) (Table 1.2). Cultural relativism, therefore, advocated an understanding of culture on its own terms and in accordance with its own internal standards and values. For Boas, culture was learned, fundamentally a product of socialization and little rooted to biology. This approach was put to great effect by Boas’s students, most influentially by Margaret Mead, whose 1928 monograph Coming of Age in Samoa stood as a testimony (albeit a problematic one²) to enduring nature/nurture or nature/culture debates (Table 1.3). Her work argued that the disturbances associated with adolescence in the US were not grounded in biological changes but were culturally shaped and ordered through childrearing and the values underpinning sexuality. Influentially, the Boasian tradition exercised the idea that evidence drawn from other cultures could be used to falsify generalized statements about the character of human behaviour, ...

Table of contents

• Cover Page
• Half Title Page
• Title Page
• Copyright Page
• Table of Contents
• List of figures and tables
• Foreword by Professor Deborah Lupton
• Acknowledgements
• Introduction
• 1 Culture
• 2 Society
• 3 Magic
• 4 Production
• 5 Kinship
• 6 Exchange
• 7 The body
• Conclusion
• Index