Medical anthropology

Medical anthropology

828 Book reviews The contents and the way of presenting the material, except for statistical sources, which aI;e slightly out of date, e.g. 1973, fu...

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828

Book reviews

The contents and the way of presenting the material, except for statistical sources, which aI;e slightly out of date, e.g. 1973, fulfill requirements of the International Monograph Series.

National Research Institute of Mother and Child, Warsaw

JADWlGA KOPCZYI~SKA-SIKORSKA

Medical Anlhropology, by GEORGE M. FOSq%R and BARBARA GALLATIN ANDERSON. Wiley, New York, 1978. 354 pp. $14.95 To turn out a first textbook in a relatively new and expanding field which lacks a clearly localized central focus and well-marked boundaries to ease the authors' efforts is no small task. Yet this is the task to which Foster and Anderson addressed themselves in writing Medical Anthro-

pology. Readers will find Medical Anthropology a short but solid treatise. From its uncomplicated title and the appearance of its attractive but uncluttered cover, the reader is alerted to a no-frills but adequate treatment of the field. Well organized and written the book shows balance. Confronting potentially delicate issues, the authors are fair in treating both traditional and scientific medical systems. The book is organized into four parts. The first spells out the origins and scope of the field. The second deals with the work o f anthropologists in the non-Western world. Part three shifts emphasis to medical systems in the Western world reflecting a good deal of work done by nonanthropologists. Part four concerns past and current articulations between anthropology and various facets of medicine. Assumed and accepted roles for anthropologists are described; new roles are suggested. Foster and Anderson lay out some plausible arguments for the utilization of trained anthropologists in settings primarily defined as medical. The last few chapters in part four could have been put into a part five entitled, "Challenges to Medical Anthropology", which would more adequately have reflected the ring of the message conveyed by the authors in these final chapters. The book offers the teacher of medical anthropology a solid, generally stimulating, well-planned instructional tool. It will probably be appreciated by new or seasoned teachers for somewhat different reasons. The beginning instructor has in this volume a useful course outline enriched with a reasonable amount of substance. The seasoned instructor will find much on which he or she will wish to elaborate in his or her own particular way. Many points in the book will provoke polemics for class discussion. In almost every use I would think that an instructor would want to supplement the book with outside readings. Undergraduate students who often appreciate the closure implied in a textbook will probably like this one because of its logical development and the fact that it is not encumbered by jargon. There are "spots", however, which may be dry to even the more interested of students. Pre-professi0nal students will appreciate the materials in parts three and four dealing with Western medical systems and the medical/moral dilemmas facing technologically advanced societies. Graduate students will find this book a good introductory statement on the field worthy of their reading time. If they have a part in designing their own courses they will find chapter headings suggestive of areas from which more specific seminar topics can be developed based on lead ideas in the chapters. Generally speaking this volume should prove useful in defining the field of medical anthropology to colleagues in other disciplines. No doubt it will be differentially

appreciated by them depending upon whether they come from the medical or the social science side of the aisle. It may come as something of a revelation to medical professionals who have had no experience with anthropology or anthropologists. I think the majority of medical professionals who have worked with anthropologists will be well attuned to the work, able in some cases to cite examples from their own experiences in support of certain points made by Foster and Anderson. Medical sociologists, who already enjoy a well established research record in Western medical institutions, may feel that certain materials developed in chapters 8-11 are a bit superficially handled in this book. Certain problem areas concerning frameworks for comparative analyses and terminology are dealt with. The recognition of these problems is important in a textbook. Trying to solve them in a textbook may call for more heroism than is warranted. To avoid using older and often unsavory terms, Foster and Anderson suggest resorting to culturally explanatory concepts of illness to provide terminology facilitating comparative work. Unfortunately, the "personalistic" and "naturalistic" framework they propose creates difficulties of its own, simply trading in one set of analytic problems for another. Foster and Anderson have produced a Valuable first textbook in medical anthropology. At the least it gives potential authors a high level target to shoot at. And for the time being, it gives our co-professionals and students a fairly good picture of what it is we have been up to for some time, outlining new directions that many of us are taking in our labors in this exciting field:

Department of Sociolooy and Anthropolooy University of Notre Dame Indiana, U.S.A.

CARL W. O'NELL

Legal and Ethical Issues in Human Research and Treatment: Psychopharmacologic Considerations, edited by DONALD M. GALLANT and ROBERT FORCE. SP Medical & Scientific Books, N.Y. 1978. 186 pages. $19.95 A line from proposed federal guidelines on research involving the institutionalized mentally disabled (Nov. 17, 1978) summarizes the thrust and level of abstraction of this volume: "The conduct of the research will be in accord with basic ethical principles of beneficence, justice, and respect for persons, that should underlie the conduct of research involving human subjects". The four chapters were presented as papers at a December 1976 symposium sponsored by the American College of Neuropsychopharmacology. One paper is by a psychiatrist, one by an attorney, and two by ethicists. Useful commentary is provided by other conference participants. There is general agreement on basic principles, but none on how they might be implemented. The authors want to build a house, and have chosen the site. But they cannot agree on either the style of the house or the materials it should be built with. The editors, who have supplied an introduction and conclusion, are more precise. They call for strengthened Institutional Review Boards (IRBs); government support for patient surrogates; required ethics and research courses in medical schools; and publication of the manner in which informed consent was obtained in all scientific articles. The strongest paper is one by the current president of the American Psychiatric Association, Alan Stone, entitled "The History and Future of Litigation in Psychopharmacologic Research and Treatment". It demonstrates an encyclopaedic knowledge of both psychiatry and the law,