*Special Issue Call for Papers: “Medicine’s ‘Shadowside’: Revisiting
Clinical Iatrogenesis”*



We warmly invite submissions from medical anthropologists that explore the
landscapes, impetuses, and outcomes specific to clinical iatrogenesis,
defined by Ivan Illich as injuries “done to patients by ineffective,
unsafe, and erroneous treatments” (1976). Drawing on Illich’s foundational
work, medical anthropologists have examined how harm and precarity, as
after-effects of structural, social, and political violence, can be written
into medicine, undergird treatment encounters, and produce ‘bad outcomes’
(see Chabrol 2018; Greenhalgh 2001; Hamdy 2008; Jain 2013; Livingston 2014;
Pinto 2014; Towghi 2018). Rather than see harm and violence as *incidental *to
medical techniques or procedures, these works show how many of
biomedicine’s treatments and cures operate by disrupting a person’s body,
sense of self, kin relations, or their social milieu.



In this special issue, we extend this precedent by more closely exploring
the means, mechanisms, impulses, and logics by which iatrogenesis comes
into being. We seek papers that investigate iatrogenesis in a range of
circumstances and contexts, including institutional or community settings,
and everyday, routinized or spectacular, “one-off” harms. We welcome
contributions that delineate how clinical iatrogenesis comes into being,
how it is identified, tracked, contested, and refigured by patients, their
advocates, healthcare providers, and others (see Shapiro 2018).  We also
seek to know more about the ways it is linked or delinked from notions of
culpability, accountability, or recourse within and beyond health systems
(see Berry 2008), and how iatrogenesis’ claims, effects, or evidences are
explained, or hidden and denied (Sadler *et al* 2016). We encourage
contributors to consider how iatrogenesis may be a political act, such as
when medicine is harnessed by state actors (among others) to achieve
injurious, deadly, or even genocidal ends (see Hoberman 2012, Lifton 1986,
Lux 2016, Metzl 2010, Smith 2013, Stevenson 2014, Varley and Varma 2018).
An ethnography of iatrogenesis, we hope, attends to both broadly-evident
structural and infrastructural origins and entailments, as well as less
easily discernable sources and effects.  We welcome contributions that are
conversant with medical anthropology, medicine, and public health and work
to achieve evidences that will be actionable across these fields.



Prospective contributors may wish to explore:


- Iatrogenesis as a consequence of ‘over-treatment’ or clinically
unjustified interventions
- Iatrogenesis as deliberative rather than incidental or accidental acts of
wrong-doing
- Iatrogenesis made manifest not by treatment, but by withholding of care
and neglect
- How medical abuse and violence – insofar as these may be qualified (or
not), recognized, and acted on by health or legal systems -- are generative
of iatrogenesis and impact providers' and patients’ notions of care, its
trajectories and consequences
- How iatrogeneses can be tied to the interweaving of deliberatively
discriminatory and exclusionary biopolitical logics – such as racism,
sexism, homophobia, ageism, or xenophobia
- The means and strategies by which iatrogenesis’ incidence, source causes,
and outcomes are written out of the institutional or bureaucratic records
- The normalization and naturalization of iatrogenesis process, effects,
and outcomes, and the ways that patients and others become habituated to
medicine’s harms
- How iatrogenesis produces diverse aftereffects and reshapes future
trajectories of care



We anticipate our special issue will help trouble the story that medicine
tells about itself, and pose a productive challenge to medical anthropology
which leans into representations of medicine as an unequivocal moral good,
healthcare providers as consistently moral actors, and health system agents
as devoid of subjective and political intent, let alone invested in or
capable of ill-will or wrong-doing. We also hope to achieve landmark
insights into the ways subjective, systematic, institutional, political,
and other non-medical forces shape medicine.  Ultimately, our goal is to
not simply consider medicine against its circumstances, but to more closely
examine medicine *as* harm, and in revisiting clinical protocols and
operations as social and cultural processes, to better account for the
hidden or darker intentions and impulses inherent to care.



Interested contributors are asked to kindly email the special issue
organizers a 500-word abstract and their institutional or organizational
affiliation and contact information *no later than March 30, 2019 *to:
[log in to unmask] *or* [log in to unmask]



*Saiba Varma                                               Emma Varley*

Assistant Professor                                      Associate Professor

Department of Anthropology                        Department of Anthropology

University of California-San Diego               Brandon University



*Suggested Resources:*



Berry, Nicole S. 2008. “Who’s Judging the Quality of Care? Indigenous Maya
and the Problem of ‘Not Being Attended’.” *Medical Anthropology, 27* (2):
164-189.

Chabrol, Fanny. 2018. “Viral Hepatitis and a Hospital Infrastructure in
Ruins in Cameroon.” *Medical Anthropology, 37* (8): 645-658.

Greenhalgh, Susan. 2001. *Under the Medical Gaze: Facts and Fictions of
Chronic Pain. *University of California Press: Berkeley.

Hamdy, Sherine F. 2008. “When the state and your kidneys fail: Political
etiologies in an Egyptian dialysis ward.” *American Ethnologist, 35* (4):
553-569.

Hoberman, John. 2012. *Black and Blue: The Origins and Consequences of
Medical Racism.* University of California Press: Berkeley.

Ilich, Ivan. 1976. *Limits to Medicine – Medical Nemesis: The Expropriation
of Health*. Pantheon Books: New York.

Jain, Lochlann S. 2013. *Malignant: How Cancer Became Us. *University of
California Press: Berkeley.

Livingston, Julie. 2014. *Improvising Medicine: An African Oncology Ward in
an Emerging Cancer Epidemic. *University of California Press: Berkeley.

Kehr, Janina. 2018. “Colonial Hauntings: Migrant Care in a French
Hospital.” *Medical Anthropology, 37* (8): 659-673.

Lifton, Robert J. 1986. *The Nazi Doctors: Medical Killing and the
Psychology of Genocide*. Basic Books: New York.

Lux, Maureen Katherine. 2016. *Separate Beds: A History of Indian Hospitals
in Canada, 1920s-1980s*. University of Toronto Press: Toronto.

Metzl, Jonathan. 2010. *The Protest Psychosis: How Schizophrenia Became a
Black Disease.* Boston, MA: Beacon Press.

Pinto, Sarah. 2014. *Daughters of Parvati: Women and Madness in
Contemporary India. *Philadelphia: University of Pennsylvania Press.

Sadler, Michelle, Mario JDS Santos, Dolores Ruiz-Berdun, Gonzalo Leiva
Rojas, Elena Skoko, Patricia Gillen and Jette A Clausen. 2016. “Moving
beyond disrespect and abuse: addressing the structural dimensions of
obstetric violence.” *Reproductive Health Matters, 24* (47): 45-55.

Shapiro, Johanna. 2018. “’Violence’ in medicine: necessary and unnecessary,
intentional and unintentional.” *Philosophy, Ethics, and Humanities in
Medicine, 13* (7): 8 pages.

Smith, Catherine. 2013. “Doctors that Harm, Doctors that Heal: Reimagining
Medicine in Post-Conflict Aceh, Indonesia.” *Ethnos: Journal of
Anthropology, 80* (2): 272-291.

Stevenson, Lisa. 2014. *Life Beside Itself: Care in the Canadian
Arctic.* University
of California Press: Berkeley.

Towghi, Fouzieyha. 2018. “Haunting Expectations of Hospital Births
Challenged by Traditional Midwives.” *Medical Anthropology, 37* (8):
674-687.

Varley, Emma and Saiba Varma. 2018. “Spectral Ties: Hospital Haunting
Across the Line of Control.” *Medical Anthropology, 37* (8): 630-644.

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