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What does it mean to be a good doctor in America today? How do such challenges as new biotechnologies, the threat of malpractice suits, and proposed health-care reform affect physicians' ability to provide quality care? These and many other questions are examined in this book, which fully explores the meaning and politics of competence in modern American medicine. Based on ethnographic studies of three distinct medical communities—physicians in rural California, academics and students involved in Harvard Medical School's innovative “New Pathway” curriculum, and oncologists working on breast cancer treatment—it demonstrates the centrality of the issue of competence throughout the medical world. Competence, the book shows, provides the framework for discussing the power struggles between rural general practitioners and specialists, organizational changes in medical education, and the clinical narratives of high-technology oncologists. In their own words, practitioners, students, and academics describe what competence means to them and reveal their frustration with medical-legal institutions, malpractice, and the limitations of peer review and medical training.

In April of 1979 the city of Sverdlovsk in Russia's Ural Mountains was struck by a frightening anthrax epidemic. Official Soviet documents reported sixty-four human deaths resulting from the ingestion of tainted meat sold on the black market, but U.S. intelligence sources implied a different story, and the lack of documentation left unresolved questions. In her investigation of the incident, the author of this book unravels the mystery of what really happened during that tragic event in Sverdlovsk. Anthrax is a virulent and deadly bacteria whose spores can remain in soil for as long as seventy years, killing grazing animals and putting humans in jeopardy of eating infected meat. Contemporary concern is more centered on anthrax as an airborne biological weapon whose inhaled spores can result in ninety percent mortality for those infected. As part of a team of doctors and researchers, the author traveled to Russia in 1992 to determine the cause and extent of the epidemic, and her narrative transforms a case of epidemiological investigation into a politically charged mystery. She creates a sense of immediacy and drama with her insider's account of the team's investigative work—the analysis of pathology photos and slides, meetings with political and public health officials, the retrieval of essential medical data—and reveals the subjective side of science as she conducts interviews with afflicted families, visits sites, and interacts with those suspected of clouding the truth.

Why do so many American women allow themselves to become enmeshed in the standardized routines of technocratic childbirth—routines that can be insensitive, unnecessary, and even unhealthy? This book is a second edition of the text. The new preface in this edition makes it clear that the issues surrounding childbirth remain as controversial as ever. The book analyzes the technocratic method of birth, its cultural variations and alternatives, and obstetric training and women's experiences in Western culture. It covers ritual and how it is used in obstetrics, and compares the technocratic and holistic paradigms of childbirth. The book demonstrates the linkages between American core values concerning technology and expertise, and prevailing obstetrical practices.

This ethnography probes the intimate experience of gestational surrogate motherhood. The book shows how surrogates and intended mothers carefully negotiate their cooperative endeavor. Drawing on anthropological fieldwork among Jewish Israeli women, interspersed with cross-cultural perspectives of surrogacy in the global context, the book traces the processes by which surrogates relinquish any maternal claim to the baby even as intended mothers accomplish a complicated transition to motherhood. The book's analysis reveals that as surrogates psychologically and emotionally disengage from the fetus they carry, they develop a profound and lasting bond with the intended mother.

This book is the first systematic description of how American doctors think about racial differences and how this kind of thinking affects the treatment of their black patients. The standard studies of medical racism examine past medical abuses of black people and do not address the racially motivated thinking and behaviors of physicians practicing medicine today. This book penetrates the physician's private sphere where racial fantasies and misinformation distort diagnoses and treatments. Doctors have always absorbed the racial stereotypes and folkloric beliefs about racial differences that permeate the general population. Within the world of medicine this racial folklore has infiltrated all of the medical sub-disciplines, from cardiology to gynecology to psychiatry. Doctors have thus imposed white or black racial identities upon every organ system of the human body, along with racial interpretations of black children, the black elderly, the black athlete, black musicality, black pain thresholds, and other aspects of black minds and bodies. The American medical establishment does not readily absorb either historical or current information about medical racism. For this reason, racial enlightenment will not reach medical schools until the current race-aversive curricula include new historical and sociological perspectives.

This book chronicles the story of disability's emergence as an area of significant sociopolitical activity in contemporary China. Attentive to how bodies are embedded in discourse, history, and personal exigency, it details ways that disability became a fount for the production of institutions and identities across the Chinese landscape during the final decades of the twentieth century. The author looks closely at the creation of the China Disabled Persons' Federation and the lives of numerous individuals, among them Deng Pufang, son of China's Communist leader Deng Xiaoping.

This book explores the unintended consequences of compassion in the world of immigration politics. It focuses on France and its humanitarian immigration practices to argue that a politics based on care and protection can lead the state to view issues of immigration and asylum through a medical lens. Examining two “regimes of care”—humanitarianism and the movement to stop violence against women—it asks what it means to permit the sick and sexually violated to cross borders while the impoverished cannot? The book demonstrates how in an inhospitable immigration climate, unusual pathologies can become the means to residency papers, turning conditions such as HIV, cancer, and select experiences of sexual violence into distinct advantages for would-be migrants. It also indicts the inequalities forged by global capitalism that drive people to migrate, and the state practices which criminalize the majority of undocumented migrants at the expense of care for the exceptional few.

This book raises issues for public policy in the medical field. It is based on data accumulated during long-term research on Navajo Indian epidemiology. Through examination of this medical microcosm, it can be seen that the role of Western medicine presently needs review, clarification, and perhaps redefinition in today's complex social milieu. This book sees a future challenge to medicine in dealing with the degenerative and man-made diseases, as contrasted with its past successes in controlling infectious diseases. The wealth of information and its in-depth analysis make this book a valuable contribution to the growing literature on cross-cultural healthcare.

This book brings together the work of writers from a range of disciplines and cultural traditions to explore the social and political dimensions of sexuality and sexual experience. The chapters reconfigure existing notions of gender and sexuality, linking them to deeper understandings of power, resistance, and emancipation around the globe. They map areas that are currently at the cutting edge of social science writing on sexuality, as well as the complex interface between theory and practice. The book highlights the extent to which populations and communities that once were the object of scientific scrutiny have increasingly demanded the right to speak on their own behalf, as subjects of their own sexualities and agents of their own sexual histories.