“Doctor, Why Didn’t You Adopt My Baby?” Observant Participation, Care, and the Simultaneous Practice of Medicine and Anthropology

Abstract

Medical anthropology has long appreciated the clinical encounter as a rich source of data and a key site for critical inquiry. It is no surprise, then, that a number of physician-anthropologists have used their clinical insights to make important contributions to the field. How does this duality challenge and enhance the moral practice and ethics of care inherent both to ethnography and to medicine? How do bureaucratic and professional obligations of HIPAA and the IRB intersect with aspirations of anthropology to understand human experience and of medicine to heal with compassion? In this paper, I describe my simultaneous fieldwork and clinical practice at an urban women's jail in the United States. In this setting, being a physician facilitates privileged access to people and spaces within, garners easy trust, and enables an insider perspective more akin to observant participation than participant observation. Through experiences of delivering the infants of incarcerated pregnant women and of being with the mothers as they navigate drug addiction, child custody battles, and re-incarceration, the roles of doctor and anthropologist become mutually constitutive and transformative. Moreover, the dual practice reveals congruities and cracks in each discipline's ethics of care. Being an anthropologist among informants who may have been patients reworks expectations of care and necessitates ethical practice informed by the dual roles.

Representing the “European refugee crisis” in Germany and beyond: Deservingness and difference, life and death

“…Simultaneously, as officials debate and enact policies to receive some people and turn away others, xenophobic groups stage demonstrations calling for refugees to be kept out (Agence France‐Presse, October 19, 2015), while throughout the country there are many offers of hospitality to those arriving from local organizations and neighborhood associations (e.g., http://www.moabit-hilft.de). We consider these realities as anthropologists variously involved in participant observation and observant participation (Sufrin ) in the refugee crisis in Germany. Our analysis of the sorting and othering of people occurs in comparative perspective with our ongoing work with migrants in Germany (Castañeda) as well as with undocumented Latin American im/migrants and refugees in the United States (Castañeda and Holmes)…”

A scoping review of the use of ethnographic approaches in implementation research and recommendations for reporting

“…There is growing recognition in academic healthcare for the ways systems of oppression (e.g., racism, sexism, and colonialism) operate within and through healthcare institutions (Evans et al, 2020; Horton, 2019; National Academies of Science Engineering and Medicine, 2018). Especially, given that underrepresented minorities are often excluded from academic positions, researchers must critically address their positionality in relation to systems of oppression when conducting research (Association of American Medical Colleges, 2019; Blackstock, 2020; McKay, 2018; Sufrin, 2015).…”

Violence at Rikers Island: Does the Doctor Make It Worse? A Clinician Ethnographer’s Work Amidst Carceral Structural Violence

“…This exploration builds on seminal work by Carolyn Sufrin, who has also worked as a physician and an anthropologist in a large urban jail (Sufrin 2017 ). In her paper on this topic, she lays out the “constantly shifting roles and obligations of practicing medicine and anthropology” and explores both tensions and ethical quandaries that come about precisely because “I was a doctor at the jail before I was an ethnographer there,” thus leading her to propose the term “observant participation” for the unique role of physician-anthropologists who are attempting to practice medicine with a critical ethnographic lens (Sufrin 2015 ).…”