The Body Full Test Bank Chapter 13 3rd Edition

Chapter 13 Test Bank

Multiple Choice

1. What subfield of anthropology tries to understand how social, cultural, biological, and linguistic factors shape the health of human beings in different cultures?
2. Physical anthropology
3. Medical anthropology
4. Linguistic anthropology
5. Biological anthropology
6. Health and illness
7. can readily be objectively measured by doctors with the right equipment.
8. form a straightforward concept well understood by physicians.
9. are stable and unchanging across the world.
10. have much variation throughout different cultures and societies.
11. In the eighteenth and nineteenth centuries American doctors often had second jobs as
12. nutritionists.
13. politicians.
14. morticians.
15. barbers.
16. Breastfeeding was universal in the United States until baby formula was developed in the
17. 1920s.
18. 1930s.
19. 1950s.
20. 1970s
21. An explanation given for medicalizing the nonmedical is
22. the growth in profits for insurance and pharmaceutical companies.
23. to decrease the prestige of physicians.
24. the denial among people to see social problems in scientific terms.
25. inaccurate, as there is a movement towards demedicalization.
26. Paul Farmer did much of his ethnographic and applied work in
27. United States.
28. Mexico.
29. Africa.
30. Haiti.
31. Paul Farmer’s work was originally focused on
32. malaria.
33. diabetes.
34. AIDS.
35. cancer.
36. Koro, a condition unique to Chinese and Southeast Asian cultures, is an example of
37. culture-bound syndrome.
38. the subjectivity of illness.
39. an explanatory mode of illness.
40. medicalization of the nonmedical.
41. Nearly all societies draw on more than one medical tradition simultaneously, a process which is called
42. medicalization.
43. the sick role.
44. symbolic treatment.
45. medical pluralism.
46. Medical anthropologist Nancy Scheper-Hughes uncovered a large criminal network engaged in the black-market sale of
47. illegal drugs.
48. children.
49. bacteria.
50. body parts.
51. The authors of the textbook define the mind as
52. synonymous with the brain.
53. an individual experience that is removed from bodily awareness.
54. outside the concern of most Western medicine.
55. emergent qualities of consciousness expressed through thought, perception, will, and imagination.
56. Healing rituals are an example of
57. a social support therapeutic process.
58. a symbolic therapeutic process.
59. the placebo effect.
60. a clinical therapeutic process.
61. Not all conditions are recognized as illness, but they can become so through a process known as
62. medical pluralism.
63. medicalization.
64. bio-enculturation.
65. sick emergence.
66. What is the “subjectivity of illness”?
67. The idea that diseases cannot be measured objectively
68. How people understand and experience their condition on a personal level
69. The process of testing that determines if a patient is really sick or not
70. The effort to blame people for their own sickness
71. When anthropologist Robert Welsch got sick in Papua New Guinea, most of the villagers attributed his symptoms to
72. the flu.
73. malaria.
74. sorcery.
75. homesickness.
76. For the Ningerum patient to get help with his or her care and treatment, the main thing to do is
77. pay lots of money.
78. describe in detail how sick he or she is.
79. display visible signs of his or her illness.
80. hide away at home.
81. Koro, the belief that one’s genitalia or nipples are shrinking, is an example of
82. a culture-bound syndrome.
83. a gender specific syndrome.
84. the psychological consequences of capitalism.
85. imitative magic.
86. Which of the following is not a factor in the path to mediumship in Candomblé?
87. Wellness
88. Biology
89. Psychology
90. Culture
91. Which of the following would be least interesting to a medical anthropologist?
92. The delivery mechanisms of a new HIV/AIDS treatment
93. The role of insurance companies in defining disease
94. The international development response to a typhoid outbreak
95. A new industrial agriculture project designed in conjunction with the International Monetary Fund
96. In Mali, people are often not bothered when they express the symptoms of schistosomiasis because
97. infection rates are so high it is not locally recognized as illness.
98. people do not have the time to “be sick.”
99. they do not have enough knowledge to differentiate between being sick and being well.
100. there is no available treatment, so there is no reason to be concerned with symptoms.
101. Among the Ningerum people of Papua New Guinea, what is a person’s expected sick role?
102. Refusing to acknowledge the severity of symptoms to have the community cajole you into seeking treatment
103. Isolating yourself in your home and refusing community visitors
104. Demonstrating the severity of your symptoms as a call to action for the whole community
105. Sitting with all other unwell members of the community, helping to take care of one another
106. The medical anthropologist and physician who set up free clinics in Haiti to treat HIV and AIDS is
107. Paul Farmer.
108. Arthur Kleinman.
109. Nancy Scheper-Hughes.
110. Kathy Dettwyler.
111. An anthropologist interested in sick roles would be most interested in
112. how ill people express their symptoms to those around them.
113. how doctors explain disease to their patients.
114. what therapeutic processes an ill person participates in.
115. the rate at which a communicable disease is passed from one person to another.
116. What is not one of the suggested reasons for increased medicalization in the United States?
117. Everyone, from pharmaceutical companies to health insurers, is better situated to profit from treating disease than from treating “moral failings.”
118. Medicalization increases the social standing and authority of doctors.
119. As a result of globalization, there have been an explosion of new infectious diseases in the last few decades.
120. Given the unparalleled success of the scientific method, Americans are more comfortable seeking scientific solutions to social problems.
121. Alcoholism used to be considered a moral failing and is now considered a disease. This shift is a prime example of
122. medicalization.
123. medical pluralism.
124. the subjectivity of illness.
125. the pliability of the human body.
126. The emergent qualities of consciousness expressed through thought, perception, will, and imagination are referred to in the textbook as
127. intersubjectivity.
128. the mind.
129. healing forces.
130. human spirit.
131. Which of the following activities or behaviors is not part of the American sick role?
132. They are free from the obligation to go to work or school because they are sick.
133. They are not expected to seek medical care from a professional or family caregiver.
134. They are expected to try to get better and assist in their care as much as possible.
135. They are free from blame for their sickness.
136. A good example of the process of medicalization is found in the changing understanding of which of the following conditions as a “disease”?
137. Diabetes
138. Alcoholism
139. Albinism
140. HIV
141. According the medical anthropologist Arthur Kleinman, the several therapeutic processes that bring healing include
142. clinical processes, symbolic processes, and social support.
143. placebo effect and symbolic medicine.
144. social support and the nocebo effect.
145. clinical processes, ritual, and placebos.
146. When a doctor observes a patient’s symptoms and prescribes a treatment that he or she thinks will act directly on the patient’s body to cure the problem, the doctor is adopting which kind of treatment process?
147. Medicalization
148. Clinical therapeutic process
149. Symbolic process
150. Persuasion
151. Frank pulled his back out and went to see a chiropractor, an orthopedic surgeon, and an acupuncturist. Which of the following practices was Frank engaging in?
152. Medicalization
153. The placebo effect
154. Medical pluralism
155. Medical singularism
156. When anthropologist Robert Welsch had a very high fever from malaria in Papua New Guinea, why did the Ningerum villagers visit and attempt to entertain him, even though he would have preferred being left alone?
157. They were trying to nurse him back to health.
158. They were trying to distract him from his symptoms.
159. They did not want to be suspected of bewitching him with sorcery.
160. They were curious about his strange illness.
161. Arthur Kleinman, a medical anthropologist who conducted research in Taiwan, argued that the key to understanding differences in perspective between doctors and patients is that healers and patients often have different
162. access to medical technology.
163. access to education and medical training.
164. class backgrounds.
165. ways of explaining what is happening to the sick persons.
166. Who is most likely to determine a physiological condition that manifests in disease?
167. The physician
168. The patient
169. The patient’s support system
170. Medical interpretivists
171. Which of the following is least likely to have driven the increase of medicalization in the United States?
172. Financial motivation from pharmaceutical companies and health insurers
173. Doctors’ increased social standing and authority
174. The rise of scientific solutions to social problems
175. Increasing secularism
176. If a medical anthropologist like Arthur Kleinman were to turn his attention to studying the outbreak of Ebola in West Africa, he would likely want to understand
177. how local people interpret the symptoms of Ebola, its causes, and its threat.
178. what was necessary in the United States in terms of protective clothing and sanitation to limit the spread of the disease.
179. the weaknesses of resources of West African nations to deal with the epidemic.
180. naïve presumptions about disease causation.
181. What is an “explanatory model” of a disease like cancer?
182. A simplified physical model of the body with all the organs affected by the cancer identified in it
183. A general approach to explaining the incidence of cancer among various groups
184. A biological theory that explains why certain people get cancer and others do not
185. A general explanation held by individual patients and their families that accounts for the patient’s symptoms, the causes of these symptoms, and how to best treat the cancer
186. In which of the following ways would the sick role of people in an African country be expected to differ from the American sick role?
187. Although it would need to be confirmed with empirical evidence, we could presume that people must want to get better and should assist in their therapy.
188. Although all societies will have some form of sick role, it is impossible to know what form the local sick role takes without interviewing and observing local people when they are sick.
189. From statistical analyses, we would expect that people will be afraid of any contagious disease.
190. Because Africans are less educated than Americans, we would expect that most people will believe in magic and ritual healing.
191. What is the most striking difference between a physician’s approach to a sick patient and a medical anthropologist’s perspective?
192. Physicians will focus on the clinical processes that explain the disease, while medical anthropologists will focus only on the patient’s symptoms.
193. Doctors will not be concerned with the patient’s feelings since as physicians they know what is happening, while the medical anthropologist will be concerned with the patient’s anxiety and fear during treatment.
194. Doctors will focus on the clinical processes that explain the disease, while medical anthropologists will want to look at the illness from all perspectives.
195. There is often little difference in perspective among these experts.
196. Ethical rules for research with human subjects require that researchers be honest with patients in a study about what drugs are being given to them. This ethical premise limits research to study the efficacy of which of the four therapeutic processes?
197. Clinical therapeutic processes
198. Symbolic therapeutic processes
199. Social support
200. Persuasion (the placebo effect)

True/False

1. Placebos have been proven to be far less effective than many other pharmaceutical interventions.
2. True
3. False
4. Health and illness are objective states.
5. True
6. False
7. The prestige and social authority doctors enjoy is relatively new.
8. True
9. False
10. Given developments in medicine in recent decades, doctors and patients most often have the same explanations for illness and disease.
11. True
12. False
13. There are certain mental illnesses that are unique to specific cultures.
14. True
15. False
16. During the Civil War surgeons were little more than butchers who amputated with large, dirty saws, using no antibiotics, few painkillers, and no antiseptics.
17. True
18. False
19. Doctors throughout the world enjoy a high degree of prestige.
20. True
21. False
22. Diabetics often have better control of their blood sugar when they are with supportive family members but poorer control when feeling isolated.
23. True
24. False
25. The first cases of HIV in Africa appeared along highways because of the interactions between prostitutes and truckers traveling long distances.
26. True
27. False
28. Medical anthropologists refer to whatever impairs the human body in physiological ways as disease, which is typically the domain of healthcare professionals.
    1. True
    2. False
29. Medical anthropologists refer to illness as psychological and social experience a patient has of disease.
    1. True
    2. False
30. The process of viewing or treating as a medical concern conditions that were not previously understood as medical problems is called medicalization.
    1. True
    2. False
31. The psychological intervention is a form of persuasion in which patients believe they are taking a strong medication but they are actually taking an inert tablet, such as a sugar pill.
    1. True
    2. False
32. The culturally defined agreement between patients and family members to acknowledge that the patient is legitimately sick is called the sick role.
    1. True
    2. False
33. The cause of the prestige enjoyed by doctors comes from the fact that doctors unionized.
    1. True
    2. False

Short Answer

1. Explain the differences between how a medical anthropologist and a physician would approach an outbreak of flu at your university.
2. Describe Arthur Kleinman’s of “explanatory models” and the concept transformed the field of medical anthropology.
3. Explain how some medical anthropologists explain the effectiveness of ritual treatments when some rituals use no substances with active chemical ingredients.
4. Explain what the power of the placebo effect as demonstrated in the French naproxen study might tell us about the effectiveness of other drugs besides painkillers.
5. If you were confronting the Ebola outbreak in West Africa, your first task would be to stabilize the epidemic and provide enough beds for all the Ebola patients as well as separate facilities for patients with other health problems. What approach would you suggest next if you followed the agenda of medical anthropologists Paul Farmer and Jim Yon Kim, who advocated an integrated program to combat the long-term effects of the epidemic?
6. Describe the process of enculturating medical doctors into biomedicine in the United States, and the resulting status hierarchies. Are these hierarchies observed cross-culturally?
7. According to medical anthropologists, how might a prayer circle in one town help a sick patient in a neighboring town?
8. Describe the process of medicalization of alcoholism in the United States and how that affects individuals experiencing alcoholism.
9. Using information presented from medical anthropology, besides the changing science of the body, what other factors are important in the way Americans breastfeed or bottle-feed their babies?
10. Describe the concept of medical pluralism and explain how this operates in your and your family’s daily life.

Short Answer Key

1. Explain the differences between how a medical anthropologist and a physician would approach an outbreak of flu at your university.
   1. How and Why Do Doctors and Other Health Practitioners Gain Social Authority?
   2. Medical doctors in the United States have one of the most prestigious, respected, and well-paid occupations. The prestige and social authority doctors enjoy, however, is relatively new. Throughout most of the eighteenth and nineteenth centuries, American doctors had low social status. Medicine was not sophisticated, and doctors often doubled as barbers. During the Civil War, surgeons were little more than butchers who amputated with large, dirty saws, using no antibiotics, few painkillers, and no antiseptics (Starr 1982).
   3. Many people assume that doctors gained prestige and authority because new medical discoveries and technologies improved their ability to heal people. ­Antibiotics like penicillin, for example, have made a huge difference in treating disease. But the major advances in health we take for granted today were mostly improvements in preventing diseases rather than curing them. Clean water, sanitation, and other public hygiene programs saved more lives than doctors’ treatments have. So how do we explain the social authority of doctors? ­Medical anthropologists have studied the social authority of healers in many societies. They identify several processes at work, the most important being the social processes that privilege the healers’ perspectives over those of their patients and the designation of otherwise normal conditions as health problems.
2. Describe Arthur Kleinman’s of “explanatory models” and the concept transformed the field of medical anthropology.
   1. How and Why Do Doctors and Other Health Practitioners Gain Social Authority?
   2. Understanding the distinction between doctors’ and patients’ perspectives is a key approach in contemporary medical anthropology. In the 1950s and 1960s anthropologists typically accepted Western medicine as superior and authoritative in much the same ways that Freidson suggests. Anthropologists generally assumed that health problems in developing countries were due to ignorance of medical knowledge and technology. A breakthrough came when Arthur Kleinman, a medical anthropologist who conducted research in Taiwan, argued that the key to understanding such differences in perspective is that healers and patients often have different explanatory models of illness, which are explanations of what is happening to the patient’s body. Kleinman asserted that the goal of medical anthropology research was not to decide who was right in their explanation, but to accept that different people would come to the illness with different concerns and different kinds of knowledge.
3. Explain how some medical anthropologists explain the effectiveness of ritual treatments when some rituals use no substances with active chemical ingredients.
   1. How Does Healing Happen?
   2. In most tribal societies that medical anthropologists studied in the twentieth century, there were some treatments that used herbs, teas, and potions. The explanatory models used in these societies sometimes drew on clinical models, but often the herbs and potions were important not so much for their chemical properties but for their symbolic ones. Although the chemical composition of the herb or potion might help the patient heal, people were largely unaware of these properties and used them in rituals for other reasons.
   3. In such cases, healing rituals act as a symbolic therapeutic process by virtue of their role in structuring the meanings of the symbols used. The symbolism of healing rituals comes from a number of sources, invoking our olfactory senses and our senses of taste and touch. It can also involve chanting, drumming, singing, and other sounds that set particular moods. Typically, the rituals provide a symbolic temporal progression, as in the form of a mythological story, that the affliction is supposed to follow for the patient to recover and heal.
4. Explain what the power of the placebo effect as demonstrated in the French naproxen study might tell us about the effectiveness of other drugs besides painkillers.
   1. How Does Healing Happen?
   2. A dramatic illustration of the power of the placebo effect comes from a French study conducted in the 1990s. In this study, researchers divided a group of hospitalized cancer patients with mild to moderate cancer pain into four groups to test the effectiveness of naproxen, at the time a new painkiller that many people now know by the brand name Aleve. None of the patients experienced so much pain that they required opiates, and the study put none of the patients in significant distress. First the patients were randomly assigned to one of two groups as they came out of cancer surgery. One group was told they would be in a random trial of a powerful new pain reliever and would receive either the test drug or an inert placebo. The second group was told nothing. Members of this second group were unaware they were in a test and would assume that they were receiving standard hospital care. Half of the patients in each group were randomly given either an inert placebo or naproxen, thus creating four groups in all. Nurses, who were unaware of the details of the study, asked patients to evaluate their pain reduction hourly using a pain scale from 1 to 100 that represents the pain experienced (Bergmann et al. 1994; Kaptchuk 2001).
5. If you were confronting the Ebola outbreak in West Africa, your first task would be to stabilize the epidemic and provide enough beds for all the Ebola patients as well as separate facilities for patients with other health problems. What approach would you suggest next if you followed the agenda of medical anthropologists Paul Farmer and Jim Yon Kim, who advocated an integrated program to combat the long-term effects of the epidemic?
   1. How Can Anthropology Help Us Address Global Health Problems?
   2. Medical anthropologists have also played a key role in making sense of how infectious diseases spread within a population, which is as much an anthropological or sociological task as it is a medical one. For example, anthropologists have played a key role in helping researchers understand the transmission of HIV, the virus that causes AIDS. In the United States and Europe, public health officials have promoted the use of condoms to interrupt the spread of HIV. But promoting condoms has not proved so effective in several African countries, Haiti, and certain Southeast Asian countries, each of which had patterns of transmission that differ significantly from those in the United States. By studying these patterns of transmission, anthropologists played a central role in helping medical researchers understand how culture was shaping HIV transmission.
6. Describe the process of enculturating medical doctors into biomedicine in the United States, and the resulting status hierarchies. Are these hierarchies observed cross-culturally?
   1. How and Why Do Doctors and Other Health Practitioners Gain Social Authority?
   2. Medical doctors in the United States have one of the most prestigious, respected, and well-paid occupations. The prestige and social authority doctors enjoy, however, is relatively new. Throughout most of the eighteenth and nineteenth centuries, American doctors had low social status. Medicine was not sophisticated, and doctors often doubled as barbers. During the Civil War, surgeons were little more than butchers who amputated with large, dirty saws, using no antibiotics, few painkillers, and no antiseptics (Starr 1982).
   3. Many people assume that doctors gained prestige and authority because new medical discoveries and technologies improved their ability to heal people. Antibiotics like penicillin, for example, have made a huge difference in treating disease. But the major advances in health we take for granted today were mostly improvements in preventing diseases rather than curing them. Clean water, sanitation, and other public hygiene programs saved more lives than doctors’ treatments have. So how do we explain the social authority of doctors? Medical anthropologists have studied the social authority of healers in many societies. They identify several processes at work, the most important being the social processes that privilege the healers’ perspectives over those of their patients and the designation of otherwise normal conditions as health problems.
7. According to medical anthropologists, how might a prayer circle in one town help a sick patient in a neighboring town?
   1. How Does Healing Happen?
   2. When Robert Welsch was studying healing practices among the Ningerum, one of his informants came down with malaria. Welsch offered him some antimalarial tablets, but his informant could not swallow them because they tasted bad. After several days of lying in bed, the man’s nephew performed a traditional ritual, smearing clay on his uncle’s painful chest, reciting magic words, and apparently removing a packet consisting of some small object wrapped in a banana leaf from the sick man’s chest. Within two hours, the man was up and about with his walking stick heading for the spring where he showered, a visible sign to everyone in the village, including the anthropologist, that he was feeling better (see Welsch 1983).
   3. To the Western mind, such examples of traditional healing strain credibility. But anthropologists around the world have observed similar responses to a wide variety of non-medical treatments. We do know that the human body is ­remarkably resilient. If we cut ourselves superficially while chopping vegetables, the wound will bleed and scab over, and gradually new skin will cover the cut. We do not fully understand how healing works, but we know that healing is more complex than most Americans recognize. Healing is a complex biocultural process: it is not just about pills and surgeries, but about the meaning that the sick person and the healers give to treatments in a specific cultural context. Healing is a complex biocultural process. Medical anthropologists generally accept that treatments help our bodies heal in four distinct therapeutic processes: (1) clinical processes, (2) symbolic processes, (3) social support, and (4) persuasion (Csordas and Kleinman 1996). We consider each of these processes next.
8. Describe the process of medicalization of alcoholism in the United States and how that affects individuals experiencing alcoholism.
   1. How and Why Do Doctors and Other Health Practitioners Gain Social Authority?
   2. Over the past fifty years, the healthcare industry has expanded dramatically, taking over more and more of our individual personal concerns. It has done so by redefining certain social, psychological, and moral problems as medical concerns. This process of viewing or treating as a medical concern conditions that were not previously understood as medical problems is called medicalization.
   3. Alcoholism is a good example of this phenomenon. Excessive use of alcohol has been a problem throughout the history of the United States, producing opposition to it in the form of the temperance movement in the nineteenth and early twentieth centuries, and Prohibition in the 1920s. For a long time, alcoholism was seen as a moral failing that caused (usually) men to abandon their jobs and families. By the 1980s, psychiatrists, HMOs, and health insurance companies began to view alcoholism as a disease defined as “recurrent substance use resulting in failure to fulfill major role obligations at work, school, home” ­(American Psychiatric Association 1994). Defining alcohol abuse as a disease, rather than as a crime, socially inappropriate behavior, sinful behavior, or moral failing, reclassifies it as a medical concern.
9. Using information presented from medical anthropology, besides the changing science of the body, what other factors are important in the way Americans breastfeed or bottle-feed their babies?
   1. How and Why Do Doctors and Other Health Practitioners Gain Social Authority?
   2. For example, consider what the medical profession has advised about breastfeeding for infants. Breastfeeding was universal until the 1950s, when baby formula was developed, and most American pediatricians promoted formula as a technologically superior way to ensure the health of the baby. By the 1970s, new scientific analyses of the contents of breast milk indicated that breast milk contained antibodies that helped the child ward off infections. Rather than viewing breast milk as unsophisticated, the medical world began to see it as nature’s way of protecting the child (Figure 13.6). About the same time in many developing countries, international aid workers were promoting baby formula as a way of producing strong, healthy babies. But by the 1990s, it became clear that this practice was not ideal: babies became malnourished because their poor mothers could not afford enough formula, and where clean drinking water was scarce, mothers often had no choice but to use unsanitary water for their baby formula, resulting in much higher rates of fatal diarrhea.
10. Describe the concept of medical pluralism and explain how this operates in your and your family’s daily life.
    1. How Can Anthropology Help Us Address Global Health Problems?
    2. Medical anthropologists have long recognized that there are many sophisticated non-Western systems of medicine—in places like India, China, and the Arab world—that had been effective for centuries before the medical systems of the United States and Western Europe developed antiseptics, antibiotics, and vaccines. As India, China, and the Arab world began to establish modern industrial societies, their healthcare facilities were integrating Western medicine with traditional practices. Medicine was not replacing these ancient traditions but supplementing them. Nearly all other societies draw on more than one medical tradition simultaneously, a concept called medical pluralism, which refers to the coexistence and interpenetration of distinct medical traditions with different cultural roots.
    3. An example of medical pluralism comes from anthropologist Carolyn Nordstrom (1988), who studied Ayurveda, a traditional medical system developed in India and Sri Lanka. Ayurvedic practitioners diagnose health problems using the classical Ayurvedic practice of reading the pulse, and they mix herbs in specified ways. But practitioners also draw upon traditional Sinhalese (referring to the people of Sri Lanka) medical ideas and practices. Nordstrom learned that practitioners often mix traditional Sinhalese herbal preparations along with those they have learned at an Ayurvedic college, and that many Ayurvedic healers frequently use stethoscopes and thermometers and dispense standard Western medicines along with their herbal preparations. She also observed that some Sinhalese Buddhist monks incorporated Ayurvedic and Buddhist principles in their therapeutic work, sometimes adding Sinhalese preparations as well (Figure 13.8).