Which Ethnography? Whose Ethnography? Medical anthropology's Epistemic Sensibilities Among Health Ethnographies.

Medical anthropologists working in interdisciplinary teams often articulate expertise with respect to ethnography. Yet increasingly, health scientists utilize ethnographic methods. Through a comparative review of health ethnographies, and autoethnographic observations from interdisciplinary research, we find that anthropological ethnographies and health science ethnographies are founded on different epistemic sensibilities. Differences center on temporalities of research, writing processes, sites of social intervention, uses of theory, and analytic processes. Understanding what distinguishes anthropological ethnography from health science ethnography enables medical anthropologists - who sometimes straddle these two ethnographic modes - to better articulate their epistemic positionality and facilitate interdisciplinary research collaborations.

Defining focused ethnography: Disciplinary boundary-work and the imagined divisions between 'focused' and 'traditional' ethnography in health research - A critical review.

This article offers the first critical review of focused ethnography, an increasingly popular research method across health disciplines. Focused ethnographers, we argue, exemplify the practice of methodological boundary work, defining their method in contrast to the 'traditional' ethnographic approach of anthropology and sociology. To examine this boundary work, we collected two samples of health research articles published over the last decade and compared how focused ethnographers and medical anthropologists described, justified, and practised ethnography. We found that the core characteristics most often asserted to differentiate focused ethnography from conventional ethnography were: a more limited study timeframe and scope; a limited subpopulation sample; more concentrated research questions; the inclusion of insider researchers; and more orientation towards applied results. We show, however, that these are imagined binaries that fail to map onto actual differences of practice in the two samples and which obscure many similarities between them. By contrast, we identified four alternative differences between the two methods of ethnography. These centre on understandings of 'research time'; the very meaning of ethnography; the relationship of researchers to 'data'; and the presumed best method of social intervention. We therefore define focused ethnography as a versatile method of ethnography that attends to specific epistemological expectations within the health sciences regarding valid proof and empirical description, the boundaries of research, the nature of research relationships, and the duty to improve biomedicine. Ultimately, our study highlights that methodological boundary-work matters, because assumed differences and unexpressed misunderstandings can prevent productive dialogue and fruitful collaboration between disciplines to address pressing health problems.

Vulnerable articulations: the opportunities and challenges of illness and recovery.

Medical anthropology overwhelmingly reveals vulnerability as a problem of powerlessness. Vulnerable groups and individuals are those exposed to the pernicious effects of inequalities, injustices, and oppressive political realities. This largely pejorative stance, we argue, simplifies the place of vulnerability within human experience and in relation to the body, health and illness. By showcasing a range of interlocking vulnerabilities, this paper reveal the spectrum of positive and negative vulnerabilities that affect health and recovery. Through the concept of vulnerable articulations, this paper argues that health and illness experiences simultaneously create and require a range of different interconnected vulnerabilities, some of them harmful, and some of them life affirming. Ethnographically, this paper explore the concept of vulnerable articulations through two contrasting case studies: a group of British and New Zealand nuclear test veterans seeking compensation from the state, and clients of equine therapy in New Zealand. These case studies reveal that understanding human vulnerability requires a close attention to how people navigate between the diverse vulnerabilities that they face, and that attaining well-being often involves harnessing positive vulnerabilities in order to lessen the effects of damaging vulnerabilities.

Elusive genes: nuclear test veterans' experiences of genetic citizenship and biomedical refusal.

Anthropological studies of genetic citizenship have focused on illnesses with medically explained etiologies. Such studies tend to trace patients' agency and resistance as they encounter genetic knowledge. By contrast, we explore how genetic knowledge is configured by those suffering from contested illnesses. Through interviews, we examine the claims for health care made by British and New Zealand veterans who in the 1950s took part in nuclear testing in the Pacific. We illustrate how genetic citizenship can be crafted largely without mainstream medical support or state legitimation, showing that participants understood genetics through personal, relational, and affective experiences. These experiences were utilized to build illness narratives in part because they were the best resources available. Veterans also trusted these discourses because they captured experiential knowledge and revealed personal and familial suffering in ways that biomedicine could not.

Biopolitical endpoints: diagnosing a deserving British nuclear test veteran.

This article examines recent claims for healthcare made by British veterans who participated in nuclear bomb testing in the 1950s. Specifically, it focuses on their claims for war disablement pensions, exploring how they seek and challenge medical diagnoses. Detailing three veteran case studies, the article offers an ethnographic analysis of illness narratives. It explores how sufferers attempt to recast and reject the evidential burdens that they face in pension appeals, and identifies three narratives strategies that they deploy aimed at linking somatic realities to political etiologies. I propose the notion of biopolitical endpoints to capture how test veterans narratively connect political and medical domains as they seek to enable state culpability and redress.