Moral Economies of Medicine Working Group

Download → Annotations of the group’s readings and discussions (Word doc)

The concept of moral economy refers to social understandings of the ethics of resource production, distribution, and exchange, including notions of obligation and norms of reciprocity. When applied to the sphere of health and medicine, the study of moral economies examines cultural ideas regarding who deserves health care, who should provide care, and what kinds of production, distribution, and exchange systems are considered fair and appropriate for healing practices. In addition to these issues, the concept of Moral Economies of Medicine addresses the cultural logics by which sickness becomes understood and addressed, and the culturally-specific criteria that characterize competent and humane care. Thus, the concept of moral economies of medicine enables inquiry into scientific-based biomedicines as well as ethnomedicines. It includes research into the historically-specific obligations that healers are considered to have towards their patients and society; and the obligations that collectivities, including the state, international organizations, and local communities, are understood to have for providing health services to disenfranchised or under-served groups.

The framework of moral economies allows traditional themes in public health and bioethics to be re-examined through the lens of anthropology inquiry. For example:

Moral Economies of Health Care could examine issues such as: the various ethical criteria and moral assumptions that justify systems of health care delivery, health care reform, and the use of medical procedures and technologies; ethical assumptions and legitimating strategies of health care policy making, cultural values informing programs dealing with health inequities; tacit assumptions and explicit debates over who is ‘deserving’ of limited resources; how egalitarian principles such as rights-based frameworks get negotiated in the context of stigmatized conditions and procedures; and how the competing values of individual rights and public health needs are conceptualized and negotiated in particular historical and social contexts. Levels of analysis may vary, and include state, international, and institutional policies, community practices and cultural discourses, as well as micro-level interactions between healers or clinicians and patients. Scholars may address comparative health care systems to illuminate, for example, how the expanding commodification of health care, the human body, and care work affects the moral economy of medicine.

Moral Economies of Expertise and Bioethics may explore the various ethical commitments nurtured in the training of future health professionals in historical and social contexts; the ways professional associations and expert initiatives convey visions of their occupation’s social obligations; how the particular institutions in which health experts work privilege particular kinds of knowledge and practice; competing impacts of ethical, scientific, legal, and business frameworks on expert identity and decision making; the relationship between expert understandings and lay / community understandings of disease and health; and analyses of the impact of recent initiatives to address community and cultural issues in biomedical care.

Activities of the Working Group
The MEM Working Group aims to provide an ongoing forum for graduate students and faculty from UNC and Duke to discuss existing research on these topics, receive feedback on their developing projects, and network with colleagues who share their interests. We aim to foster conversation about how diverse research speaks to the MEM approach, and conversely, how the MEM approach can be articulated across disciplinary boundaries to create a broad-based scholarly dialogue.