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technical paper

AAA Annual Meeting 2021

November 18, 2021

Baltimore, United States

The Aporia of Risk: Rejecting Health Care in the Age of Pharmaceutical Dominance

keywords:

care

institutions

fear

In everyday life, government institutions engage in a wide variety of functions that can be described as providing ‘care’ to the populace. However, there is often a gap between the ‘rhetoric of care’ espoused by institutional spokespeople and the realities of how care functions in people’s everyday lives (Pinto 2014; Stevenson 2014; Biehl 2005), producing tensions of uncertainty, doubt, anxiety, anger, creativity, and even humor. Through diverse methods such as archival research, ethnographic encounters, and multimodal discourse analysis, our papers investigate this gap between institutional certainties and everyday doubts generated in the space of care. In both Canada and Peru, for example, there is a particularly stark contrast between government rhetoric on Indigenous relations and the lived realities of Indigenous peoples (Huayhua 2014; 2016; Niezen 2013; MacLachlan 2013). In medical and legal discourse there is often a discontinuity between the registers spoken by experts and by service recipients that can serve to increase distrust and anxiety at the expense of the effective distribution of care (Dumit 2012; Mol 2002; Conley and O’Barr 1998). Medical mechanisms of visibility, which try and often fail to produce knowable subjects must make repeated efforts to shore up certainty against the inevitable dissolution of diagnostic and narrative fact (Fleck 1979). While this work helps to create subjects that can be diagnosed, treated, and recorded, it often does so at the cost of silencing patient’s disorderly truths (Pinto 2014). Discourse analyses (Wortham, Reyes 2015) of political speech, like those produced during the COVID19 pandemic, reveals the ‘dissonant discourses’ used by government spokespeople, riddled with uncertainties and contradictions. Often these tensions get glossed over in discourse through the use of metaphor (Charteris-Black 2011; Lakoff 1991), leaving the public without a language for their everyday struggles. These tensions between institutionally produced facts and everyday uncertainties are diverse and instructive. Uncertainty can function as both a debilitating aporia (Derrida 1992; Bubandt 2014) and a creative force (Cooper, Pratten 2015). Using this lens, we note how an aura of institutional uncertainty underpins all of social life, constantly threatening dissolution (Boltanski 2011). However, we also examine how uncertainty is not just an inert atmosphere, it is also generated in contingent social relations (Whyte 2015; Berthomé et al 2012), in inscrutable relations of power (Bonhomme 2012; Allard 2012; Lepselter 2016), and even in hopeful and doubtful modes of practice (Whyte 2005; Cooper, Pratten 2015). At its core, this panel seeks to ask how people live their everyday lives in the shadow of uncertainty by way of institutional power (Foucault 1980) and how the analysis of institutional ‘truths’ in the delivery of care can provide both contiguities and disruptions in our attempt to understand intersecting dimensions of contemporary life including indigeneity, health, and justice.

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