New Publication “Rethinking Sociality and Health through Transfiguration”

In this introductory article to the Special Section, we intend to literally bring sociality to (bodily) life and ask what medical anthropology might gain by using the lens of sociality for a better understanding of the phenomena it is concerned with. Conversely, we probe how the field of health and illness – including themes concerning embodiment, vulnerability, suffering, and death – might help to further spell out the notion of sociality both conceptually and methodologically. Drawing on the contributors’ ethnographic enquiries into contemporary health phenomena in East Africa, South America, and Western Europe, we do so by bringing sociality into conversation with transfiguration. By this we refer to: (1) the constantly unfolding processes of particular extended figurations encountering, affecting, and becoming enmeshed in each other; as well as (2) the (temporarily) stabilized figurational arrangements emerging from these enmeshments. It is our hope that this notion of transfiguration will help render visible the modalities through which human engagements with each other and the world form diverse arrangements. Moreover, we aim to better understand the processes by which these arrangements – which we term ‘extended figurations’ – interact with each other, change over time, and possibly vanish and make way for others. A detailed appreciation of the workings of these extended figurations, we believe, can significantly enhance our comprehension of the particular processes of change that stand at the center of our ethnographic interest. In this sense, the concept of transfiguration constitutes one possible way of structuring the messiness and complexity of sociality for analytical purposes.

The chemical substance synthetic phosphoethanolamine (fosfoetanolamina sintética) was developed at the University of São Paulo (USP) in Brazil at the beginning of the 1990s and, until 2014, was tested on and distributed to cancer patients by members of USP’s Chemistry Institute (IQSC) in the city of São Carlos. That year, the production and distribution of ‘Fosfo’, as it became popularly known, was forbidden by IQSC’s director with the support of USP’s rector and the Brazilian National Sanitary Surveillance Agency (ANVISA). Shortly after this first prohibition, however, Fosfo gained popularity and became a national symbol of local scientific innovation and hope for a cancer cure. Likewise, it became an object of regulatory disputes involving multiple sectors of Brazilian society. Despite several further efforts by some scientists and patients to legitimate Fosfo as a pharmaceutical, ANVISA never authorized it. Nevertheless, at the same time as parts of Brazil’s established medical communities were becoming suspicious of Fosfo, its informal production and dissemination were increasing surreptitiously, with many Fosfo users and stakeholders questioning the legitimacy of conventional cancer therapies. In this article, I aim to understand the impact of Fosfo as a biotechnological innovation in terms of the ‘transfiguration’ of the physical and juridical persons involved in this controversy. Through the lens of transfiguration, the engagement and therapeutic-regulatory experiences of Fosfo users and stakeholders appear as deviant journeys that introduce discontinuities into established biomedicine and imply radical transformations at multiple levels, ranging from individuals to larger institutional environments.

Aging – both the definition and the actual process of aging – has undergone fundamental local and global changes in the past decades. Various advances in technology and medicine increasingly allow senior citizens in Switzerland to ‘age successfully’ and have shifted societal expectations about what aging should include. This article looks at a group of senior citizens who encounter an increasing discrepancy between the demands fostered by the dominant discourse of ‘successful aging’ and the infrastructure made available to them. At the same time, seniors with disabilities are transfigured and come to stand for dependence, frailty, and decline because of this reconceptualization of aging. This article analyzes the cases of three senior citizens with disabilities which show the consequences of changed normative imaginaries, practices, and infrastructures on how senior citizens with disabilities experience their socialities.

To date, most social anthropological studies on aging in African contexts focus on care for poor older people provided by related others. The focus of this article is different as it focuses on older people with better financial means than the average: civil servants belonging to Dar es Salaam’s middle class. Furthermore, this contribution shifts the focus from care provided through related others to practices of everyday self-care, the care that these older people provide for themselves with the help of relatives in Tanzania and the USA. In order to stay healthy and cope with diagnosed chronic conditions, older participants in this study engage in physical exercises, eat ‘good food’, and go for regular medical check-ups. This article argues that these health-promoting self-care practices of older urban dwellers reflect changing experiences of aging, health, and care, and point to transfigurations of the social imaginary of aging in Dar es Salaam’s middle class.

The process of organized assisted suicide (OAS), permitted in Switzerland under specific circumstances, requires applicants to produce and circulate an array of medico-legal documents. Obtaining these documents involves stressful interactions with family doctors, turning the bureaucratic experience into a very personal, and rather intimate, form of sociality. In this Think Piece, I suggest that by following how such documents are produced and circulated, we can better understand how OAS reveals an underlying tension between two figurations of life. Normatively, life is seen as a source of value that needs to be protected and preserved, but OAS statutes acknowledge that some individual lives require professional assistance to die. While legal protections are set up in order to protect life from OAS, these same protections are responded to via the establishment of a bureaucratic infrastructure that facilitates death. In this sense, medico-legal documents not only expose a tension between life and lives, but also enable the navigation of a bureaucracy that facilitates death within a legal framework designed to protect life.