Course objectives and tentative/proposed course syllabus:
Syllabus – Anthropology 316 (#3495) UW-Whitewater, Spring 2008 Instructor: Michael J. Oldani Anthropology 316 email: oldanim@uww.edu Carlson 2005 , T and Th 2:15 to 3:30 phone: 472-1728 Room: Hyer 215 office: White 421 office hours: T and Th 2 to 3pm Prerequisites: 3 units of Sociology or Anthropology (or perm. of inst.) Pharmaceuticals, Culture, and Society Course Description: Increasingly, prescription pharmaceuticals are playing an everyday role (re)shaping human life on both a global (i.e., population) level and a local level (i.e., on the level of communities, families, and the individual). This course will take a multi-disciplinary perspective towards assessing the impact of pharmaceuticals on these various sites. We will use a “critical pharmaceutical studies” approach focusing heavily on anthropological issues (i.e., concentrating on the socio-cultural effects of the pharmaceutical industry has on medical practice as well as the person and other social institutions). Additionally, we will analyze medications/pharmaceuticals by looking at “life-cycles” and specific “life stages” of particular drugs (‘a biography of things’ approach). Various texts (books and literature) from different disciplines that maintain a critical perspective and strive for transparency of pharmaceutical industry practices and culture will be read, discussed, and critiqued. These sources include medical ethics, public health, investigative journalism, medical sociology, medical anthropology, etc. Student Objectives:
• Develop a critical awareness of pharmaceutical industry practices on both a global and local scale
• Develop an understanding of the socio-cultural factors involved in drug development, design, marketing, and
• Expand one’s knowledge of the literature and other sources for researching issues related to pharmaceuticals
• Understand the impact of pharmaceutical prescribing on large populations as well as on the individual (i.e.
• Develop an analytic skill set for assessing the side effects (both pharmacological and social) of prescription
• Enhance one’s analytic, argumentative, and writing skills through the research, writing, and presenting of a
Required Books for Purchase: 1. The Rise of Viagra: How the Little Blue Pill Changed Sex in America, M. Loe (2004) 2. Selling Sickness: How the World’s Biggest Pharmaceutical Companies are Turning us all Into Patients, R. Moynihan and A. Cassels (2005) 3. The Last Normal Child: Essays on the Intersection of Kids, Culture and Psychiatric Drugs, L. Diller (2006) Suggested Books for Research/Purchase: The Male Pill: A Biography of a Technology in the Making, N. Oudshoorn (2003) Global Pharmaceuticals: Ethics, Markets, Practices, edited by Petryna, Lakoff, Kleinman (2006) Listening to Prozac, P. Kramer (1993) Generation Rx, G. Critser (2005) Testosterone Dreams: Rejuvenation, Aphrodisia, Doping, J. Hoberman (2005) The $800 Million Pill: The Truth Behind the New Cost of Drugs, M. Goozner (2004), U of CA Press, Additional readings: Will be provided through electronic reserves (“ER”), D2L postings in PDF files, and book/journal article reserves in Anderson Library.
PART ONE:
Analytic Frames for Critical Pharmaceutical Studies
Week 1: The Anthropology of Pharmaceuticals: A biographical approach/Viagra (9/4) Discussion 1 (1/22): General outline of readings presented, student expectations and background discussed. Instructor will present provide a brief overview of major anthropological themes as well as pharmaceutical issues to be addressed during the semester. Grading explained. Readings: Class handout Discussion 2 (1/24): Why use the ‘life-cycle’ approach to study pharmaceuticals? Readings: 1).Van der Geest, Susan Reynolds Whyte and Anita Hardon (1996) The Anthropology of Pharmaceuticals: A Biographical Approach. AnnualReview of Anthropology 25:153-78. (Suggestion: read in reverse order as listed.) (ER) 2). Preface and Chapter 1 of ‘The Rise of Viagra’ Suggested Readings: -Emergent Forms of Life: Anthropologies of Late or Post-Modernities. Fischer, Michael (1999). Annual Review of Anthropology 28:455-478; -“Hormones for Men,” New Yorker (2004), (ER – under Individual and Society Link) -Kopytoff (1986) The cultural biography of things: commoditization as process (pp. 65-91). In The Social Life of Things: Commodities in Cultural Perspective. Edited by A. Appadurai. Cambridge University Press: Cambridge. -Van der Geest, Susan Reynolds Whyte and Anita Hardon, Social Lives of Medicine (2003), “Introduction: Materia Medica.”
Week 2: “Bioprospecting,” Biotechnology, and the Pharmaceutical Industry/Viagra [Due February 1st: reaction paper #1 (15pts) in D2L dropbox, by 11pm] Discussion 1 (1/29): A time to discuss Research and Development through the growth of the biotechnology industry. Some questions to focus on: what is the relation of biotech’s to big Pharma? What is being exchanged between the private and the public sectors? How do market forces shape medicine and science? Readings: 1. Introduction and Chapter 1 (“The Longest Search”) from The $800 Million Pill: The Truth Behind the New Cost of Drugs, M. Goozner (2004), U of CA Press, ER 2. Chapter 2 (The Rise of Erectile Dysfunction) from the Rise of Viagra Film: Sex, Drugs and Middle Age (CBC) Discussion 2 (1/31): A long history of bioprospecting by governments. Also an opportunity to critically examine how multinational corporations value non-western forms of herbal/natural ways of healing. Readings: 1. “The Indian Healer” from Indian Givers, J. Weatherford (1988), ER 2. “The Failed Crusade,” from The $800.00 Dollar Pill, Goozer (2002) (ER, excerpts) Film: Sex, Drugs and Middle Age, cont. Suggested Readings: -Making PCR: A Story of Biotechnology; Rabinow (1996) -Maya Medicine in the Biological Gaze: Bioprospecting Research as Herbal Fetishism. R. Nigh (2003). Current Anthropology 43(3): 451-477 (ER, under ‘Culture, Medicine, and Health link). Week 3: Bioprospecting Cont./Viagra [DUE: Research Project Ideas (10pts)/D2L Drop box, (2/8 by 11pm)] Discussion 1 (2/5): Reading: 1. “From Market to Market: Bioprospecting’s Idioms of Inclusion,” In American Ethnologist 30(3), August 2003, C. Hayden. (ER) 2. “Explorations in a New World,” In The Creation of Psychopharmacology, D. Healy (2002), Pp. 77-128. (ER) Discussion 2 (2/7): 1.”Explorations” (above), cont. 2. Chapter 3 (“Fixing the Broken Male Machine”) and Chapter 4 (“The Pill Doesn’t Always Thrill”) in The Rise of Viagra
Week 4: The FDA/Viagra [DUE: Reaction Paper #2 in D2L Drop box 2/15] Discussion 1 (2/12): 1. “The Birth of the Modern Pharmaceutical Trade,”(Chapter 6) in Protecting American’s Health: The FDA, Business, and One Hundred Years of Regulation, P. Hilts, (2003), UNC Press. Pp. 95-107. (ER) 2. “ New Drugs, New Problems,” (Chapter 7) In P. Hilts’ Protecting American’s Health. (ER) 3. “The Search for the Female Viagra” in the Rise of Viagra (Chapter 5)” Discussion 2 (2/14): 1. “The End of the Great Buffer” in Generation Rx: How Prescription Drugs are Altering American Lives, Minds, and Bodies, G. Critser (2005), Houghton Mifflin Company. (ER – under ‘Individual and Society’ link) 2. “Strange Case of Dr. Jeckl and Ms Hyde” (ER – under ‘Culture, Medicine, and Health’ Link) 3. “John Rock’s Error” (The construction of female birth control.) in the New Yorker (ER – under ‘Culture, Medicine, and Health’ link) Week 5: Viagra, Hormone Therapy, and Beyond/Clinical Trials
[DUE: Rough Draft Outline of Final Project in D2L dropbox (10pts), 2/22]
Discussion 1 (2/19): 1. “Hormones for Men,” New Yorker Magazine (ER – under ‘Individual and Society’ Link) 2. Chapter 6 (“A Pill for Everything?”) in TheRise of Viagra 3. Epilogue: “A Hard Act to Follow” in The Rise of Viagra Discussion 2 (2/21): 1. “Outlaw Biomedical Innovations: Hormone Therapy and Beyond” (Chapter 4) in Testosterone Dreams: Rejuvenation, Aphrodisia, Doping, J. Hoberman (2001) –ER/Posted on D2L 2. “The First Man on the Pill”: Disciplining Men as Reliable Test Subjects (Chapter 8) in The Male Pill: A Biography of a Technology in the Making (N. Oudshoorn), 2003, Duke University Press; Pp. 171-190. (ER/posted on D2L 3. “Ethical Variability,” A. Petryna From American Ethnologist, TBA 4. “Guinea Pigging,” C. Elliot from the New Yorker PART II: Pharmaceutical Industry Distribution and Marketing Week 6: From Marketing to Mongering [DUE: Reaction Paper #3 (a short book review, at least three chapters on the ‘Rise of Viagra’); 2/29] Discussion 1 (2/26): In class assignment: Bring to class in written form 2 to 3 conclusions you have drawn from the first section of this course. Themes from section one have been the ‘Case Study of Viagra’; Drug development – penicillin, ‘epo’, Chloramphenicol, Clorpromazine, Taxol, etc.; Pharmaceutical Industry research and “bioprospecting” versus Government/not-for-profit research institutions (and universities) – use ‘RxDrug Journal’ (see assignments below) here for discussion Discussion 2: Looking closely at Moynihan and Cassels’ arguments in ‘Selling Sickness’ 1. Introduction and Prologue in Selling Sickness 2. Selling to Everyone (Chapter 1) and Making Risks Into Medical Conditions (Chapter 5); Selling Sickness Week 7: Pharmaceutical Marketing – Global and Local Perspectives Due: Reaction paper #4 in D2L Dropbox (15pts); 3/7 Discussion 1 (3/4): Pharmaceutical Marketing and Globalization – Effects on populations/nation-states Readings:
1. “The Pharmaceutical Nexus.” In Global Pharmaceuticals: Ethics, Markets, Practices. (A. Petryna, a. Lakoff,
and A. Kleinman eds.), 2006, Duke University Press.
2. “Pharmaceutical Governance” by J. Biehl; In Global Pharmaceuticals: Ethics, Markets, Practices. (A.
Petryna, a. Lakoff, and A. Kleinman eds.), 2006, Duke University Press.
3. “Did Antidepressants Depress Japan?” New York Times; ER (under I and S link) 4. “Shaping Public Perceptions” (Chapter 7) in Selling Sickness Discussion 2 (3/6): Pharmaceutical Marketing at a Local Level – The Effects of Drug Rep/”Detail Men”/Pharmaceutical Salespersons on the prescription writing habits of doctors.
1. “High Contact:” Gifts and Surveillance in Argentina.” By A. Lakoff, In Global Pharmaceuticals (see above) 2. “Thick Prescriptions: Toward an Interpretation of Pharmaceutical Sales Practices” (Oldani 2004; MAQ); ER 3. “The Drug Pushers,” by Carl Elliot in the Atlantic Monthly (April 2006); ER
Week 8: The Spectrum (and Spectre) of Mongering Discussion 1 (3/11): Overt Mongering Readings: Drug Reps and Advertising as Mongering
1. “The Fight Against Disease Mongering” by Moynihan and Henry in Plos Medicine online see link:
http://medicine.plosjournals.org/perlserv/?request=get-toc&issn=1549-1676&volume=3&issue=4
2. “Doughnuts for the doctors” (Chapter 2.) in Selling Sickness 3. “Advertising Disease” (Chapter 7) in Selling SicknessDiscussion 2 (3/13): Overt Mongering, cont. Readings:
1. The Pharmacopoeia of Risk Reduction, by J. Greene in Prescribing by Numbers (2007) Johns Hopkins U.
2. “Cholinesterase Inhibitors: Drugs Looking for a Disease?” by M. Maggini, N. Vanacore, and R. Raschetti,
3. “Medicine Goes to School: Teachers as Sickness Brokers for ADHD,” by C. Phillips in Plos (see link above) 4. “Latest Mania: Selling Bipolar Disorder,” by D. Healy in Plos (see link above) 5. “Giving Legs to Restless Legs: A Case Study of How the Media Helps Make People Sick,” by Woloshin and
6. “Combating Disease Mongering: Daunting but Nonetheless Essential,” by I Heath, see plos link above
Week 9: Final Issues Concerning Marketing/Mongering
[DUE: Reaction Paper #5 in D2L Dropbox (A review (at least three chapters of Selling Sickness); 3/21] Discussion 1 (3/18): Subtle Mongering: ‘Reducing Risk’ Readings: 1. Greene’s The Pharmacopeia of Risk Reduction (pdf file on course homepage) 2. Chapter 8 (Test the Markets: Osteoporosis) and 3.Chapter 9 (Taming the Watchdogs: Irritable Bowel Syndrome, In Selling Sickness. 4. Medicine Goes to School: Teachers as Sickness Brokers for ADHD,” by C. Phillips see link below: 5. Combating Disease Mongering: Daunting but Nonetheless Essential,” by I Heath, see plos link: http://medicine.plosjournals.org/perlserv/?request=get-toc&issn=1549-1676&volume=3&issue=4 Discussion 2 (3/20): Catch-up date/Film, TBA; Hand in RxDrug Diaries/Journals Spring Break: 3/22 to 3/30 – No class PART III: Pharmaceutical Effects/Affects Case Two: Psychopharmacology and Children Week 10: Prozac (Fluoxetine HCl) [Due: Annotated Bibliography AND Abstract (half page, single spaced) WITH main argument of final research project in D2L dropbox (10pts each); 4/4] Discussion 1 (4/1): Promoting Psychopharmacology Readings: 1. “How the Pharmaceutical Industry Promotes Drugs and Chemical Theories of Mental Illness” in Blaming the Brain, Vallenstein, E (1998); ER/pdf file
2. “Introduction” and Chapter 1, “Makeover” in Listening to Prozac (1993), by P. Kramer – course homepage in pdf file. 3.Men and Depression: Facing Darkness/Newsweek (ER, anthropology 302 link) 4. What every woman should know about antidepressants/Glamour (Homepage/ER)
Discussion 2 (4/2): Prozac/Psychotropics as a Way of Life Readings: 1. “ Anatomy of an Epidemic: Psychiatric Drugs and The Astonishing Rise of Mental Illness in America,” Whitaker, 2005 (ER/Homepage pdf file) 2. “Introduction” (Prozac as a Way of life, Elliot, 2004) (ER/Course Homepage, PDF file) 3. “Introduction,” and Chapter 1., last normal child? Begin Final Project presentations
Week 11: Psychopharmacology and the Self: Pills and Play
[Due: Reaction Paper #6, 4/11 in Dropbox]/Final Presentations Discussion 1 (4/8): Psychiatry’s Biomedical dilemma: Epidemics of Disorder(s) and the Power of the Pill(s) Readings:
1. “The Meaning of Medicating: Pills and Play,” Wilson, 2005 (ER/Homepage pdf file) 2. “Neurochemical Selves,” Rose (2003) (ER/Homepage PDF file) 3. “Psychiatric Patients: Filling Their Own Scripts (The Case of “Internet Man”),” Oldani, 2006/Dissertation,
Discussion 2 (4/10): Medical and Psychiatric Consumers Readings:
1. “Psychiatric Drug Promotion and the Politics of Neoliberalism,” Moncrieff (2006) – Anthropology 302 E-
2. “Pharmaceutical Marketing and the Invention of the Medical Consumer,” Applbuam, I and S130 ER link
Week 12: Children in the Psychopharmacological Era Due: ROUGH DRAFT in dropbox, 4/18 Final presentations, cont.
Discussion 1 (4/14) and 2 (4/16): Children and Ab/normality Readings:
1. What’s Normal? (Groopman/New Yorker); ER 2. Coping with a “Living Imbalance”: Add-Ogenic Forces in Families, Schools, and Society (Chapter 4) form
“Running on Ritalin” (Diller, 1998); ER
3. Chapters 2 and 3 from the Last Normal Child 4. Film: Medicating Kids - ADHDWeek 13 : Children and Psychotropics, cont. Due: Reaction Paper #7 in D2L Drop Box, 4/25 – Must discuss as least three chapters from Last Normal Child Final Presentations, cont.
Discussion 1: Generation Rx? Readings:
1. NY Times link to Children and psychotropics – article and video clips (TBA) 2. Chapter 4 from Last Normal Child Discussion 2: Generation Rx, cont. Readings:
1. Bipolar article, TBA 2. “Residential School in a bottle” (Oldani manuscript), TBA
Week 14: A Culture of High Prescribing?
Final Presentations, cont. Discussion 1 (4/29) and 2 (5/1):The Last Normal Child Week 15: The Future of Pharmaceuticals Final Presentations, cont. Due: RxDrugDiary Discussion 1 (5/6) and Discussion 2 (5/8): Readings: 1. "Big Pharma Faces Grim Prognosis" link: http://online.wsj.com/article_print/SB119689933952615133.html 2. "An Anti-Addiction Pill?" link: http://www.nytimes.com/2006/06/25/magazine/25addiction.html?_r=1&oref=slogin 3. "Dr. Drug Rep" link: 4. ‘SIRT’ pharmaceuticals, TBA Week 16: Final Papers DUE in dropbox on 5/16 by 11pm Week 17: FINAL GRADES entered into WINS on 5/22
Student Work Requirements: 1. Students will be required to submit a weekly “reaction paper.” These papers will be a one-page, single spaced (or two-pages double spaced) that critically explore their thoughts concerning current readings and classroom discussions. There is no ‘right or wrong’ way to do a reaction paper – its a chance to build upon one’s own particular critical understanding of pharmaceutical issues presented and discussed throughout the semester. Three of the reaction papers must be short reviews of the three books we will read – see weekly outline above. (7 x 15pts each = 105pts). 2. A RxDrug Diary must be kept during the semester – and handed in twice for me to grade/review (week 9 and week 15) – this Diary must include entries that list what drugs you have learned about this semester via the readings and current events you may pick up on outside of class. You must enter at least TEN drugs/compounds/remedies from the readings (e.g., “talked about ‘epo’ today, never heard of it before – was discussed in class too” – then list author and source; “watched the news again, they mentioned Avendia and that it killed some patients…” the diary can be a ‘notebook’ or it can be a .doc file you keep current and then print out and hand in (with name on it!). (100pts possible). 3. Attendance/Class participation. Everyone starts off with 100 total points in this course, missing a class via an unexcused absence will cost you 5 points. Missing a class when you are introducing an article will cost you 10pts. (100pts possible) A final paper will be required as well (10 to 15 pages) which will trace the life-cycle (ethnography/biography) of a particular pharmaceutical product – from the past, the present or perhaps a future compound (150pts). 3) Attendance and class participation is mandatory, including brief, routine introductions of a particular readings and a final paper presentation (10 to 15 minutes) (100pts = 50pts, routine intro to reading + 50pts final pres.). Note: Additional assignments may emerge as well as ‘pop-quizzes’ to ensure readings are being covered. Note: Missing class requires prior arrangements with instructor, a legitimate medical excuse, a family/personal emergency, or extracurricular commitment (e.g., athletic schedule conflict). 4. Final Research Project:
• Ideas for Final Project = 10pts (3 to 5 drugs you have an initial interest in)
• Annotated/working bibliography = 15pts (at least 10 sources/5 can be from course readings)
• One Page Abstract plus main ARGUMENT = 15pts
• Rough Draft of final project = 75 pts (at least 5 pages)
• Class presentation = 40pts (approx. 10 to 15 min.)
• Final Draft of Research Project = 100pts (10 to 12 pages) • Total Points = 270pts Total Course points = 575 POINTS Note: What is the final research project? This will be discussed and worked on starting with our first class, so DO NOT PANIC about this project. I promise that it will come together (in your mind) as we start our readings and discussions. In short, you are going to be asked to write a ‘social/cultural’ history of a prescription drug following the life-cycle and/or biographical approach. This simply means you will do research into the discovery of the drug, the development of the drug, the marketing of the drug, and the impact of the drug on society, culture, human beings, healthcare, medicine, psychiatry, etc. These all can be seen as life stages of a particular drug. Some of you will focus more intensely on a particular stage than other stages (like development versus marketing) – that is OK. Keep in mind some drugs straddle the il/legal divide – stimulants such as Ritalin, heroin/morphine, marijuana, etc. You can feel free to look into these types of prescriptions/drugs as well. (The UW-Whitewater grading Scale:) 90% - 100% = A 80 - 89 = B 70 - 79 = C 60 - 69 = D < 60 = F
Additional Information: The University of Wisconsin-Whitewater is dedicated to a safe, supportive and non-discriminatory learning environment. It is the responsibility of all undergraduate and graduate students to familiarize themselves with University policies regarding Special Accommodations, Academic Misconduct, Religious Beliefs Accommodation, Discrimination and Absence for University Sponsored Events (for details please refer to the Schedule of Classes; the “Rights and Responsibilities” section of the Undergraduate Catalog; the Academic Requirements and Policies and the Facilities and Services sections of the Graduate Catalog; and the “Student Academic Disciplinary Procedures (UWS Chapter 14); and the “Student Nonacademic Disciplinary Procedures" (UWS Chapter 17). The UW System standard for work required per credit is that students are expected to invest at least 3 hours of combined in-class and out-of-class work per week for each academic unit (credit) of coursework; thus, a 3-credit course will typically require a minimum of 9 hours of work per week (144 hrs./semester).
BIBLIOGRAPHY
Appadurai, A. (ed.) 1986 The Social Life of Things: Commodities in Cultural Perspective. Cambridge: Cambridge University Press. Critser, G. 2005 Generation Rx: How Prescription Drugs are Altering American Lives, Minds,and Bodies. New York: Houghton Mifflin Company. Elliot, C. 2003 Better Than Well: American Medicine Meets the American Dream. New York: W. W. Norton. Elliot, C. and T. Chambers (eds.) 2004 Prozac as a Way of Life. Chapel Hill: University of North Carolina Press. Hawthorne, F. 2003 The Merck Druggernaut: The Inside Story of a Pharmaceutical Giant. Hoboken, NJ: Wiley and Sons, Inc. Healy, D. 1997 The Anti-Depressant Era. Cambridge: Harvard University Press. 2002 The Creation of Psychopharmacology. Cambridge: Harvard University Press. 2004 Let Them Eat Prozac: The Unhealthy Relationship Between thePharmaceutical Industry and Depression. New York: New York University Press. Hoberman, J. 2005 Testosterone Dreams: Rejuvenation, Aphrodisia, Doping. Berkeley: University of California Press. Goozner, M. 2002 The $800 Million Pill. Berkeley: University of California Press. Kramer, P. 1993 Listening to Prozac. New York: Penguin. Lexchin, J. 1984 The Real Pushers: A Critical Analysis of the Canadian Drug Industry. Vancouver: New Star Books. Luhrmann, T. 2000 Of Two Minds: The Growing Disorder in American Psychiatry. New York: Knoff. Metzl, J. M.
2003 Prozac on the Couch: Prescribing Gender in the Era of Wonder Drugs. Durham: Duke University Press. Moynihan R. A. Cassels 2005 Selling Sickness: How the World’s Biggest Pharmaceutical Companies areTurning us all into Patients. New York: Nation Books/Avalon Publishing Co. Ong, A. and S. J. Collier (eds.) 2006 Global Assemblages: Technology, Politics, and Ethics as Anthropological Problems. Oxford: Blackwell Publishing. Oudshoorn, N. 2003 The Male Pill: A Biography of a Technology in the Making. Durham: Duke University Press. Petryna, A., Lakoff, A. and A. Kleinman (eds.) 2006 Global Pharmaceuticals: Ethics, Markets, Practices. Durham: Duke University Press. Rabinow, P. 1996 Making PCR: A Story of Biotechnology. Chicago: University of Chicago Press. White, S. R., Hardon, A. and S. van der Geest 2003 Social Lives of Medicine. Cambridge: Cambridge University Press.
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