801
ARTICLE
Visions of Care:
Medicalization and Public
Patienthood in Sao Paulo,
Brazil
Naomi Zucker, University of Pennsylvania
ABSTRACT
Encompassing a range of critiques, from new regimes of governmental-
ity and biopolitical control to the iatrogenic effects of scientific medicine’s
incursion into everyday life to the normative power of medicine, medical-
ization has become a central concept in anthropology and the critical so-
cial sciences. Drawing on three months of fieldwork at a primary care clinic
in São Paulo, Brazil, I explore how and to what effect a group of health
professionals have taken up this concept as part of their own critical proj-
ects. Founded and run by a group of sanitaristas or “public health doctors”
working at the intersection of social science, medicine, and philosophy, the
clinic is intentionally structured around an ambitious vision of comprehen-
sive, “humanized,” anti-medicalizing health care. Attending to how medi-
calization is deployed in the clinic offers an entry point into the complex
entanglements of judgment, discipline, citizenship, and care as they com-
bine, refract, and reinforce or contradict each other in particular encounters
between patients and providers. As health care providers inadvertently re-
produce the very forms of discipline they seek to resist, we are able to more
readily apprehend the kinds of patienthood being imagined and assumed at
the clinic, and to explore how medicalization functions as both an embodi-
ment of vision and an instantiation of its limits. [Keywords: Medicalization,
care, discipline, patienthood, collective health, primary care, SUS, Brazil]
Anthropological Quarterly, Vol. 90, No. 3, p. 801–830, ISSN 0003-5491. © 2017 by the Institute for
Ethnographic Research (IFER) a part of The George Washington University. All rights reserved.