Medical Anthropology in an Era of Authoritarianism

Başak Can’s timely essay speaks to the challenges of medical anthropological research under authoritarian regimes not only in Turkey but in other parts of the Middle East. There, governments led by dictators, monarchs, or warring parliaments may feel threatened by the critical findings of health-related ethnographic research. Obstacles placed in researchers’ way may include failure to receive research funding, visas, or permits; lengthy institutional review board processes resulting in research delays and denials; requests for study revision that fundamentally alter the nature of research; and refusal of individual hospitals, clinics, or physicians to allow a research project to move forward, either out of fear of what a medical anthropological study might reveal or because clinicians themselves feel professionally jeopardized, especially in state-run healthcare settings. Even in the private medical sector, research access may be hard to achieve, particularly when research topics are sensitive (e.g., infertility, abortion) or when physicians are concerned about protecting their paying patients’ privacy. Gaining access to private clinics and hospitals may require powerful physician allies to act as intermediaries, or wastas, to use the Arabic term. This “politics of patronage” (Inhorn 2004) may create compromising conditions of hierarchy and indebtedness, including the possibilities of research surveillance, expectations of reciprocity, or censorship of research findings. As two medical anthropologists who work on reproductive health care in the Middle East, we have experienced most of these struggles in our own studies. For example, Marcia C. Inhorn, who has researched infertility and assisted reproductive technologies in the Arab world over thirty years, has experienced all of these obstacles, to varying degrees. Beginning her project in Egypt in the late 1980s, she was able to situate her study with relative ease in an Alexandrian public maternity hospital. There, she conducted more than a year’s worth of research with little intervention. However, the political climate in Egypt had shifted by the mid-1990s, when she returned to study the introduction of in vitro fertilization (IVF) in the country. Increasing repression of the Islamic movement under the authoritarian regime of Hosni Mubarak meant that research questions surrounding religion were now quite “sensitive,” as she was told by Egypt’s Binational Fulbright Commission. By the early 2000s, the Fulbright Commission itself was under new