Visions of Care: Medicalization and Public Patdenthood in Sao Paulo,Brazil

Encompassing a range of critiques, from new regimes of governmentality and biopolitical control to the iatrogenic effects of scientific medicine's incursion into everyday life to the normative power of medicine, medicalization has become a central concept in anthropology and the critical social sciences. Drawing on three months of fieldwork at a primary care clinic in Sao 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 projects. 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 comprehensive, "humanized," anti-medicalizing health care. Attending to how medicalization is deployed in the clinic offers an entry point into the complex entanglements of judgment, discipline, citizenship, and care as they combine, refract, and reinforce or contradict each other in particular encounters between patients and providers. As health care providers inadvertently reproduce 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 embodiment of vision and an instantiation of its limits.