Psychiatric practice and the exigencies of the state: an ethnomedical view

The purpose of this paper is to illustrate the powerful role that the state has in the practice of psychiatry in contemporary American society. An ethnomedical frame of reference is adopted, which is to say that psychiatric practice is looked at culturally and comparatively. In any society social and cultural characteristics condition and structure medical practice. In this sense, psychiatric practice provides an example to be analyzed in relation to other systems of medical practice. The ways in which the modern state, an omnipresent and compelling social structure, can intrude into the dynamics of psychiatric practice is illustrated by means of two case analyses. These draw attention to unique ethnomedical properties of psychiatric practice and to the potentially tragic effect that the state can have on its conduct. Analysis of the material presented is conducted against the background of information from the anthropological and social historical study of medicine and from medical practice in the Soviet Union.