This book explores the moral lives of mental health clinicians serving the most marginalized individuals in the US healthcare system. Drawing on years of fieldwork in a community psychiatry outreach team, Brodwin traces the ethical dilemmas and everyday struggles of front line providers. On the street, in staff room debates, or in private confessions, these psychiatrists and social workers confront ongoing challenges to their self-image as competent and compassionate advocates. At times they openly question the coercion and forced-dependency built into the current system of care. At other times they justify their use of extreme power in the face of loud opposition from clients. This in-depth study exposes the fault lines in today's community psychiatry. It shows how people working deep inside the system struggle to maintain their ideals and manage a chronic sense of futility. Their commentaries about the obligatory and the forbidden also suggest ways to bridge formal bioethics and the realities of mental health practice. The experiences of these clinicians pose a single overarching question: how should we bear responsibility for the most vulnerable among us?

Medicine and morality in rural Haiti are shaped both by different local religious traditions and by biomedical and folk medicine practices. People who become ill may seek treatment from Western doctors, but also from herbalists and religious leaders. This study examines the decisions guiding such choices, and considers moral issues arising in a society where suffering is associated with guilt but where different, sometimes conflicting, ethical systems coexist. It also reveals how in the crisis of illness people rework religious identities and are forced to address fundamental social and political problems.

Chronic pain challenges the central tenet of biomedicine: that objective knowledge of the human body and mind is possible apart from subjective experience and social context. Sufferers, finding that chronic pain alters every aspect of life, often become frustrated and distrust a profession seemingly unable to explain or effectively treat their illness. The authors of this innovative volume offer an entirely different, ethnographic approach, searching out more effective ways to describe and analyze the human context of pain.
How can we analyze a mode of experience that appears to the pain sufferer as an unmediated fact of the body and is yet so resistant to language? With case studies drawn from anthropological investigations of chronic pain sufferers and pain clinics in the northeastern United States, the authors explore the great divide between the culturally shaped language of suffering and the traditional language of medical and psychological theorizing. They argue that the representation of experience in local social worlds is a central challenge to the human sciences and to ethnographic writing, and that meeting that challenge is also crucial to the refiguring of pain in medical discourse and health policy debates.
Anthropologists, scholars from the medical social sciences and humanities, and many general readers will be interested in "Pain as Human Experience," In addition, behavioral medicine and pain specialists, psychiatrists, and primary care practitioners will find much that is relevant to their work in this book.

This book explores the moral lives of mental health clinicians serving the most marginalized individuals in the US healthcare system. Drawing on years of fieldwork in a community psychiatry outreach team, Brodwin traces the ethical dilemmas and everyday struggles of front line providers. On the street, in staff room debates, or in private confessions, these psychiatrists and social workers confront ongoing challenges to their self-image as competent and compassionate advocates. At times they openly question the coercion and forced-dependency built into the current system of care. At other times they justify their use of extreme power in the face of loud opposition from clients. This in-depth study exposes the fault lines in today's community psychiatry. It shows how people working deep inside the system struggle to maintain their ideals and manage a chronic sense of futility. Their commentaries about the obligatory and the forbidden also suggest ways to bridge formal bioethics and the realities of mental health practice. The experiences of these clinicians pose a single overarching question: how should we bear responsibility for the most vulnerable among us?