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In Session: Biopolitical Vietnam
4: Psychopharmaceutical Adherence and Family Caregivers in Postreform Vietnam
Tuesday, March 23, 2021
12:00pm – 1:30pm EDT
Bucknell University, United States
This presentation examines the role of family caregivers (người thân or người nhà) in adherence to psychopharmaceuticals in Ho Chi Minh City. Vietnam has one of the highest rates of nonadherence to prescription drugs in the world (Okumura, Wakai, and Umenei 2002). Recent theorizing on medicine and biopolitics describes psychopharmaceuticals as a technology of a deinstitutionalizationed and individuated self (Rose 2003). Drug compliance has become a means for patients to manage themselves in the wake of decreased state welfare programs (Buus 2014, Brijnath and Antoniades 2016). For example, in the West, adherence to potentially life-long medications suggests the internalization of a medicalized framework of everyday life (D’Arcy 2019). In Vietnam, however, doctors stress the importance of adherence without the expected calls for self care. Rather, these injunctions are directed at the family caregivers in attendance at the patient’s consultations. That is, adherence is framed as a project of familial care. The manner in which Vietnamese families become enrolled in and, in turn, negotiate medicine taking is not simply a dilution of biopolitical projects but an extension of them into the family. Challenging the state-citizen binaries that characterize Vietnam studies (c.f. Gammeltoft 2014), caregivers’ role in medicine taking indicates that the family is not simply a buffer against or a conduit for biopolitical governance. Here, adherence relies less on the responsibilization of the patient than on caregivers’ labor and relationships.