he people I met who were involved with IVF in Ecuador already perceived reproduction as an assisted experience. their comfort with the technological inter-ventions of IVF was related to their comfort with the idea of God’s intervention in reproduction. this comfort was shared by IVF practitioners, who were trying to make things, namely embryos, with God’s assistance, through biological prin-ciples formulated within laws of nature that excluded the presence of God. the Protestant reformation postulated a God who no longer intervened in the natu-ral world. In combination with ensuing Enlightenment thought, this view posited physical matter as devoid of animation or intelligence. this was arguably a more drastic shift in the Western worldview than any in the preceding millennia (V. Nelson 2001). as part of this disenchanted world, biological reproduction became a natural phenomenon that could be observed and understood separate from the newly separated “social” and “spiritual” domains. Within these principles of sci-entific materialism, laboratories came to house objects that were understood to be inert

The Gay International and this small minority of Arab same-sex practitionerswho adopt its epistemology have embarked on a project that can best bedescribed as incitement to discourse.45As same-sex contact between men has notbeen a topic of government or journalistic discourse in the Arab world of the lasttwo centuries, the Gay International’s campaign since the early 1980s to univer-salize itself has incited such discourse. The fact that the incited discourse is char-acterized by negativity toward the mission of the Gay International is immaterial.By inciting discourse on homosexual and gay and lesbian rights and identities,the very ontology of gayness is instituted in a discourse that could have only tworeactions to the claims of universal gayness: support them or oppose them with-out ever questioning their epistemological underpinnings.

“Oppressed women are easily overlooked. Please support us in the fi ght for their rights.” A writer on another feminist website picked up the poster and retorted that “agency is easily over-looked if you actively erase it.”13 The feminists, Muslim and non- Muslim alike, who drew attention to this campaign poster are among those who ask us why so many, including human rights campaigners, presume that just because Muslim women dress in a certain way, they are not agentic individuals or cannot speak for themselves. These feminists are not ignoring the abuses the women suffer; to the contrary, they are suggesting that we ought to talk to them to fi nd out what problems they face rather than treating them as mute garbage bags.

Drawing from this analysis, we can begin to approachthe Trump Voter (and any voter, for that matter) not as acoherent political subject whose vote indexes their demo-graphically marked positionality but instead as an agentshaped by structural contradictions (such as the simul-taneity of unprecedented corporate profits on the onehand, and depressed wages and widespread underem-ployment on the other) that give specificformtoandin-form personal experiences with the ubiquitous tensionsbetween individuated action and social embeddedness.In this light, a vote for Trump can be seen not necessarilyas an attempt to reconcile such structural contradictionsbut instead as an index of how those contradictions givea particular shape to broader“irresolvable tensions”be-tween subjects’self-conceptualizations as autonomousagents and, conversely, as citizens of a political public

The two factors that pressure pharmaceutical companies in this regard are monopsonistic government payer systems (especially in Europe) and the threat of arbitrage. Monopsony allows governments to make their own cal-culations of how much they are willing to pay for a drug, how much they are willing to allow it to be priced on their national market (direct price con-trols), and what instruments they will use to make these determinations. In some countries—the United Kingdom, most notably—health economics has developed as an elaborate discipline precisely in order to make such cost-benefit calculations, between expense to the government and the quality of life years that would accrue through the use of a particular drug.17 Other gov-ernments (including in the U.K. and most European countries) use systems of international price referencing, by which they will study the prices of the drugs in other markets and determine their own willingness to pay based on those prices.

Biological race in the form of “ge ne tic factors” was off ered to explain the effi cacy of BiDil for self- identifi ed Black persons. BiDil’s patent holder produced scholarship hypothesizing that heart failure in Black persons was primarily due to a ge ne tic cause, excluding the plethora of nonge ne tic contributors. For these racial scientists, genes that were unique or restricted to Black people produced “a pathophysiology . . . that may involve nitric oxide insuffi ciency.” One cardiologist explicitly disputed the relevance of nonbiological causes of the increased rates of heart failure among Black persons, arguing that data “do not support socioeconomic factors as im-portant contributors to the excess mortality rate seen in African Americans aff ected with heart failure.” Th is cardiologist avowed “[h]eart failure in blacks is likely to be a diff erent disease.” Moreover, the diff erence was all in the genes: “[T]he emerging fi eld of genomic medicine has provided insight into potential mechanisms to explain racial variability in disease expres-sion” (Washington 2007, 322)

Rationalist and relativistan-thropologies have long battled along the lines of “rational” and “irrational,” “knowledge” and “belief,” “natural” and “cultural,” “universal” and “local.” In doing so, rationalists and relativists have reinscribed these lines even while contesting along them.

Most trials are set up so that either theyare successful and a new, more intensive treatment regimen is indicated, or they fail, and the status quo prevails.Only the trials that backfire and find excessive side effects result in reduced treatment. Mydoctors are troubled by howeasy it is to put people on medication because they meet guideline criteria, but howdifficult it is to get them off.Often no studies are conducted to determinewhen it would be betteror safer to stop giving a medication to a patient, even while there arevery few studies of the long- term effectiveness or safetyof those medications.26 None of these studies interest drug companies because, again, they would shrink the market for treatments.The general trend is that the only trials conducted by the industryare those that would grow the market by increasing the amount of medication in ourcollective lives

. Consequently, mother love is best bracketed and understood as (m)other loves. The following discussion obviously makes no claims to universality. Nor is it an argument for a "culture of poverty" addressed specifically to the situation of shantytown mothers and children. Although it does not surprise me to discover some resonances and resemblances with mothering practices at other times and places, it is to the particularities of the Brazilian situation that the following is addressed. 3 The women and children whose painful lives I dare to expose here are the end in and of themselves of my analysis.

During my first field experience in Brazil, I learned firsthand how challenging cultural relativism could be. Preferences for physical proximity and comfort talking about one’s body are among the first differences likely to be noticed by U.S. visitors to Brazil. Compared to Americans, Brazilians generally are much more comfortable standing close, touching, holding hands, and even smelling one another and often discuss each other’s bodies. Children and adults commonly refer to each other using playful nick-names that refer to their body size, body shape, or skin color. Neighbors and even strangers frequently stopped me on the street to comment on the color of my skin (It concerned some as being overly pale or pink—Was I ill? Was I sunburned?), the texture of my hair (How did I get it so smooth? Did I straighten my hair?), and my body size and shape (“You have a nice bust, but if you lost a little weight around the middle you would be even more attractive!”). During my first few months in Brazil, I had to remind myself constantly that these comments were not rude, disrespectful, or inappropriate as I would have perceived them to be in the United States. On the contrary, it was one of the ways that people showed affection toward me. From a culturally rela-tivistic perspective, the comments demonstrated that they cared about me, were concerned with my well-being, and wanted me to be part of the community. Had I not taken a culturally relativistic view at the outset and instead judged the actions based on my cultural perspective, I would have been contin-ually frustrated and likely would have confused and offended people in the community. And offending your informants and the rest of the community certainly is not conducive to completing high-qual-56 PERSPECTIVES: AN OPEN INTRODUCTION TO CULTURAL ANTHROPOLOGY