Applying the Index of Care to the Case Study of a Bronze Age Teenager Who Lived with Paralysis: Moving from Speculation to Strong Inference

Abstract

Bioarchaeology has come a long way in using differential diagnosis, attending to the osteological paradox, using biocultural frameworks to integrate different levels of analysis, and developing ways to work with small sample sizes and fragmentary remains. The Index of Care, designed to support bioarchaeology of care research, offers a new scientifically based and systematic tool to collect and integrate a range of information in life history, disease processes, and cultural context. This online tool assists researchers to work with multiple lines of evidence by providing a rigorous four step process for describing pathologies, determining disabilities, constructing a care model, and examining caregiving implications. However, bioarchaeology of care analysis is challenging when differential diagnosis is unable to rule out more than one possible disease. In examining how to approach this problem, the authors applied the Index of Care to the case of a young female with a lower limb paralysis most likely resulting from one of two conditions. The authors create parallel interpretations through the construction of two care models, providing a basis for strong inference regarding the experience of paralysis.