This article addresses the need to problematize “cases” in science and technology studies work, as a middle-range theory issue. The focus is not on any one case study per se, but on why case studies exist and endure in STS. Case studies are part of a specific problematization in the field. We therefore explore relations between motivation for the use of cases, their constitution, and ways they can be invoked to make particular kinds of arguments in STS. We set out (...) to examine the case as an object that links together research practices, intellectual debates, and programmatic concerns in our own work. Based on our experiences and on this reflection on the links between cases and questions in STS, we propose a number of casemaking strategies that shift and enrich the deployment of ethnographic cases as an epistemic tool in STS. (shrink)

In this article, I investigate the process of coordination between three ‘bodies’ of surgery: the patient-ensemble(s) constructed in pre-operative activities; the surgeon-body constructed with these ensembles in the operating room; and the body-world inhabited by the surgeon. This investigation is done through an ethnography of a neurosurgical clinic, with an analytical focus on the relationship between the spatial configuration of the body of the surgeon and the embodied practices of operating that this configuration demands. My argument is that coordination between (...) those three bodies is organized in the layered space into which the multiple ensembles of surgery are assembled. This relationship, I suggest, lies at the core of the power and technical expertise held by surgeons, and constitutes a challenge for explorations of other forms of articulation between subject body-worlds and the embodiment of power in subject-bodies. (shrink)

Analyses of assisted reproductive technologies have demonstrated how objectification and agency can coexist in infertility centres. How objectification creates opportunities for empowerment, however, has not yet been explored. In analysing women’s narratives of assisted conception in Colombian infertility clinics, I demonstrate the complexity in women’s embodied experiences of various objectifying stages of assisted conception and argue that their experiences produced multiple forms of embodied agency. Women used diagnostic procedures to learn about their bodies and infertility complications, which augmented their authority (...) over their bodies and treatment. They drew upon their embodied knowledge to reduce treatment anxieties, while sensations such as pain were made purposeful, and hence meaningful, as women strove to reconfigure the significance of the embodied sensations of conception in a context of medicalized reproduction. In these narratives, we see that lived bodies are productive agents of social change, generating meanings and working to reshape dominant social understandings. (shrink)

How might the agency of the subaltern be conceptualized within the intersection of multiple worlds? Actor-network theory’s translation framework for understanding agency portraying this as entrepreneur and talking of a world in the making is arguably “imperialist,” “managerial,” and “monolithic.” Draws from the enactment turn of ANT and insights into the politics of representation, this article elaborates an alternative framework which focuses on displacement. By examining the case of dialysis patients, the article explores the displacing practices that follow the disruption (...) of routines in dialysis. Patients have to go through a process of problematization, distribution, hybridization, and restabilization, in order to sustain the coexistence of their alternative practices with dialysis. Unlike entrepreneurs in the translation model who transform the world by interesting others, enduring trials, and becoming spokespersons for all, those patients who manage to displace and sustain the coexistence of multiple worlds avoid interesting, still less confronting, the hegemonic actors and claiming representation for themselves. This article suggests the displacement of agency as a generic alternative. (shrink)

This article presents an archaeological inquiry into the early histories of Quality of Life measures, and takes this as an occasion to rethink the concept of the ‘medical model of disability’. Focusing on three instruments that set the ground for the emergence of QoL measures, namely, the Karnofsky Performance Scale, and the classification of functional capacity as a diagnostic criterion for heart diseases and as a supplementary aid to therapeutic criteria in rheumatoid arthritis – I discuss how medicine, throughout the (...) emergence of QoL, began to expand its gaze beyond the confines of the body to what that body does in daily life. Building upon Armstrong et al.’s notion of ‘distal symptoms’ and Wahlberg’s idea of ‘knowledge of living’, I propose the notion of disabilitization to encapsulate this expansion of the clinical gaze, through which medicine has come to articulate diseases and their treatments in new ways, and in so doing, has inadvertently created disability as a new kind of knowledge category in itself – a category that is defined not through its reduction to mere pathology, but through its dispersal into everyday life. I present this concept not as a periodization, but as a provocative discontinuity with the totalizing history assumed within the medical model of disability, and in so doing, ask what, in fact, holds ‘the medical model’ together, and whether there might be other ways of understanding medicine’s complex relationship to disability than what the concept of the medical model allows us to envisage. (shrink)

Medical anatomy is one of the key sites of the scientific production, reproduction and maintenance of sex and gender. Our Human Anatomies Project explores the construction, reconstruction and maintenance of difference in genital anatomies, focusing especially on the clitoris. This article focuses on representations of human genitalia in the form of cyberanatomies - video, CD-ROM and internetbased renderings of human bodies. In cyberspace as elsewhere, the biomedical expert remains the proper and dominant mediator between humans and their own bodies, despite (...) the democratization of knowledges supposedly possible through the Internet. Special attention is given to the specific sites of production and distribution of these different cyberanatomies. Through our review of the globalization of cyberanatomies, we have come to witness the very sedimentation of sex/gender/sexuality in new arenas of representations of human bodies. Western biomedical imperialism and globalization of a standardized (American) body are taken up as core theoretical concerns. (shrink)

It is often assumed that it was the alliance between patient associations and neuroscience, which originally made dementia a matter for intervention. In parallel ways, science and technology studies often attributes the power to define and act upon matters of life to biomedicine and science. The concern here is that the science centrism of STS contributes to the dominance of science and biomedicine by granting these analytical privileges. As a result, alternative modes of acting, for instance in care, are disarticulated (...) and made absent. This article mobilizes the sensibilities of anthropology to difference and draws upon excerpts of data from fieldwork in dementia care to show this and argue that there are different practices that act upon life and its limits; that these enact different versions of life and dementia; and that they matter because they shape how people are cared for and live and die with dementia. (shrink)

ArgumentAt the turn of the twentieth century the Norwegian market flourished with milk products intended for infants. But medical doctors argued in favor of “going back to nature”: Women ought to breastfeed their children. This paper explores how a re-naturalization of mother's milk emerged within experimental medicine. The prescribed “natural way” did not develop within medicine alone. The paper demonstrates how the natural developed within a relational space of different versions of milk: the free-market milk, the dirty and decaying milk, (...) and the non-nutritional milk. But why did Norwegian mothers, in contrast to the development in for instance the US, continue to breastfeed their infants? Drawing on the work of the leading pediatrician Theodor Frølich, the paper suggests that this may in part be explained by the development of a distinct version of care: A matter-of-fact, pragmatic and flexible version of care that nevertheless came to enact mother's milk as the supreme form of nutrition to which there was hardly a competing or healthy alternative. “The natural way” became a thought style and was made integral to everyday culture. (shrink)

Science studies has often been against the normative dimension of epistemology, which made a naturalistic study of science impossible. But this is not to say that a new type of normativity cannot be detected at work inscience studies. This is especially true in the second wave of studies dealing with the body, which has aimed at criticizing the physicalization of the body without falling into the various traps of a phenomenology simply added to a physical substrate. This article explores the (...) work of Isabelle Stengers and Vinciane Despret in that respect, and shows how it can be used to rethink the articulation between the various levels that make up a body. (shrink)

Many different professionals play a key role in maintaining welfare in a welfare society. These professionals engage in moral judgements when using (new) technologies. In doing so, they achieve that radical responsibility towards the other that Levinas describes as being at the very core of ethics. Also, professionals try to assess the possible consequences of the involvement of specific technologies and adjust their actions in order to ensure ethical responsibility. Thus, ethics is necessary in order to obtain and sustain one's (...) professionalism. This presents care institutions with the challenge to design work processes and technology work in ways that include a sense of ‘the Other’ and make moral judgement an indispensable part of professional competence in technology. This article provides new understandings of the way ethics are involved in care institutions. Nurses’ moral judgements are sophisticated with regard to ethical perspectives. In hospitals, nurses combine Latour's notion of symmetry in human/technology relations with an ethics implying ethical priority to human beings over other beings. This combination of ethics is not only sophisticated; it is also paradoxical, as it puts together mutually contradictory ethics. Instead of causing moral confusion, this ethical paradox is employed to produce a particularly refined notion of care situations, allowing nurses’ care to include patients and technology alike. (shrink)

As the number of medical and health humanities degree programs in the United States rapidly increases, it is especially timely to consider the range of specific disciplinary perspectives that might benefit students enrolled in these programs. This paper discusses the inclusion of one such perspective from the field of Science and Technology Studies The author asserts that STS benefits students in the medical and health humanities in four particular ways, by: challenging the “progress narrative” around the advancement of biomedicine as (...) scientific practice, evaluating the meaning of technology, especially in how technology orients us towards sickness and how health technology is in turn shaped by social and cultural values, assessing the plurality of biomedical epistemologies, rather than assuming biomedicine is one, cohesive body of knowledge that does not differ across contexts, and critiquing bias in biomedical practice and science, especially in the marginalization of women’s voices and in the racial and postcolonial trajectories of contemporary biomedicine. The paper discusses the theoretical importance of these four trajectories to the medical and health humanities, as well as the venues for inclusion of STS within coursework and programming at Case Western Reserve University. The paper also comments on how programming at other institutions might be adapted to incorporate STS scholarship. By drawing on numerous examples of research in the anthropology, sociology, history, and the philosophy of science, this article seeks to open a conversation about the value of science and technology studies to health humanities pedagogy. (shrink)

In the face of what has been referred to as a crystal methamphetamine ‘‘epidemic’’ among gay men in North America, a number of health promotion efforts have been developed. While these efforts vary in approach, a core feature is the assumption that a user’s health depends on distinguishing accurate truths about CMA from inaccurate beliefs about CMA. Drawing on insights developed by Bruno Latour, this article unravels how this distinction plays out in the context of one expression of CMA health (...) promotion. I suggest that CMA health promotion may be more usefully understood as form of collective work in which various players throw up different knowledge practices for debate rather than an effort to mark the difference between truth and belief. In doing so, I suggest that of Latour, and science studies more generally, offers an opportunity for rethinking the nature of health promotion writ large. (shrink)

In Tanzania, the encounter between a traditional malady called degedege and the modern malady malaria is a fight to participate in the making of the bodies of women and children as well as the agents that afflict them. In their respective settings,degedege and malaria are considered two of the most common threats to the well-being of pregnant women and their young children. Local, national, and international public-health concerns for the early treatment of malaria compel biomedical practitioners to claim that degedege (...) is malaria. This article explores the power of this translation through an examination of the processes involved in treating degedege and the processes involved in treating malaria. I examine what is gained and what is lost through scientific or public health efforts to translate concepts, objects of practice, and agents of affliction from one form of care to another. (shrink)

Through a fieldwork study of the practice of methadone substitution at a French addiction clinic, the classic ‘theory of action’ is criticized and an alternative one proposed. A sketch of the debates among French drug specialists, drug users and legislators shows the pertinence for these practitioners of such a theoretical question; further, the ethnographic data suggest that they can be seen as actually trying out an alternative to this ‘theory of action’.