This version has been superseded by the one published in Spring, 2014.

For the past several years patients have been expected to play a key role in their recovery. Self management and disease management have reached a hype status. Considering these recent trends what does this mean for the division of responsibilities between doctors and patients? What kind of role should healthcare providers play? With findings based on a qualitative research project of an innovative practice for people with Chronic Obstructive Pulmonary Disease (COPD) we reflect on these questions. In-depth interviews conducted with (...) people with COPD, physiotherapists and a pulmonologist show that shifting responsibilities require a supportive attitude from healthcare providers and a dialogical communication between patients and professionals. Our findings show more is needed in order to motivate people with COPD to take responsibility and become co-owners in a process of recovery. The case example illustrates that people with COPD need support from fellow patients to learn to accept their disabilities. Awareness that COPD is more than just a lack of air, that mind and body interact, is a first step to investigate other potential problems and to enhance one’s quality of life. (shrink)

This essay recognizes that the interactions that define medical care are problematic and that narrative is invoked to overcome these strains. Being grounded in science, medicine, too, might be influenced by a particular world-view that arose in the natural philosophy of the Scientific Revolution. If narrative responds to this sort of medicine, it may retain traces of this mindset. A feminist approach responds to this viewpoint and may used beneficially to analyze both the story of medicine and the stories within (...) medicine. Tensions discussed from this perspective are those between sickness and health and those between patient and provider; also questioned are suitable form(s) of narrative and whose narratives are valued. Suggestions for broadening narrative to address these issues include letting the body speak for itself, overcoming the power differential in the patient/provider interaction and using standpoints to foster a more equal and just medical system. (shrink)

In science studies the laboratory has been positioned as a privileged place for understanding scientific practice. Laboratory studies foregrounded local spaces of knowledge production in the natural sciences, and in doing so made the laboratory key to social science epistemologies. This article explores how laboratory studies and observational methods have been tied up together in the science and technology studies project of making scientific practice visible. The author contrasts powerful rhetorics of witnessing and revelation in some significant STS texts with (...) the negotiated and partial ways in which observing science work is done in social science practice. Drawing on empirical material generated with bioscientists and social scientists, the article explores how researchers may resist the observational gaze and mark aspects of knowledge work as private and solitary. The author concludes by arguing that epistemologies of vision point to some unsettling parallels between the study of knowledge-making in STS and audit regimes in contemporary research, and considers how both might devalue invisible work. This analysis suggests that there is a need to reconsider the significance of thinking in the ensemble of knowledge production practices for methodological, epistemological, and strategic reasons. (shrink)