Phase I clinical trials are the first stage of testing new pharmaceuticals in humans. The majority of these studies are conducted under controlled, inpatient conditions using healthy volunteers who are paid for their participation. This article draws on an ethnographic study of six phase I clinics in the United States, including 268 semistructured interviews with research staff and healthy volunteers. In it, I argue that an institutional banalization of risk structures the perceptions of research staff and healthy volunteers participating in (...) the studies. For research staff, there are three mechanisms by which risk becomes banal: a perceived homogeneity of studies, Fordist work regimes, and data-centric discourse. For healthy volunteers, repeat study participation contributes to the institutional banalization of risk both through the process of desensitization to risk and the formation of trust in the clinics. I argue that the institutional banalization of risk also renders invisible ethical concerns about exploitation of underprivileged groups in pharmaceutical research. (shrink)

By the 1950s, eugenics had lost its scientific status; it now belonged to the context rather than to the content of science. Interest in the subject was also at low ebb. But that situation would soon change dramatically. Indeed, in an essay-review published in 1993, Philip Pauly commented that a “eugenics industry” had come to rival the “Darwin industry” in importance, although the former seemed less integrated than the latter. Since then, the pace of publication on eugenics, including American eugenics, (...) has only accelerated, while the field has become even more fractured, moving in multiple and even contradictory directions. This essay explores the trajectory of work on the history of American eugenics since interest in the subject revived in the 1960s, noting trends and also fractures. The latter are seen to result partly from the fact that professional historians no longer own the subject, which has attracted the interest of scholars in several other disciplines as well as scientists, political activists, and journalists, and also from the fact that the history of eugenics has almost always been policy-oriented. Historians’ desire to be policy-relevant and at the same time attentive to context, complexity, and contingency has generated tensions at several levels: within individuals, among historians, and between professional historians and others who also engage with the history of eugenics. That these tensions are resolved differently by different authors and even by the same authors at different times helps explain why the fragmentation that Pauly noted is not likely to be overcome anytime soon. (shrink)

This article brings insights from feminist science and technology studies to bear on recent public debates over the human papillomavirus vaccine, which prevents many cervical cancers, and male circumcision as potential HIV preventive. In the United States, attempts to mandate HPV vaccination have activated intense concerns about female “promiscuity,” whereas talk of promoting circumcision against HIV has triggered scant anxiety about American boys’ sexuality. The authors show how intersections among gender, sexuality, race, and age have shaped responses to these two (...) containment technologies—and how the technologies’ deployment both relies on and reproduces meanings of gender and sexuality that constitute the omnipresent “double standard.” The analysis develops an original feminist sociology of containment, explicating how social relations shape the innovation, reinvention, and use of technologies to contain particular sorts of bodies, fluids, and sexual practices—by whom, under what conditions, and for what purposes. (shrink)

Feminist scholars have identified how race and gender discourses influence the creation and implementation of school-based sexual health education and the provision of health care, yet there are few studies that examine how race and gender work in sexual health promotion as it occurs through community-based public health efforts. Drawing on three years of ethnographic research in a low-income Puerto Rican community, this article demonstrates how a gendered racial project of essentializing Latinx culture surrounding young women’s sexuality and reproduction works (...) to both obscure and reinforce race and racism in sexual health promotion. Professional stakeholders mobilize culture as an explanation for high birth rates among young Latinas in the city and reproduce a “Latino culture narrative” in which Latina gender and sexuality is understood as deterministic and homogenous. Simultaneously, an ideology of colorblindness enables the uncritical promotion of long-acting reversible contraception and obscures the history of reproductive oppression experienced by women of color. I consider how colorblindness and culture narratives allow stakeholders to abdicate responsibility for gendered racial inequality and conclude by advocating for the incorporation of racial and reproductive justice frameworks in sexual health promotion. (shrink)

This article analyzes efforts to govern men’s reproduction in postwar India’s population control program from 1960 to 1977. It argues that the Indian state’s unconventional emphasis on men was linked to a gendered strand of social scientific research known as family planning communications and its investments in reframing reproductive control in behavioral terms. Communication scientists’ goal to understand the role of mass communications in shaping “reproductive decision-making” dovetailed with prevailing cultural ideologies of masculinity that readily associated men with economic rationality (...) and calculative reasoning. Consequently, scientists cast Indian men as indispensable targets of behavioral interventions into reproduction due to their ostensible status as familial and social “decision-makers.” This reframing prompted Indian family planning officials to create novel interventions into men’s reproductive bodies and beliefs, exhorting them to use contraception and desire fewer children. The study thus offers new approaches for theorizing how men become framed as legitimate subjects of reproductive control. (shrink)

This article addresses India's contemporary population control policies and practices as a form of gender violence perpetrated by the state and transnational actors against poor, Adivasi and Dalit women. It argues that rather than meeting the needs and demands of these women for access to safe contraception that they can control, the Indian state has targeted them for coercive mass sterilisations and unsafe injectable contraceptives. This is made possible by the long-term construction of particular women's lives as devalued and disposable, (...) and of their bodies as excessively fertile and therefore inimical to development and progress. It further considers how population policy is currently embedded in the neoliberal framework of development being pursued by the Indian state. In particular, it argues that the violence of population policies is being deepened as a result of three central and interrelated aspects of this framework: corporate dispossession and displacement, the intensification and extension of women's labour for global capital, and the discourses and embodied practices of far-right Hindu supremacism. At the same time, India's population policies cannot be understood in isolation from the global population control establishment, which is increasingly corporate-led, and from broader structures of racialised global capital accumulation. The violence of India's contemporary population policies and the practices they produce operate at several different scales, all of which involve the construction of certain bodies as unfit to reproduce and requiring intervention and control. (shrink)

Appropriate and balanced decision-making is sentinel to goal setting and the provision of appropriate clinical care that are attuned to preserving the best interests of the patient. Current family-led decision-making in family-centric societies such as those in Singapore and other countries in East Asia are believed to compromise these objectives in favor of protecting familial interests. Redressing these skewed clinical practices employing autonomy-based patient-centric approaches however have been found wanting in their failure to contend with wider sociocultural considerations that impact (...) care determinations. Evaluation of a number of alternative decision-making frameworks set out to address the shortcomings of prevailing atomistic and family-centric decision-making models within the confines of end-of-life care prove these alternative frameworks to be little better at protecting the best interests of vulnerable patients. As a result, we propose the Welfare Model that we believe is attentive to the relevant socio-culturally significant considerations of a particular case and better meets the needs of end-of-life care goals of preserving the welfare of patients. Employing a multi-professional team evaluation guided by regnant psychosocial, legal, and clinical standards and the prevailing practical and clinical realities of the particular patient’s setting the Welfare Model provides a clinically relevant, culturally sensitive, transparent, and evidence-based approach to care determinations. (shrink)