The analysis undertaken in this paper explores the significance of a central finding from a recent field study of home care case management practice: a notable feature of case management work is the preparation of an orderly, ordered space where care may be offered. However, out of their encounters with an almost endless variety of situations, out of people's diverse narratives of need, case managers seem able to pick out only limited range of recognized needs to which to respond and (...) demonstrate a series of responses themselves equally limited. Though this observation suggests a kind of efficiency that is currently highly valued within healthcare systems, it also underlines the system's inability to engage difference and variability in a meaningful way. This inability or limitation in effectively engaging difference is conceptualized here as, in some sense, a problem, and the nature of this problem is explored through the rhetorical process of problem setting. The central question becomes how might we develop and deploy an orderly and coherent system of care without essentializing people's experiences, without treating these experiences reductively, without, in a Foucaultian frame of reference, allowing what can be understood as similarity or resemblance among clients and situations to be folded back into sameness? As we encounter complexity, variability and difference in practice, how should we treat it? (shrink)

Experimental philosophers advocate expansion of philosophical methods to include empirical investigation into the concepts used by ordinary people in reasoning and action. We propose also including methods of qualitative social science, which we argue serve both moral and epistemic goals. Philosophical analytical tools applied to interdisciplinary research designs can provide ways to extract rich contextual information from subjects. We argue that this approach has important implications for bioethics; it provides both epistemic and moral reasons to use the experiences and perspectives (...) of diverse populations to better identify underlying concepts as well as to develop effective interventions within particular communities. (shrink)

Anthropology?its methodology, its paths to knowing; but also its epistemology, its modes of knowing?saturates the practices of Science and Technology Studies (STS). In a nutshell, anthropology has helped STS find ways to break open the discourses of science. If we were to believe our ?natives??scientists?and accept what they say about what they do and know on their own terms, we would not be able to add anything to these stories. And so in STS, we have modified the anthropological propensity to (...) make the strange familiar and invented the technique of making the familiar strange. Now we can reimagine our natives? stories, note how they are told, and investigate why they are told the way they are?relating them to the practices from which they spring. Our terminological tinkering?refusing to adopt the terms of the actors?is, then, also an epistemological tinkering; we account for these practices in terms of our own. (shrink)

Evidence-based medicine has been studied as a rich and diverse set of epistemic and infrastructural practices that relate imperfect medical knowledges to complex clinical practices. We examine instances of medical decision-making where medical professionals relate recommendations from clinical practice guidelines to individual patient characteristics when deciding to prescribe implantable cardioverter defibrillators to treat heart failure. When connecting evidence-based recommendations to decisions about individual patients, we find that clinical deliberations invoke different times, such as linear, chronological time, and biological aging, as (...) well as different futures, such as individual future risks and the future sustainability of health systems. Such different “temporalities of evidence” are integral parts of clinicians’ considerations concerning economy, suffering, risks, and hopes in making decisions on individual patients. In line with calls to anchor science and technology studies scholarship studying EBM in the concerns that matter most to patients and health care providers, we argue that the social study of EBM needs to attend to such temporalities to understand how evidence is weighed, which outcomes are considered important, and hence which clinical action is proposed. However, since different ways of “doing time” lead to different appreciations of the clinical outcomes, the notion of clinical “anchoring” becomes rather elusive. (shrink)

In 1967 Garfinkel and Bittner were investigating good organizational reasons for bad clinic records, demonstrating how the reading of such records as sociological data should be reported to the understanding of their production’s practical contingencies and to the situated circumstances of their use. This seminal paper opened new avenues of research related to the study of records in various professional contexts and of their transformation, to the development of praxiological approaches to practical and professional texts, or to the study of (...) historical documents and archives. To contribute to this ethnomethodological strand of research, I propose a case-study of artworks’ records management at the museum, investigated as a perspicuous site to reflect upon how artworks are experienced, apprehended and defined in the institutional ordinary business. Drawing on observations and materials collected at the French National Museum of Modern Art, I study records’ careers and describe their material and organizational properties, by giving a close look at some elements. More particularly, I focus on one distinctive property of some records: their thickness, investigated as a scheme of interpretation of the situated features of documentation work. By reading artworks’ records as local collective practices of assemblage, disruption and reconfiguration of pieces of documentation, I demonstrate that what is documented in this process is not only the artwork: it is also the collective work of working with artworks, dealt with as ongoing achievements of institutional practices. (shrink)

This paper focuses on the push to stabilise society through civil defence education (CDE) in the changing context of nationalism and populism. We analysed the way in which justifications and criticism of civil defence education (CDE) have evolved as an ordering project intended to solve the problems with dangers that were variously defined. We identified two locations of the danger to be tackled by the new CDE – external and specific; and internal and general – which partly correspond to key (...) political events: the migrant and Ukraine crises, and pre-election battles. Transformation of dangers stabilised education’s subservient role while destabilising educators’ position in the public debate. Drawing on relational sociology, qualitative analysis of the Czech media, and interviews, we show that the dangers defined by educational actors are circumvented to be replaced by populist and nationalist problems that were not the problems of the actors who would be most affected by the proposed curricular changes. We suggest looking at contemporary nationalists’ claims in education as a sign that topological arrangements are being reshaped among political, educational, and civic actors in terms of divides, externality, and irrelevance. (shrink)

The close ties between modes of governing, subjectivities and critique in contemporary societies challenge the role of critical social research. The classical normative ethos of the unmasking researcher unravelling various oppressive structures of dominant vs. dominated groups in society is inadequate when it comes to understand de-politicizing mechanisms and the struggles they bring about. This article argues that only a non-normative position can stay attentive to the constant and complex evolution of modes of governing and the critical operations actors themselves (...) engage in. The article outlines a non-normative but critical programme based on an ethos of re-politicizing contemporary pervasive modes of governing. The analytical advantages and limitations of such a programme are demonstrated by readings of both Foucauldian studies and the works of and debates regarding the French pragmatic sociology of Boltanski and Thévenot. (shrink)

Cognitive forms vary considerably as a human being detaches herself from what is closest and most personal and moves to communicate — in the broad sense of taking part in a common matter — across increasing relational distances. The article proposes to deal with the variety of cognitive formats which cannot `commonize' cognition to an equal degree, relating them to a set of regimes of engagement with the world that are identified in terms of the dependency between the human agent (...) and her environment. The good that engagement aims to guarantee orients how reality is grasped and specifies the format of what constitutes relevant information. This analysis offers new insight into the composition of communities as well as persons who have to cope with the plurality of cognitive formats and engagements from the very familiar to the most public. (shrink)

The paper asks how certain zones of technical practice or technologies come to matter as "the Technological", a way of construing political change in terms of technical innovation and invention. The social construction of technology (SCOT) established that things mediate social relations, and that social practices are constantly needed to maintain the workability of technologies. It also linked the production, representation and use of contemporary technologies to scientific knowledge. However, it did all this at a certain cost. To understand something (...) as socially constructed implies that it can be positioned on a pre-given social grid. Making this understanding stick risks affronting others with the claim that their position is not singular, only ordinary. It also runs the risk of not having purchase on those aspects of technological relationality that overflow the framing context of the social (Callon et al. 2002). Building on the ground prepared by SCOT and relying on the work of (Stengers 2000) and (Simondon 1964, 1989), the paper discusses how technologies could be understood as relational events within the contemporary political space. Developing an account of technologies centred on relationality, this paper outlines an epistemology and ontology of the anomalies of technological events, and suggests how excess could explain the Technological. (shrink)

Theorizing about perception is often motivated by a belief that without a way of ensuring that our perceptual experience correctly reflects the external world we cannot be sure that we perceive the world at all. Historically, coming up with a way of securing such epistemic contact has been a foundational issue in psychology. Recent ecological and enactive approaches challenge the requirement for perception to attain epistemic contact. This article aims to explicate this pragmatic starting point and the new direction of (...) inquiry that this opens up for psychology. It does so by detailing the development of James J. Gibson’s ecological psychology. Securing epistemic contact has been a leitmotiv in Gibson’s early work, but subsequent developments in Gibson’s works can teach us what it takes to adopt a pragmatic approach to psychology. We propose a reading of the developments in Gibson’s original works that shows that, since perception is a mode of acting, perception aims for pragmatic contact before allowing for epistemic contact. Amplifying these pragmatist lines of thought in Gibson’s works we end by considering situations where an individual is adapted to the intricacies of specific social practices. These situations show how pragmatic contact can also afford attaining epistemic contact. (shrink)

The evidence-based practice and evidence-based medicine movements have promoted standardization through guideline development methodologies based on systematic reviews and meta-analyses of best available research. EBM has challenged clinicians to question their reliance on practical reasoning and clinical judgement. In this paper, we argue that the protagonists of EBM position their mission as reducing uncertainty through the use of standardized methods for knowledge evaluation and use. With this drive towards uniformity, standardization and control comes a suspicion towards intuition, creativity and uncertainty (...) as integral parts of medical practice. We question the appropriateness of attempts to standardize professional practice through a discussion of the importance of uncertainty. Greenhalgh’s taxonomy of uncertainty is used to inform an analysis of the clinical reasoning occurring in a potentially life threatening emergency situation with a young patient. The case analysis is further developed by the use of the Canadian philosopher Bernard Lonergan’s theory about understanding and objective knowing. According to Lonergan it is not by getting rid of or even by reducing uncertainty, but by attending systematically to it and by relating to it in a self-conscious way, that objective knowledge can be obtained. The paper concludes that uncertainty is not a regrettable and unavoidable aspect of decision making but a productive component of clinical reasoning. (shrink)

This paper links two domains of recent interest in science and technology studies, complexity and ignorance, in the context of knowledge practices observed among synthetic biologists. Synthetic biologists are recruiting concepts and methods from computer science and electrical engineering in order to design and construct novel organisms in the lab. Their field has taken shape amidst revised assessments of life’s complexity in the aftermath of the Human Genome Project. While this complexity is commonly taken to be an immanent property of (...) biological systems, this article presents an epistemological view of complexity according to which complexity relates to a specific scientific theory or model and refers to that which exceeds the theory or model’s explanatory power. This epistemological view allows us to narrate a particular story about the changing relationship between biology and synthetic biology in the last decade and accounts for early knowledge practices in synthetic biology that “ignored” biology. This article further argues that while the failure of ignorance to produce clear-cut results for synthetic biologists has led practitioners back to biology, the entanglements between different pragmatic orientations and ways of knowing trouble the implications of this return for assessments of the complexity of biological systems. (shrink)

The author presents an historical account of scientific work conducted at a commercial biotech firm in San Diego called Hybritech. It tells of disruptions in research programs following the acquisition of the company by the pharmaceutical giant Eli Lilly in 1986. The story centers on responses to an organizational challenge that research managers and scientists in any setting, academic or industrial, must confront—how to create and sustain an organizational culture that is conducive to creativity and innovation. The case provides an (...) occasion for evaluating the strengths and weaknesses of two leading theoretical accounts of innovation in social studies of science and technology—sociological network analysis and actor-network theory. (shrink)

First published in 2009, the collection of essays edited by François Vatin is now republished in a new edition, with two additional contributions: a final chapter entitled “What measuring means: disputes on quantification and valuation in sociology,” in which Pauline Barraud de Lagerie, Alexandra Bidet, and Etienne Nouguez discuss the main contributions of the book to the international debate on valuation ; and a chapter by the late Alain Desrosières—to whom the new edition of the book is dedicated—in which the (...) author, a pioneer of the French sociology of quantification , draws on his own intellectual biography to show how the making of public statistics has changed in the last 50 years.The study is divided into four sections. The first one collects three essays on the “practical construction of norms” in such diverse fields as the production of pressure-cookers , phone communication , and healthcare . The seco .. (shrink)

This paper examines how middle managers in the long term care sector use the discourse of professionalism to create ‘appropriate’ work conduct of care workers. Using Watson’s concept of professional talk, we study how managers in their daily work talk about professionalism of vocationally skilled care workers. Based on observations and recordings of mundane conversations by middle managers, we found four different professional talks that co-exist: appropriate looks and conduct, reflectivity about personal values and ‘good’ care, methodical work methods, competencies. (...) Jointly, these professional talks constitute an important discursive resource for middle managers to facilitate change on the work floor. Change involves the reconfiguration of care work and different managerial-worker relations. Middle managers use professional talks in both enabling and disenabling ways vis-à-vis care workers. Based on these findings, we suggest a more nuanced portrayal of the relationship between managers and professionals. Rather than being based on an intrinsic opposition, i.e. ‘managers versus professionals’, this relationship is flexibly reconstructed via professional talk. (shrink)

In 2008, the Minister of Health for Iceland issued a new regulation intended to govern assessment practices related to placement in nursing homes. One of the aims of the regulation was to ensure that those with the most severe need would have priority. This would be achieved, in part, by requiring older people to exhaust all available community‐based service options before an assessment for placement would even take place. The new regulation was received with some hostility and criticism on the (...) part of older people and their relatives, who described the changed expectations as ‘abandonment’ by the authorities. We present our analysis of these changes by examining how older people and families are reconfigured through the new policy and argue that this ‘new’ practice of de‐institutionalization is underpinned by a shifting epistemic and normative context that is working to create a new identity and a different way of life in advanced age in Iceland. The analysis has implications for other nations as well, as much policy related to older people is broadly informed by this idea that ‘home is best’, that is, the idea that more care simply needs to happen outside of institutional settings. (shrink)

Studies on ‘Big Science’ have shifted our perspective from the complexity of scientific objects and their representations to the complexity of sociotechnical arrangements. However, how scientists in large-scale research attend to this complexity to facilitate and afford knowledge production has rarely been considered to date. In this article, we locate organizational complexity on the level of organizing practices that follow multiple and divergent logics. We identify three strategies of managing organizational complexity, drawing on existing literature on large-scale research as well (...) as own empirical research. The three strategies are: segmenting research infrastructure, introducing elements of bureaucratic governance, and implementing standards and standardization. We illustrate these strategies with examples from our empirical case study on experimental particle physics research at CERN’s Large Hadron Collider. While the strategies we identified help to cope with the complexity of some organizational tasks by dividing, ordering, or mediating between divergent organizational logics, we find that organizational complexity overall is not reduced but rather displaced. We argue that dealing with complexity is a dynamic and ongoing process, which inevitably generates novel organizational complexity. (shrink)