Extensive scholarship has described the historical and ethical imperatives shaping the emergence of the brain death criteria in the 1960s and 1970s. This essay explores the longer intellectual history that shaped theories of neurological consciousness from the late-nineteenth century to that period, and argues that a significant transformation occurred in the elaboration of those theories in the 1960s and after, the period when various disturbances of consciousness were discovered or thoroughly elaborated. Numerous historical conditions can be identified and attributed to (...) the production of the new theories that emerged from that period-on, not least in the broader social and cultural transformations that occurred with decolonialization, pro-democracy movements, and civil and disability rights advocacy, all contexts which exerted pressures on the institutions and professions of medicine. In this telling, the discovery of the locked-in patient is thus the exploration of a transformed vision of medical patients – one that moved them from a liminal indefinite space into a firmly grounded epistemological existence – in a backdrop in which medical professionals in particular and society in general was beginning to see the body differently. With this new vision, came a relational theory of consciousness to, a reading of a body and it signs, that shifted consciousness from an internally-derived state into a relationally-constructed object. The ontology of consciousness, whatever it was, thereby became entangled with the social condition of consciousness, one that bridged the worlds of close relationship with the social movements and anxieties about personhood that emanated out of that fraught period. (shrink)

The historiography of immunology since 1999 is reviewed, in part as a response to claims by historians such as Thomas Söderqvist the field was still immature at the time. First addressed are the difficulties, past and present, surrounding the disciplinary definition of immunology, which is followed by a commentary on the recent scholarship devoted to the concept of the immune self. The new literature on broad immunological topics is examined and assessed, and specific charges leveled against the paucity of certain (...) types of histories, e.g. biographical and institutional histories, are evaluated. In conclusion, there are compelling indications that the history of immunology has moved past the initial tentative stages identified in the earlier reviews to become a bustling, pluripotent discipline, much like the subject of its scrutiny, and that it continues to develop in many new and exciting directions. (shrink)

This article deals with the author’s experiences in studying cochlear implantation over a period of some years. While no overt controversy surrounded the device or the practices associated with it in the Netherlands when this work started, studying its introduction became complex. Following others, the research strategy that was evolved might be termed one of mediation and intervention. It entailed treating the views and aspirations of research subjects, clinical and lay, with equal regard. It entailed promotion of dialogue. For reasons (...) that are discussed in the article, the attempt was made to translate this dialogue to the political level. The challenge confronting the author was simultaneously methodological and political. (shrink)

‘‘Undone science’’ refers to areas of research that are left unfunded, incomplete, or generally ignored but that social movements or civil society organizations often identify as worthy of more research. This study mobilizes four recent studies to further elaborate the concept of undone science as it relates to the political construction of research agendas. Using these cases, we develop the argument that undone science is part of a broader politics of knowledge, wherein multiple and competing groups struggle over the construction (...) and implementation of alternative research agendas. Overall, the study demonstrates the analytic potential of the concept of undone science to deepen understanding of the systematic nonproduction of knowledge in the institutional matrix of state, industry, and social movements that is characteristic of recent calls for a ‘‘new political sociology of science.’’. (shrink)

Launch of clinical investigation represents a substantial escalation in commitment to a particular clinical translation trajectory; it also exposes human subjects to poorly understood interventions. Despite these high stakes, there is little to guide decision-makers on the scientific and ethical evaluation of early phase trials. In this article, we review policies and consensus statements on human protections, drug regulation, and research design surrounding trial launch, and conclude that decision-making is largely left to the discretion of research teams and sponsors. We (...) then review what is currently understood about how research teams exercise this discretion, and close by laying out a research agenda for characterizing the way investigators, sponsors, and reviewers approach decision-making in early phase research. (shrink)

This essay details a historical crossroad in biochemistry and microbiology in which penicillin was a co-agent. I narrate the trajectory of the bacterial cell wall as the precise target for antibiotic action. As a strategic object of research, the bacterial cell wall remained at the core of experimental practices, scientific narratives and research funding appeals throughout the antibiotic era. The research laboratory was dedicated to the search for new antibiotics while remaining the site at which the mode of action of (...) this new substance was investigated. This combination of circumstances made the bacterial wall an ontology in transit. As invisible as the bacterial wall was for clinical purposes, in the biological laboratory, cellular meaning in regard to the action of penicillin made the bacterial wall visible within both microbiology and biochemistry. As a border to be crossed, some components of the bacterial cell wall and the biochemical destruction produced by penicillin became known during the 1950s and 1960s. The cell wall was constructed piece by piece in a transatlantic circulation of methods, names, and images of the shape of the wall itself. From 1955 onwards, microbiologists and biochemists mobilized new names and associated conceptual meanings. The composition of this thin and rigid layer would account for its shape, growth and destruction. This paper presents a history of biochemical morphology: a chemistry of shape – the shape of bacteria, as provided by its wall – that accounted for biology, for life itself. While penicillin was being established as an industrially-manufactured object, it remained a scientific tool within the research laboratory, contributing to the circulation of further scientific objects. (shrink)

Collaborative forms of work such as extended networks, expert groups, and consortia increasingly structure biomedical activities. They are particularly prominent in the cancer field, where procedures such as multicenter clinical trials have been instrumental in establishing the specialty of oncology, and subfields such as cancer genetics, where bioclinical activities—for example, testing for breast and ovarian cancer genes and follow-up interventions—are predicated on the articulation of a number of tasks performed by new clinical collectives. In this article, we examine the founding (...) and development of a French bioclinical collective—the Groupe Génétique et Cancer —that coordinates and structures the activities of most French actors in cancer genetics and operates simultaneously in the clinical, research, and regulatory domains. To examine the group’s structure and dynamics, the article combines information gathered through traditional fieldwork methods with information elicited from a coauthorship and semantic-network analysis of the publications of GGC members from 1969 to 2001. (shrink)

How are “interesting” research problems identified and made durable by academic researchers, particularly in situations defined by multiple evaluation principles? Building on two case studies of research groups working on rare diseases in academic biomedicine, we explore how group leaders arrange their groups to encompass research problems that latch onto distinct evaluation principles by dividing and combining work into “basic-oriented” and “clinical-oriented” spheres of inquiry. Following recent developments in the sociology of valuation comparing academics to capitalist entrepreneurs in pursuit of (...) varying kinds of worth, we argue that the metaphor of the portfolio is helpful in analyzing how group leaders manage these different research lines as “alternative investment options” from which they were variously hoping to capitalize. We argue portfolio development is a useful concept for exploring how group leaders fashion “entrepreneurial” practices to manage and exploit tensions between multiple matrices of valuation and conclude with suggestions for how this vocabulary can further extend analysis of epistemic capitalism within science and technology studies. (shrink)

This article concerns itself with the reception of Rous' 1911 discovery of what later came to be known as the Rous Sarcoma Virus (RSV). Rous made his discovery at the Rockefeller Institute for Medical Research which had been primarily established to conduct research into infectious diseases. Rous' chance discovery of a chicken tumor led him to a series of conjectures about cancer causation and about whether cancer could have an extrinsic cause. Rous' finding was received with some scepticism by the (...) scientific community that held that cancer was not infectious and favored explanations which located the origins of cancer in the inner mechanism of the cell. After 4 years of unsuccessful effort to isolate and further determine the virus Rous felt compelled to discontinue his work on cancer viruses. When 55 years later, the significance of Rous's discovery was attested by the award of the Nobel Prize, it opened up debates about the issues of delayed recognition and scientific reputation. This article also considers why Rous' hypothesis of a viral origin of cancer could not be incorporated into the existing body of knowledge about cancer before the 1950s. (shrink)

The article reconsiders the nature and location of science in the development of genetic classification. Drawing on field studies of medical genetics, we explore how patient categorization is accomplished in between the clinic and laboratory. We focus on dysmorphology, a specialism concerned with complex syndromes that impair physical development. We show that dys-morphology is about more than fitting patients into prefixed diagnostic categories and that diagnostic process is marked by moments of uncertainty, ambiguity, and deferral. We describe how different forms (...) of evidence are brought into play and how patterns of physical features are identified as genetic or not. We suggest that clinical categorical work helps articulate the genetic as an emergent domain of medical classification and that moments of ambiguity and deferral create an imperative space that helps legitimate the need for more technoscience, and consequently, more clinical judgment with which to fix the genetic future. (shrink)

This article concerns itself with the reception of Rous’ 1911 discovery of what later came to be known as the Rous Sarcoma Virus. Rous made his discovery at the Rockefeller Institute for Medical Research which had been primarily established to conduct research into infectious diseases. Rous’ chance discovery of a chicken tumor led him to a series of conjectures about cancer causation and about whether cancer could have an extrinsic cause. Rous’ finding was received with some scepticism by the scientific (...) community that held that cancer was not infectious and favored explanations which located the origins of cancer in the inner mechanism of the cell. After 4 years of unsuccessful effort to isolate and further determine the virus Rous felt compelled to discontinue his work on cancer viruses. When 55 years later, the significance of Rous’s discovery was attested by the award of the Nobel Prize, it opened up debates about the issues of delayed recognition and scientific reputation. This article also considers why Rous’ hypothesis of a viral origin of cancer could not be incorporated into the existing body of knowledge about cancer before the 1950s. (shrink)

In this article, I am using the example of the introduction of osteosynthesis into surgical routine practice to analyze the use of the notions of art and science in medical innovation. The examination of the renegotiations of power and responsibility associated with the introduction of this new technique shows that proponents and critics actively linked their arguments to more fundamental epistemological and social issues. The proponents claimed to manage the uncertainties of innovation through making surgery more scientific, drawing on the (...) ideals of control, rationality, objectivity, and predictability. The critics mobilized another discursive pattern. They considered surgery an art and emphasized the individuality, contingency, and situatedness of medical practice. I investigate the discursive function of these argumentative patterns and how they played out in the concrete example of this surgical technique. (shrink)

This paper looks at the commodification of interferon, marketed by Hoffmann La Roche as Roferon A in 1986, as a case study that helps us understand the role of pharmaceutical industry in cancer research, the impact of molecular biology on cancer therapy, and the relationships between biotech start-ups and established pharmaceutical firms. Drawing extensively on materials from the Roche company archives, the paper traces interferon’s trajectory from observed phenomenon to product. Roche embraced molecular biology in the late 1960s to prepare (...) for the moment when the patents on some of its bestselling drugs were going to expire. The company funded two basic science institutes to gain direct access to talents and scientific leads. These investments, I argue, were crucial for Roche’s success with recombinant interferon, along with more mundane, technical and regulatory know-how held at Roche’s Nutley base. The paper analyses in some detail the development process following the initial success of cloning the interferon gene in collaboration with Genentech. It looks at the factors necessary to scale up the production sufficiently for clinical trials. Using Alfred Chandler’s concept of ‘organizational capabilities’, I argue that the process is better described as ‘mobilisation’ than as ‘translation’. (shrink)

[Przekład] W artykule dokonano przeglądu historiografii immunologii od 1999 roku, co w pewnym stopniu jest odpowiedzią na stanowisko takich historyków jak Thomas Söderqvist, którzy twierdzili, że to pole badawcze nie było wówczas dość rozwinięte (Söderqvist i Stillwell). Najpierw wskazano przeszłe i teraźniejsze problemy, które historiografia ma ze zdefiniowaniem immunologii, a następnie skomentowano ostatnie studia nad pojęciem immunologicznego „ja”. W dalszym toku przeglądu przeanalizowano i oceniono nowe publikacje poświęcone zróżnicowanym zagadnieniom immunologii oraz niektóre charakterystyczne oskarżenia formułowane wobec niedostatku pewnych dziedzin historii, (...) na przykład historii biograficznych i historii instytucji. W podsumowaniu przedstawiono konkurujące ze sobą kierunki, w których rozwinęła się historia immunologii, wychodząc poza wstępne, tymczasowe stadia uchwycone w poprzednim przeglądzie, i stając się wielogłosową, pluripotencjalną dyscypliną, podobną do przedmiotu jej badań. Pokazano też, że historia immunologii nadal rozwija się na wiele nowych i ekscytujących sposobów. (shrink)