In this paper I explore the various meanings of embodiment from a patient’s perspective. Resorting to phenomenology of health and medicine, I take the idea of ‘lived experience’ as starting point. On the basis of an analysis of phenomenology’s call for bracketing the natural attitude and its reduction to the transcendental, I will explain, however, that in medical phenomenological literature ‘lived experience’ is commonly one-sidedly interpreted. In my paper, I clarify in what way the idea of ‘lived experience’ should be (...) revisited and, subsequently, what this reconsideration means for phenomenological research on embodiment in health and medicine. The insight that the body is a condition of possibility for world-disclosing yet, at the same time, itself conditioned by this world forces us to not only zoom in on the body’s subject-side, but also on its object-side. I argue that in order to render account for this double body ontology, phenomenology should include empirical sociological analyses as well. I thus argue in favor of the idea of a socio-phenomenology. Drawing on material from my own research project on embodied self-experiences after breast surgery, I show how this approach can be fruitful in interpreting the impact of disfigurements on a person’s embodied agency, or a person’s ‘I can’. (shrink)

Unlike sonographic examinations, sonic fetal heartbeat monitoring has received relatively little attention from scholars in the social sciences. Using the case of fetal heartbeat monitoring as part of midwifery prenatal care in Germany, this contribution introduces music as an analytical tool for exploring the aesthetic dimensions of obstetrical surveillance practices. Based on ethnographic stories, three orchestrations are compared in which three different instruments help audiences to listen to what becomes fetal heartbeat music and to qualify fetal and pregnant lives in (...) relation to each other. In the Doppler-based orchestration, audible heartbeat music is taken as a sign of a child in need of parental love and care cultivated to listen. The Pinard horn makes esoteric fetal music that can be appreciated by the midwife as a skilled instrumentalist alone and helps to enact a child hidden in the belly. The cardiotocograph brings about soothing music and a reassuring relationship with a child but also durable scripts of juridical beauty. This material-semiotic analysis amplifies how well-being is shaped in midwifery prenatal care practices. (shrink)

Most children and families have not had direct contact with child psychological and psychiatric experts. Instead they encounter developmental theories, etiological explanations and depictions of childhood disorders through indirect channels such as newspapers. Drawing on actor–network theory, this article explores two child psychological and psychiatric modes of ordering children’s mental health discernible in Sweden’s largest morning newspaper, Dagens Nyheter, during the years 1980 to 2008: a psychodynamic mode and a neuro-centered mode. In the article I show how these two relatively (...) contemporaneous modes greatly differed in how they enacted children’s mental health. The psychodynamic mode stressed the parents’ role in structuring and affecting the child’s unconscious and saw them as the primary cause of any mental illness. In contrast, the neuro-centered mode highlighted that mental issues were related to the child’s brain and proposed different solutions depending on whether the child’s brain functioned in a ‘normal’ or ‘atypical’ manner. Each mode moreover suggested differing contexts to their discussions, with the psychodynamic mode solely discussing the parental milieu while the neuro-centered mode mainly focused on how society affected children with ‘atypical’ brains. The two modes thus had significantly diverging implications for the reader on how to understand and manage children and their psychological well-being. I further argue in the article for the relevance of actor–network theory in historical studies of psychology and psychiatry. (shrink)

The article discusses three versions of context. First, UK Government legislation, the British Cattle Tracing System, as a context that frames and guides good farming practices to promote accountability for cattle movements and to control disease. It describes how the legislative context creates particular constructions of farmers, cows, and good and bad farming practices. Second, the article creates context as the local farm-based practices of cattle movement and monitoring. Differences and similarities between the legislative requirements and the farm-based practices are (...) discussed. The farming practices are primarily practices of responsibility and care that are embodied, relational, collective, and responsive. The article draws upon feminist insights into responsibility and accountability that accountability is mundane practices of touch, regard, looking back, and becoming with. Thereby, the article creates a third context in which local farming practices, legislation, and feminism meet and interact with one another. Within this “meta-context” of interferences between contexts, accountability is revisioned as the very condition of farm-based practices of care and responsibility. At the same time, the article revisions context as emergent in interferences and enacts alternative versions of farmers, cows, and good and bad practices. (shrink)

Reflecting on a three year long exploratory research of ethics committees in the Czech Republic authors discuss the current role and identity of research ethics committees. The research of Czech ethics committees focused on both self-presentation and self-understanding of ECs members, and how other stakeholders (representatives of the pharmaceutical industry) view them. The exploratory research was based on formal and informal communication with the members of the ethics committees. Members of the research team took part at six regular voluntary meetings (...) of the ethics committees' members, organised by the Forum of Czech Ethics Committees, and at three summer schools of medical ethics. There were realised twenty-five semi-structured interviews as well as six focus group sessions and a participant observation of several regular meetings of three ethics committees. On the grounds of experience from the interviews a simple questionnaire survey was realised among the members of the ethics committees. The ethics committees comprise a community of members working voluntarily, without claims to remuneration or prestige; the unifying goal is protection of subjects of research. The principal working methods are dialogue and agreement. The members of the ethics committees thus, among other things, create an informal community, which can be to a certain extent seen as a Kantian ethical community in a weak sense. The phenomenon of ethics committees can also be described by terms of an epistemic community and a community of practice. These concepts, which are borrowed from other authors and areas, are used as a way how to think of ECs role and identity a bit differently and are meant as a contribution to the current international debate on the topic. (shrink)

I analyse scientific articles on human pheromones from a critical feminist perspective, using new materialist feminist theories, in particular, the work of Judith Butler, Karen Barad and Annemarie Mol. Pheromones were defined by Karlson and Lüscher in 1959 as ‘substances which are secreted to the outside by an individual and received by a second individual of the same species, in which they release a specific reaction – for example, a definite behavior or a developmental process’. In humans, it remains unclear (...) whether substances act as pheromones. With reference to Butler, I show how heteronormativity as a discourse influences research on two potential human pheromones, androstadienone and estratetraenol. I argue that experiments on these two substances have been set up to combine sex-specificity, heterosexuality and reproduction. In these experiments, only the inconsistent effects of androstadienone and estratetraenol were demonstrated. With reference to Barad, I interpret this inconsistency as an indicator of ‘resistant matter’. I argue that in order to experimentally show ‘heteronormative pheromones’ materialities (pheromones) have to merge with discourse (heteronormativity). Androstadienone and estratetraenol partly refuse this collaboration. Finally, I refer to Mol's concept of multiple realities and discuss whether alternative, non-heteronormative effects of pheromones occur instead. (shrink)

This article is a critical examination of practices and representations that constitute international education. While international education has provided substantial contributions and benefits for nation-states and international students, we question the discourses and practices which inform the international education export industry. The ‘brand identities’ of receiving or host countries imply that they are welcoming, respectful of multiculturalism and have a well established intellectual history, in contrast to international students' embodied experiences. There is also a tendency to represent and regard international (...) students as disembodied learners. We conclude that these disjunctures between disembodied representations and embodied experiences are undermining the kinds of cosmopolitan sensibilities that international education claims to provide. (shrink)

This essay argues that Berger and Mohr’s A Fortunate Man (1967) – comprising social observation and photographs of the rural practitioner, Dr. Sassall and his patients – enacts an embodied, intersubjective empathy called “pain-work.” The book enacts “pain-work” through two strategies. Firstly, by conflating three ways of seeing – Berger’s observation, Mohr’s photography, and Sassall’s medical gaze – it shows that the clinical encounter embodies objective vision through intersubjective pain. Secondly, it employs the concepts of recognition and witnessing to show (...) how the subjectivity of the physician is distributed in his community. Thus, Berger and Mohr witness Sassall’s witnessing of his patients; even as Sassall and his patients are constituted intersubjectively, so too are Berger, Mohr, and Sassall. (shrink)

It is foundational to ethics and bioethics that individuals will have to make hard decisions, frequently in challenging circumstances. But the scenarios and standard modes of theorizing in bioethics may fail to address important ethical questions, in part because of a paradigmatic focus on individual rights and freedoms in the context of decision making. There is a growing conviction that theorists of ethics and bioethics must reframe our core units of analysis to attend to health in public, collective, relational terms.1 (...) This would involve a move from an approach that focuses primarily on the relation between doctors and patients or between researchers and research subjects to something very different— something .. (shrink)

Biomechanical engineering is marked by highly experimental efforts to craft mechanical devices that might one day alleviate the scarcity of transplantable organs in the USA. A pronounced desire among bioengineers involves melding humans with machines, bearing the promise of perfecting the natural yet messy flaws of the ‘natal’ body. Not all bodies are considered equal within this field, however. Visual renderings of heart devices — as an unusual sort of body prosthesis — foreground a specialized aesthetic, where the well-toned male (...) form defines an idealized generic of beauty and perfection. This analysis considers the moral underpinnings of the embodied aesthetic in specific reference to engineers’ efforts to fabricate implantable ‘artificial’ hearts. Of central concern are the sociomoral consequences of a standardized male beauty, set alongside the striking absence — or invisibility — of the female form within this rarified field of science. (shrink)

Self-tracking devices point to a future in which individuals will be more involved in the management of their health and will generate data that will benefit clinical decision making and research. They have thus attracted enthusiasm from medical and public health professionals as key players in the move toward participatory and personalized healthcare. Critics, however, have begun to articulate a number of broader societal and ethical concerns regarding self-tracking, foregrounding their disciplining, and disempowering effects. This paper has two aims: first, (...) to analyze some of the key promises and concerns that inform this polarized debate. I argue that far from being solely about health outcomes, this debate is very much about fundamental values that are at stake in the move toward personalized healthcare, namely, the values of autonomy, solidarity, and authenticity. The second aim is to provide a framework within which an alternative approach to self-tracking for health can be developed. I suggest that a practice-based approach, which studies how values are enacted in specific practices, can open the way for a new set of theoretical questions. In the last part of the paper, I sketch out how this can work by describing various enactments of autonomy, solidarity, and authenticity among self-trackers in the Quantified Self community. These examples show that shifting attention to practices can render visible alternative and sometimes unexpected enactments of values. Insofar as these may challenge both the promises and concerns in the debate on self-tracking for health, they can lay the groundwork for new conceptual interventions in future research. (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)

In recent years, many qualitative sociologists, anthropologists, and social theorists have critiqued the use of algorithms and other automated processes involved in data science on both epistemological and political grounds. Yet, it has proven difficult to bring these important insights into the practice of data science itself. We suggest that part of this problem has to do with under-examined or unacknowledged assumptions about the relationship between the two fields—ideas about how data science and its critics can and should relate. Inspired (...) by recent work in Science and Technology Studies on interventions, we attempted to stage an encounter in which practicing data scientists were asked to analyze a corpus of critical social science literature about their work, using tools of textual analysis such as co-word and topic modelling. The idea was to provoke discussion both about the content of these texts and the possible limits of such analyses. In this commentary, we reflect on the planning stages of the experiment and how responses to the exercise, from both data scientists and qualitative social scientists, revealed some of the tensions and interactions between the normative positions of the different fields. We argue for further studies which can help us understand what these interdisciplinary tensions turn on—which do not paper over them but also do not take them as given. (shrink)

This article responds to recent debates in critical algorithm studies about the significance of the term “algorithm.” Where some have suggested that critical scholars should align their use of the term with its common definition in professional computer science, I argue that we should instead approach algorithms as “multiples”—unstable objects that are enacted through the varied practices that people use to engage with them, including the practices of “outsider” researchers. This approach builds on the work of Laura Devendorf, Elizabeth Goodman, (...) and Annemarie Mol. Different ways of enacting algorithms foreground certain issues while occluding others: computer scientists enact algorithms as conceptual objects indifferent to implementation details, while calls for accountability enact algorithms as closed boxes to be opened. I propose that critical researchers might seek to enact algorithms ethnographically, seeing them as heterogeneous and diffuse sociotechnical systems, rather than rigidly constrained and procedural formulas. To do so, I suggest thinking of algorithms not “in” culture, as the event occasioning this essay was titled, but “as” culture: part of broad patterns of meaning and practice that can be engaged with empirically. I offer a set of practical tactics for the ethnographic enactment of algorithmic systems, which do not depend on pinning down a singular “algorithm” or achieving “access,” but which rather work from the partial and mobile position of an outsider. (shrink)

This article engages with medical practice to develop a philosophically informed understanding of epistemic engagement in medicine, and epistemic object relations more broadly. I take my point of departure in the clinical encounter and draw on French psychoanalytical theory to develop and expand a taxonomy already proposed by Karin Knorr-Cetina. In so doing, I argue for the addition of an abject-type object relation; that is, the encounter with objects that transgress frameworks and disrupt further investigation, hence preventing dynamic engagement and (...) negatively shaping our epistemic pathways. This article is primarily theoretical, although partly grounded in qualitative fieldwork. (shrink)

First, this article will outline the metaphysics of `the social' that implicitly and explicitly connects the work of classical and contemporary cosmopolitan sociologists as different as Durkheim, Weber, Beck and Luhmann. In a second step, I will show that the cosmopolitan outlook of classical sociology is driven by exclusive differences. In understanding human affairs, both classical sociology and contemporary cosmopolitan sociology reflect a very modernist outlook of epistemological, conceptual, methodological and disciplinary rigour that separates the cultural sphere from the natural (...) objects of concern. I will suggest that classical sociology — in order to be cosmopolitan — is forced (1) to exclude non-social and non-human objects as part of its conceptual and methodological rigour, and (2) consequently and methodologically to rule out the non-social and the non-human. Cosmopolitan sociology imagines `the social' as a global, universal explanatory device to conceive and describe the non-social and non-human. In a third and final step the article draws upon the work of the French sociologist Gabriel Tarde and offers a possible alternative to the modernist social and cultural other-logics of social sciences. It argues for a inclusive conception of `the social' that gives the non-social and non-human a cosmopolitan voice as well. (shrink)

Politically, Europe has been unable to address itself to a constituted polity and people as more than an agglomeration of nation-states. From the resurgence of nationalisms to the crisis of the single currency and the unprecedented decision of a member state to leave the European Union, core questions about the future of Europe have been rearticulated: Who are the people of Europe? Is there a European identity? What does it mean to say, “I am European?” Where does Europe begin and (...) end? and Who can legitimately claim to be a part of a “European” people? The special issue seeks to contest dominant framings of the question “Who are the people of Europe?” as only a matter of government policies, electoral campaigns, or parliamentary debates. Instead, the contributions start from the assumption that answers to this question exist in data practices where people are addressed, framed, known, and governed as European. The central argument of this SI is that it is through data practices that the EU seeks to simultaneously constitute its population as a knowable, governable entity, and as a distinct form of peoplehood where common personhood is more important than differences. (shrink)

Moshe Tati, a sanitation worker in Jerusalem, was among the first of more than a thousand mortally sick Israelis who signed up for illicit and clandestine ‘transplant tour’ packages that included: travel to an undisclosed foreign and exotic setting; five-star hotel accommodation; surgery in a private hospital unit; a ‘fresh’ kidney purchased from a perfect stranger trafficked from a third country. Although Tati’s holiday turned into a nightmare and he had to be emergency air-lifted from a rented transplant unit in (...) a private hospital in Adana, Turkey back to Israel, Moshe became a poster-boy of transplant tourism for the next decade. João Cavalcanti was among the first of 38 residents of the slums of Recife recruited by retired military Captain Ivan da Silva and his sidekick Captain Gadddy Tauber to travel to Durban, South Africa to provide a spare kidney to an Israeli transplant tourist in Durban. This article examines the logics and practices through which kidney buyers and kidney sellers, organs brokers, surgeons and their accessories convince themselves that they are engaged in an illegal but still mutually beneficial ‘medical-recreational’ adventure, an ‘extreme medical sport’ of sorts. While life, health and survival motivate ‘transplant tourism’, a euphemism for human trafficking in spare body parts, the freedom to roam, mobility, is an essential feature of transplant tours for kidney buyers and kidney sellers. (shrink)

Analytical ethnography does not presume a principal analytical frame. It does not know (yet) where and when the field takes place. Rather, the ethnographer is in search for appropriate spatiotemporal frames in correspondence with the occurrences in the field. Accordingly, the author organizes a dialogue between conceptual frames and his various empirical accounts. He confronts snapshots of English Crown Court proceedings with models of event and process from micro-sociology and macro-sociology. A range of–more or less early or late, relevant or (...) irrelevant, contingent or predetermined–processual events serves as the vantage point to access event and process relations. In this line, Crown Court proceedings serve as an introductory and exemplary field for analytical ethnography, because they involve both: (strong) events and their process and (strong) processes and their events. (shrink)

Dis/Abling Practices: Rethinking Disability The paper discusses how ordinary acts of everyday life make up the complex and contingent scenarios of disabilities that create enabling and disabling (dis/abling) practices. Drawing on qualitative empirical data the societal visibility and relevance of dis/abling practices are analyzed by connecting disability studies and sociological ideas with insights from Science and Technology Studies (STS). The essay explores how (visual) dis/ability is the outcome of human and non-human configurations and suggests that dis/ability can be understood neither (...) as an individual bodily impairment nor as a socially attributed disability. Rather, dis/ability refers to complex sets of heterogeneous practices that (re-)associate bodies, material objects, and technologies with sensory practices. These practices, the paper concludes, draw attention to the multiple processes that (re-) concatenate the conduct of human affairs. (shrink)

Since Foucault introduced the notion of biopolitics, it has been fiercely debated—usually in highly generalized terms—how to interpret and use this concept. This article argues that these discussions need to be situated, as biopolitics have features that do not travel from one site to the next. This becomes apparent if we attend to an aspect of biopolitics that has only received scant attention so far: the knowledge practices required to constitute populations as intelligible objects of government. To illustrate this point, (...) the article focuses on processes of biopolitical bordering: the delineation of the target population that is to be known via statistical practices. Drawing on the example of Estonia I show that methodological decisions involved in this work have important biopolitical implications as they affect the size and composition of the population, thus shaping the design of programmes of government aiming at its regulation. (shrink)

In order to understand the lived experiences of physicians in clinical practice, we interviewed eleven expert, respected clinicians using a phenomenological interpretative methodology. We identified the essence of clinical practice as engagement. Engagement accounts for the daily routine of clinical work, as well as the necessity for the clinician to sometimes trespass common boundaries or limits. Personally engaged in the clinical situation, the clinician is able to create a space/time bubble within which the clinical encounter can unfold. Engagement provides an (...) account of clinical practice as a unitary lived experience. This stands in stark contrast to the prevailing notion, referred to as a dual discourse, that describes medicine as the addition of humanism to science. Drawing on Aristotle’s notion of phronesis and Sartre’s definition of the situation, we illustrate how this novel perspective entwines clinical practice, the person of the clinician, and the clinician’s situation. (shrink)

This paper is about the ontology of a cancer diagnosis at high-end hospitals in Colombia. Drawing on a seventeen-month ethnographic fieldwork study in this country, it pays attention to how dermatologists, pathologists, and oncologists looked at my partner’s skin during a routine medical checkup and enacted two seemingly contradictory diagnoses: a lethal melanoma and a benign dysplastic nevus—commonly known as mole. Because their differences under the microscope or through dermatology goggles may be subtle, physicians often disagree on what they see. (...) When medical services are not unrelated to the economic possibilities of patients to pay for them, what emerges through a microscope might be different. With neoliberal medical reforms in Colombia as background, this paper focuses on the ontological indeterminacy of cancer and its relationship to high-end hospitals and a patient who could, albeit not without effort, pay for the treatment. Thus, I argue that how physicians saw was not unrelated to what they saw and therefore to their practices of medicine in neoliberal Colombia. How do medical practices and ways of seeing in Colombia enter into composition with the bodies they study? Could the same skin tissue simultaneously be cancerous and noncancerous? (shrink)

This paper examines folk theories of algorithmic recommendations on Spotify in order to make visible the cultural specificities of data assemblages in the global South. The study was conducted in Costa Rica and draws on triangulated data from 30 interviews, 4 focus groups with 22 users, and the study of “rich pictures” made by individuals to graphically represent their understanding of algorithmic recommendations. We found two main folk theories: one that personifies Spotify and another one that envisions it as a (...) system full of resources. Whereas the first theory emphasizes local conceptions of social relations to make sense of algorithms, the second one stresses the role of algorithms in providing a global experience of music and technology. We analyze why people espouse either one of these theories and how these theories provide users with resources to enact different modalities of power and resistance in relation to recommendation algorithms. We argue that folk theories thus offer a productive way to broaden understanding of what agency means in relation to algorithms. (shrink)

This article focuses on blood donation as a form of bloodletting in a context where donation is commonly seen to alleviate the symptoms of `thick blood'. It deals with the gendered aspects of blood donation, and the parallels drawn between donating blood and menstruating. Women are seen not to need to donate blood as much as men, who, in the absence of menstruation, are more prone to thick blood and require a means to expunge the ensuing excess. While blood donation (...) professionals strive to reconstruct donation as a selfless and ungendered act, counterposing the `facts' of arterial blood circulation to local blood-lore and beliefs, lay understandings challenge this construction in the use they make of blood donation centres or by reiterating the personalistic and gendered dimensions of donation. The article explores cases of patients who use hormonal contraceptives which suppress menstruation and express concerns over the resulting accumulation of blood in the body. It considers how blood donation is adopted by some women as a means of dispelling both the perceived inconveniences of menstrual bleeding and its swelling effects. Such literalized engagements with medical technologies reveal a conception of the body as a permeable, malleable and recipient-like enclosure. These views are often characterized as `ignorance' by medical practitioners, where ignorance is seen to derive not only from the absence of knowledge, but from the presence of the wrong kind of knowledge. (shrink)

We develop the concept of ‘aesthetic practices’ to capture the work needed for population data to be disseminated via government data portals. Specifically, we look at the Census Hub of the European Statistical System and the Danish Ministry of Education’s Data Warehouse. These portals form part of open government data initiatives, which we understand as governing technologies. We argue that to function as such, aesthetic practices are required so that data produced at dispersed sites can be brought into relation and (...) projected as populations in forms such as bar charts, heat maps and tables. Two examples of aesthetic practices are analysed based on ethnographic studies we have conducted on the production of data for the Hub and Warehouse: metadata and data cleaning. Metadata enables data to come into relation by containing and accounting for the differences between data. Data cleaning deals with the indeterminacies and absences of data and involves algorithms to determine what values data can obtain so they can be brought into relation. We attend to how both aesthetic practices involve normative decisions that make absent what exceeds them: embodied knowledge that cannot or has not been documented as well as data that cannot meet the forms required of data portals. While these aesthetic practices are necessary to sustain data portals as ‘sites of projection,’ we also bring critical attention to their performative effects for knowing, enacting and governing populations. (shrink)

The political integration of the European Union is fragile for many reasons, not least the reassertion of nationalism. That said, if we examine specific practices and infrastructures, a more complicated story emerges. We juxtapose the political fragility of the EU in relation to the ongoing formation of data infrastructures in official statistics that take part in postnational enactments of Europe’s populations and territories. We develop this argument by analyzing transformations in how European populations are enacted through new technological infrastructures that (...) seek to integrate national census data in “cubes” of cross-tabulated social topics and spatial “grids” of maps. In doing so, these infrastructures give meaning to what “is” Europe in ways that are both old and new. Through standardization and harmonization of social and geographical spaces, “old” geometries of organizing and mapping populations are deployed along with “new” topological arrangements that mix and fold categories of population. Furthermore, we consider how grids and cubes are generative of methodological topologies by closing the distances or differences between methods and making their data equivalent. By paying attention to these practices and infrastructures, we examine how they enable reconfiguring what is known and imagined as Europe and how it is governed. (shrink)

In this introduction, we address some of the complexities associated with the emergence of medicine’s bodies, not least as a means to ‘working with the body’ rather than simply producing a critique of medicine. We provide a brief review of some of the recent discussions on how to conceive of medicine and its bodies, noting the increasing attention now given to medicine as a technology or series of technologies active in constituting a multiplicity of entities – bodies, diseases, experimental objects, (...) the individualization of responsibility for health and even the precarity of life. We contrast what feminist theorists in the tradition of Judith Butler have referred to as the question of matter, and Science and Technology Studies with its focus on practice and the nature of emergence. As such we address tensions that exist in analyses of the ontological status of ‘the body’ – human and non-human – as it is enacted in the work of the laboratory, the randomized controlled trial, public health policy and, indeed, the market that is so frequently entangled with these spaces. In keeping with the recent turns toward ontology and affect, we suggest that we can regard medicine as concerned with the contraction and reconfiguration of the body’s capacities to affect and be affected, in order to allow for the subsequent proliferation of affects that, according to Bruno Latour, marks corporeal life. Treating both contraction and proliferation circumspectly, we focus on the patterns of affects wrought in particular by the abstractions of medicine that are described in the contributions to this special issue. Drawing on the work of A.N. Whitehead, we note how abstractions such as ‘medical evidence’, the ‘healthy human body’ or the ‘animal model’ are at once realized and undercut, mediated and resisted through the situated practices that eventuate medicine’s bodies. Along the way, we touch on the implications of this sort of perspective for addressing the distribution of agency and formulations of the ethical and the political in the medical eventuations of bodies. (shrink)

Community supported agriculture programs are transforming the way people relate to food and agriculture. Many researchers have considered the transformative potential of CSAs on economic, social, and environmental relations. They illustrate how participants are embedded in broader political economic transformations. The same focus, however, has not been given to CSAs’ transformative impact on individual shareholders—especially in terms of their relationship to food and health. We draw together literatures from behavioral economics, econometrics, and political ecology to evaluate the potential impacts of (...) CSA participation on food lifestyle behaviors. Using primary data drawn from a survey of four groups with distinct food acquisition environments, we compare respondents’ self-assessed food-related behaviors along three different categories: produce versus processed food consumption, food away from home consumption, and food acquisition and interest in nutrition. By documenting between-group differences, we confirm that shareholders display significant absolute differences to other groups along numerous indicators related to the above-stated categories and in general assessments of health. These differences correspond directionally to behaviors public health officials identify as correlated to beneficial health outcomes. We conclude by theorizing how the food environments delineated by a CSA exchange relationship provide unique reflexive opportunities for participants to develop diverse food-related skills and behaviors. (shrink)

In cognitive science, long-term anticipation, such as when planning to do something next year, is typically seen as a form of ‘higher’ cognition, requiring a different account than the more basic activities that can be understood in terms of responsiveness to ‘affordances,’ i.e. to possibilities for action. Starting from architects that anticipate the possibility to make an architectural installation over the course of many months, in this paper we develop a process-based account of affordances that includes long-term anticipation within its (...) scope. We present a framework in which situations and their affordances unfold, and can be thought of as continuing a history of practices into a current situational activity. In this activity affordances invite skilled participants to act further. Via these invitations one situation develops into the other; an unfolding process that sets up the conditions for its own continuation. Central to our process account of affordances is the idea that engaged individuals can be responsive to the direction of the process to which their actions contribute. Anticipation, at any temporal scale, is then part and parcel of keeping attuned to the movement of the unfolding situations to which an individual contributes. We concretize our account by returning to the example of anticipation observed in architectural practice. This account of anticipation opens the door to considering a wide array of human activities traditionally characterized as ‘higher’ cognition in terms of engaging with affordances. (shrink)

In this article we move beyond the problematic distinction between ‘higher’ and ‘lower’ cognition by accounting for so-called ‘higher’ cognitive capacities in terms of skillful activities in practices, and in terms of the affordances exploited in those practices. Through ethnographic research we aim to further develop the new notion of skilled intentionality by turning to the phenomenon of the tendency towards an optimal grip on a situation in real-life situations in the field of architecture. Tending towards an optimal grip is (...) an inherently affective and dynamic phenomenon. It has been under explored in philosophy, despite its central place in Merleau-Ponty’s phenomenology. When the architects experience discontent, attention is typically solicited by the affordances through which possible ways of continuing the improvement of the design can be explored. In various ways this tension or disequilibrium - fueling a tendency towards an optimal grip - is encountered in the complex architectural design practices that we observed. Based on our field material we distinguish between: a) grip in visual perception, b) grip on the design, and c) grip on ‘how to design’. The move towards an optimal grip takes shape by joining forces with a landscape of affordances. This landscape includes, for instance, affordances for grasping a cup of coffee, affordances provided by a cardboard model to improve it, as well as for engaging with a person who is not physically present. Because they are skilled, the architects can be responsive to these different affordances in similar ways. Furthermore, in practice the architects are responsive to multiple affordances simultaneously. Through our analysis of the tendency towards an optimal grip we show that our surroundings contribute to skillful action and cognition in a far more complex way than is currently acknowledged in philosophy and cognitive science. (shrink)

Artificially Intelligent robotic technologies increasingly reflect a language of interaction and relationship and this vocabulary is part and parcel of the meanings now attached to machines. No longer are they inert, but interconnected, responsive and engaging. As machines become more sophisticated, they are predicted to be a “direct object” of an interaction for a human, but what kinds of human would that give rise to? Before robots, animals played the role of the relational other, what can stories of feral children (...) tell us about what it means to be human? What of ‘relationship’ do AI and robotic scientists draw on to generate ideas about their relational others? I will address these questions by reference to the work of Martin Buber in I and Thou. (shrink)

It is the purpose of this special issue to acknowledge the shifting definitions and uses of the conceptual and empirical in the field of Science and Technology Studies, and to explore the constructive potential of this condition. In this introductory essay we point to four formulations in STS for the relation between the conceptual and the empirical which do not figure them as binaries or opposites: the empirical as a path to the conceptual, the conceptual as practical and empirical, the (...) empirical as an instantiation of the conceptual, and a conceptual minimalism. We then point to some inspirations in contemporary thought for engaging creatively with the conceptual and empirical, and conclude by summarizing the contributions to this issue. (shrink)

Many in the international development community have embraced the randomized controlled field experiment, akin to a biomedical clinical trial for social interventions, as the new “gold evidential standard” in program impact evaluation. In response, critics have called upon the method’s advocates to consider the moral dimensions of randomization, leading to a debate about the method’s ethics. My research intervenes in this debate by empirically investigating how researchers manage the perception of randomization in the field. Without the possibility of a placebo, (...) researchers rhetorically and materially frame the experiment differently for the control and treatment groups. Three technologies allow for this differential framing: geographic separation, temporal delay, and public randomization ceremonies. Geographic separation is a “technology of opacity” designed to obscure unequal resource distribution by disentangling the intervention and research components of the experiment for the control group. The latter two are technologies of transparency designed to expose the element of randomization but downplay conditions that may affect participant buy in. All three technologies work to preclude collective definitions of fair resource allocation, yet they are not fully successful in preventing modes of confrontation and resistance that lie outside of the experiment’s framing. (shrink)

The rapid spread of electronic fingerprinting not only creates new regimes of surveillance but compels users to adopt novel ways of performing their bodies to suit the new technology. This ethnography uses two Indian case studies – of a welfare office and a workplace – to unpack the processes by which biometric devices become effective tools for determining identity. While in the popular imaginary biometric technology is often associated with providing disinterested and thus objective evaluation of identity, in practice ‘failures (...) to enrol’ and ‘false rejects’ frequently cause crises of representation. People address these by tinkering with their bodies and changing the rules, and in the process craft biometric bodies. These are assembled bodies that link people and objects in ways considered advantageous for specific identity regimes. By using assemblage theory, the article proposes an alternative interpretation of new surveillance regimes as fluid practices that solidify through the agency of multiple actors who naturalize particular power/knowledge arrangements. (shrink)

Forensic DNA phenotyping is a genetic technology that might be used in criminal investigations. Based on DNA samples of the human body found at crime scenes, it allows to infer externally visible characteristics (such as eye, hair and skin colour) and continental-based biogeographical ancestry. By indicating the probable visible appearance of a criminal suspect, forensic DNA phenotyping allows to narrow down the focus of a criminal investigation. In this article, drawing on interviews with forensic geneticists, we explore how their narratives (...) translate contemporary focus on criminal molecularized bodies. We propose the concept of (de)materialization to approach three aspects of the forensic geneticists’ views. The first regards considering bodies as mutable entities. The second relates to socially contingent meanings attributed to bodies. The third regards to controversies surrounding data reliability. By reflecting upon the (de)materialization of criminal bodies, forensic geneticists juxtapose the defence and unsettling of forensic DNA phenotyping claims. (shrink)

Surgical training has traditionally involved a lengthy apprenticeship to a series of master surgeons, who teach medical students and residents the techniques of surgery while allowing them to work on patients in the operating room. This article examines surgical training as a structured environment that prepares students for the embodied lessons taught by a surgeon. It argues that even the most seemingly mechanical of surgical techniques contains social lessons when taught by a surgeon within the rich environment of the operating (...) room. (shrink)

Drawing on an ethnographic study of the installation and maintenance of Paris subway wayfinding system, this article attempts to discuss and specify previous claims that highlight stability and immutability as crucial aspects of material ordering processes. Though in designers’ productions, subway signs have been standardized and their consistency has been invested in to stabilize riders’ environment, they appear as fragile and transforming entities in the hands of maintenance workers. These two situated accounts are neither opposite nor paradoxical: they enact different (...) versions of subway signs, the stabilization of which goes through the acknowledgment of their vulnerability. Practices that deal with material fragility are at the center of what we propose, following Annemarie Mol and Maria Puig de la Bellacasa, to term a care of things. Foregrounding such a care of things is a way to surface a largely overlooked dimension of material ordering and to renew how maintainability issues are generally tackled. (shrink)

How do technologies such as webcams influence health care and what concepts may describe this? This article explores the literature and analyses what people looking through webcams do within a particular health care practice in the Netherlands, that is, within the rehabilitation of people suffering from severe chronic obstructive pulmonary disease or asthma. Several ways to describe the activities webcams support and perform are identified. The webcam is concentrating the activities of its users, by making them focus on the task (...) at hand and magnifies the characteristics of the already existing relationships between webcam users by imposing a relational distance that fits best with intimate contacts. Although webcams shift notions of space and distance, their working appears to be related, to a great extent, to their location. (shrink)

There are roughly two meanings attached to the concept of dignity: humanitas and dignitas. Humanitas refers to ethical and juridical notions of equality, autonomy and freedom. Much less understood is the meaning of dignitas, which this paper develops as peoples’ engagement with aesthetic values and genres, and hence with differences between people. Departing from a critical reading of Georgio Agamben’s notion of ‘bare life’, I will analyze a case where aesthetics are quite literally at stake: women who lost their hair (...) due to cancer treatment. The analysis shows a complicated interplay between varying evaluations of female baldness by the self and others, mediated by (often strongly negative) cultural imaginaries, and aesthetic genres depicting conventional ways of ‘looking good’. The paper concludes by arguing for a reconnection of the two notions of dignity, and for a rehabilitation of aesthetics in daily life and care as fundamental values for organizing our societies. (shrink)

Nurses and ethicists worry that the implementation of care at a distance or telecare will impoverish patient care by taking out ‘the heart’ of the clinical work. This means that telecare is feared to induce the neglect of patients, and to possibly hinder the development of a personal relation between nurse and patient. This study aims to analyse whether these worries are warranted by analysing Dutch care practices using telemonitoring in care for chronic patients in the Netherlands. How do clinical (...) practices of nursing change when telecare devices are introduced and what this means for notions and norms of good nursing? The paper concludes that at this point the practices studied do not warrant the fear of negligence and compromised relations. Quite the contrary; in the practices studied, telecare lead to more frequent and more specialised contacts between nurses and patients. The paper concludes by reflecting on the ethical implications of these changes. (shrink)

This paper describes the approach of empirical ethics, a form of ethics that integrates non-positivist ethnographic empirical research and philosophy. Empirical ethics as it is discussed here builds on the ‘empirical turn’ in epistemology. It radicalizes the relational approach that care ethics introduced to think about care between people by drawing in relations between people and technologies as things people relate to. Empirical ethics studies care practices by analysing their intra-normativity, or the ways of living together the actors within these (...) practices strive for or bring about as good practices. Different from care ethics, what care is and if it is good is not defined beforehand. A care practice may be contested by comparing it to alternative practices with different notions of good care. By contrasting practices as different ways of living together that are normatively oriented, suggestions for the best possible care may be argued for. Whether these suggestions will actually be put to practice is, however, again a relational question; new actors need to re-localize suggestions, to make them work in new practices and fit them in with local intra-normativities with their particular routines, material infrastructures, know-how and strivings. (shrink)

This article uses Betty Friedan’s idiosyncratic invocations of heart disease in her work from the 1960s through the 1990s, as well as her autobiographical comments about it and her theory of the feminine mystique, to grapple with a feminist articulation of heart disease. Although this leading cause of death for women in industrialized countries has been peripheral to feminist health discourse and most women’s preoccupations, heart disease played an interesting narrative role in Friedan’s work and life. Drawing on Friedan’s unconventional (...) philosophy of health provides an opportunity to problematize health awareness and reconsider the role of disease and health in feminist critique more generally. As we try to understand gendered stories of disease that are emerging at the dawn of the 21st century, rereading Friedan can help illuminate the limits, possibilities and dangers of framing heart disease as a ‘women’s health issue’. (shrink)

Science and technology studies concerned with the study of lay influence on the sciences usually analyze either the political or the normative epistemological consequences of lay interference. Here I frame the relation between patients, knowledge, and the sciences by opening up the question: How can we articulate the knowledge that patients develop and use in their daily lives and make it transferable and useful to others, or, `turn it into science’? Elsewhere, patient knowledge is analyzed either as essentially different from (...) or similar to medical knowledge. The category of experiential knowledge is vague and is used to encompass many types of experience, whereas the knowledge of the `expert patient’ may be assumed to have the shape of up-to-date medical information. This paper shows through a case study of people with severe lung disease that patient knowledge can be understood as a form of practical knowledge that patients use to translate medical and technical knowledge into something useful to their daily life with disease. Patients coordinate this with homegrown know-how and advice from fellow patients, weighing different values - of which `taking good care of one’s body’ is but one - that may conflict in a specific situation. These practices result in sets of techniques that may be made useful to others. The paper argues for two alternatives to state-of-the-art medical research to turn patient knowledge into science: ethnographies of knowledge practices and the collection and making accessible of techniques. (shrink)

Discussing the workings of technology in care as aesthetic rather than as ethical or epistemological interventions focusses on how technologies engage in and change relations between those involved. Such an aesthetic study opens up a repertoire to address values that are abundant in care, but are as yet hardly theorized. Kamphof studies the problem that sensor technology reveals things about the elderly patients without the patients being aware of this. I suggest improvement of these relations may be considered in aesthetic (...) terms, for instance by developing the affective quality of people’s technological relationships. (shrink)

The “patient perspective” serves as an analytical tool to present patients as knowing subjects in research, rather than as objects known by medicine. This paper analyses problems encountered with the concept of the patient perspective as applied to long-term mental health care. One problem is that “having a perspective” requires a perception of oneself as an individual and the ability to represent one’s individual situation in language; this excludes from research patients who do not express themselves verbally. Another problem is (...) that the idea of “talk” as a representation of the world ignores the fact that talk is also performative in the world: it requires, at least, the ability to deal with an interview situation. To think up alternative ways of including patients as subjects in research, I develop an approach that takes this performativity as a starting point. Analysing practical situations and activities, I argue that patients enact appreciations, making known what they like or dislike by verbal or non-verbal means in a given material environment, in situations that are co-produced by others. Thus, subjectivity is linked to situations and interactions, rather than just to individual characteristics; to “patient positions,” rather than “patient perspectives.”. (shrink)

This article analyzes how the recent call for accounting in health care interferes with daily care practice and raises the question of how accounting practices relate to the aim of good care. The most influential accounting methods in the Netherlands suggest ways for professionals to legitimize their activities. The analysis of washing patients in long-term mental health care shows that different styles of accounting evaluate and legitimize care while structuring notions of what good care is. A specific style of accounting (...) enforces certain values but does not tell about the tragic or unexpected effects that come with it, nor does it provide a repertoire to deal with these. Thus, care practices incorporating specific styles of accounting remain dependent on forms of care that are not accountable or ask for new forms of reflexivity. (shrink)