The work of Julian Herman Lewis helps to expose the underlying racial organization of laboratory normality in early twentieth-century medicine. In the 1920s and 1930s, Lewis launched a critique of prevailing racial theory, as he established an academic career in pathology at the University of Chicago. As one of the small number of black research physicians at the time, Lewis met barriers to his work that eventually derailed his career. Although his research fell short of its goals, his work continues (...) to provide a key insight into medical laboratory standards as they became institutionalized in Lewis’s field of clinical pathology. By avoiding attributions of race and following prevailing practices of racial exclusion, medical laboratories quietly reasserted social norms in the formation of laboratory normality. An examination of Lewis’s critiques and his research sharpens questions about the development of the concept of “normal” in the human sciences and a related tendency in twentieth-century medicine to conflate difference with pathology. (shrink)

Opponents of the provision of therapeutic, healthy limb amputation in Body Integrity Identity Disorder cases argue that such surgeries stand in contrast to the goal of medical practice – that of health restoration and maintenance. This paper refutes such a conclusion via an appeal to the nuanced and reflective model of health proposed by Georges Canguilhem. The paper examines the conceptual entanglement of the statistically common with the normatively desirable, arguing that a healthy body can take multiple forms, including that (...) of an amputee, provided that such a form enables the continuing ability to initiate new norms of existence. It concludes that the practice of healthy limb amputation in cases of Body Integrity Identity Disorder is not only compatible with the goal of medicine but is potentially the only method of achieving this goal in the face of a complex and often mischaracterized disorder. (shrink)

This paper explores the impact that developments in the field of neuroprosthetics will have on the ethical viability of healthy limb amputation, specifically in cases of Body Integrity Identity Dis...

In recent years we have seen the emergence of “personalised medicine.” This development can be seen as the logical product of reductionism in medical science in which disease is increasingly understood in molecular terms. Personalised medicine has flourished as a consequence of the application of neoliberal principles to health care, whereby a commercial and social need for personalised medicine has been created. More specifically, personalised medicine benefits from the ongoing commercialisation of the body and of genetic knowledge, the idea that (...) health is defined by genetics, and the emphasis the state places on individual citizens as being “responsible for” their own health. In this paper I critique the emergence of personalised medicine by examining the ways in which it has already impacted upon health and health care delivery. (shrink)

Within contemporary science, it is common practice to compare data points to the _average_, i.e., to the statistical mean. Because this practice is so familiar, it might at first appear not to be the sort of thing that requires explanation. But recent research in cognitive science gives us reason to adopt the opposite perspective. Research on the cognitive processes involved in people’s ordinary efforts to make sense of the world suggests that, instead of using a purely statistical notion of the (...) average, people tend to use a value-laden notion of the _normal_. This finding about ordinary cognition gives us reason to rethink certain familiar facts about scientific practice. In particular, it suggests that the fact that scientists so often make use of the statistical average should be seen as a highly surprising fact, the sort of thing that calls out for explanation. To understand it, we turn to work in the history of science, and especially to work on the ways in which the practice of science changed over the course of the 19th century. (shrink)