The Body Multiple is an extraordinary ethnography of an ordinary disease. Drawing on fieldwork in a Dutch university hospital, Annemarie Mol looks at the day-to-day diagnosis and treatment of atherosclerosis. A patient information leaflet might describe atherosclerosis as the gradual obstruction of the arteries, but in hospital practice this one medical condition appears to be many other things. From one moment, place, apparatus, specialty, or treatment, to the next, a slightly different “atherosclerosis” is being discussed, measured, observed, or stripped away. (...) This multiplicity does not imply fragmentation; instead, the disease is made to cohere through a range of tactics including transporting forms and files, making images, holding case conferences, and conducting doctor-patient conversations. The Body Multiple juxtaposes two distinct texts. Alongside Mol’s analysis of her ethnographic material—interviews with doctors and patients and observations of medical examinations, consultations, and operations—runs a parallel text in which she reflects on the relevant literature. Mol draws on medical anthropology, sociology, feminist theory, philosophy, and science and technology studies to reframe such issues as the disease-illness distinction, subject-object relations, boundaries, difference, situatedness, and ontology. In dialogue with one another, Mol’s two texts meditate on the multiplicity of reality-in-practice. Presenting philosophical reflections on the body and medical practice through vivid storytelling, The Body Multiple will be important to those in medical anthropology, philosophy, and the social study of science, technology, and medicine. (shrink)

New Materialisms brings into focus and explains the significance of the innovative materialist critiques that are emerging across the social sciences and humanities. By gathering essays that exemplify the new thinking about matter and processes of materialization, this important collection shows how scholars are reworking older materialist traditions, contemporary theoretical debates, and advances in scientific knowledge to address pressing ethical and political challenges. In the introduction, Diana Coole and Samantha Frost highlight common themes among the distinctive critical projects that comprise (...) the new materialisms. The continuities they discern include a posthumanist conception of matter as lively or exhibiting agency, and a reengagement with both the material realities of everyday life and broader geopolitical and socioeconomic structures. Coole and Frost argue that contemporary economic, environmental, geopolitical, and technological developments demand new accounts of nature, agency, and social and political relationships; modes of inquiry that privilege consciousness and subjectivity are not adequate to the task. New materialist philosophies are needed to do justice to the complexities of twenty-first-century biopolitics and political economy, because they raise fundamental questions about the place of embodied humans in a material world and the ways that we produce, reproduce, and consume our material environment. Contributors Sara Ahmed Jane Bennett Rosi Braidotti Pheng Cheah Rey Chow William E. Connolly Diana Coole Jason Edwards Samantha Frost Elizabeth Grosz Sonia Kruks Melissa A. Orlie. (shrink)

A central theme throughout the impressive series of philosophical books and articles Stephen Toulmin has published since 1948 is the way in which assertions and opinions concerning all sorts of topics, brought up in everyday life or in academic research, can be rationally justified. Is there one universal system of norms, by which all sorts of arguments in all sorts of fields must be judged, or must each sort of argument be judged according to its own norms? In The Uses (...) of Argument Toulmin sets out his views on these questions for the first time. In spite of initial criticisms from logicians and fellow philosophers, The Uses of Argument has been an enduring source of inspiration and discussion to students of argumentation from all kinds of disciplinary background for more than forty years. (shrink)

While many "benchtop-to-bedside" research pathways have been developed in "Type I" translational medicine, vehicles to facilitate "Type II" and "Type III" translation that convert scientific data into clinical and community interventions designed to improve the health of human populations remain elusive. Further, while a high percentage of physicians endorse the principle of citizen leadership, many have difficulty practicing it. This discrepancy has been attributed, in part, to lack of training and preparation for public advocacy, time limitation, and institutional resistance. As (...) translational medicine and physician-citizenship implicate social, political, economic and cultural factors, both enterprises require "integrative" research strategies that blend insights from multiple fields of study, as well as rhetorical acumen in adapting messages to reach multiple audiences. This article considers how argumentation theory's epistemological flexibility, audience attentiveness, and heuristic qualities, combined with concepts from classical rhetoric, such as rhetorical invention, the synecdoche, and ethos, yield tools to facilitate translational medicine and enable physician-citizenship. (shrink)

In evidence-based medicine (EBM), methodology has become the central means of determining the quality of the evidence base. The “gold standard” method, the randomised, controlled trial (RCT), imbues medical research with an ethos of disinterestedness; yet, as this essay argues, the RCT is itself a rhetorically interested construct essential to medical-professional boundary work. Using the example of debates about methodology in EBM-oriented research on complementary and alternative medicine (CAM), practices not easily tested by RCTs, I frame the problem of method (...) as a fundamentally rhetorical problem, situated within a boundary drama, and deeply rooted in the discursive practices of science and medicine. The genre of the RCT report, for example, idealises the research process and can tilt the course of arguments about CAM, while the notion of efficacy can function as a rhetorically mobile boundary object that can redefine the very terms of debate. I suggest herein that arguments about method in CAM debates can productively be read, metonymically, as expressions of more general anxieties in medicine about knowledge and evidence, community values, and professional boundaries; as such, these debates can illuminate some of the rhetorical dimensions of EBM. (shrink)

Recent scholarship in medical humanities has expressed strong concern over the ability of pharmaceuticals companies to medicalize discomfort and subsequently invent diseases. In this article, I explore the clinical debates over the ontology of the sinus headache as a possible counter-case. Extending Foucault’s concept of principles or rarefaction, this paper documents the efforts of clinicians to resist the pharmaceutically-provided understanding of the sinus headache. In so doing, it offers institutions of rarefaction and rarefactive assemblages as useful heuristics for the exploration (...) of disease legitimization discourse. (shrink)

Foucault's work has had a profound impact on the medical humanities over the last decade or so. However, most work to date has focused on Foucault's earlier writings rather than his later contributions on the self and governmentality. This article assesses the significance of the concept of governmentality for critical scholarship in the medical humanities, particularly in creating ethical awareness in the field of health care. It examines the context for Foucault's later work, and contributions arising from scholarship building on (...) this work. The governmentality literature, it is argued, raises novel questions about the ways we have come to think about health care in late modern societies. However, there are some limitations with this body of work which have not been fully acknowledged by scholars. The article discusses some of these limitations and offers some suggestions for a fruitful way forward. (shrink)

This article investigates the uneasy process of integrating midwifery’s alternative, women-centered model of childbirth care within the medically-dominated healthcare system in Canada. It analyses the impure processes of rhetorical identification and differentiation that characterized the debate about how to regulate midwifery in Ontario by examining a selection of submissions from diverse health care groups with vested interest in the debate’s outcome. In divergent ways, these groups strategically appeal to the value of the “public interest” in order to advance professional concerns. (...) The study considers the implications of this rhetorical process for re-defining midwifery’s distinctive professional identity in relation to other health professions, to the state, and to the women for whom midwives care. Likewise, it suggests the relevance of rhetorical analysis for understanding the discursive formation and re-formation of health models, values, and professions in Western culture. (shrink)