JournalTOCs

BioSocieties
Journal Prestige (SJR): 0.779

Citation Impact (citeScore): 2
Number of Followers: 2

Hybrid journal (It can contain Open Access articles)
ISSN (Print) 1745-8552 - ISSN (Online) 1745-8560
Published by Springer-Verlag

[2467 journals]

Science and democracy on stage at the Science and Technology Select
Committee
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  Abstract: Abstract In this article, we explore the legalisation of mitochondrial donation in the UK as the latest iteration of an established sociotechnical imaginary of permissive yet highly scrutinised human embryo research in the country. The focus of our analysis is the work of the UK House of Commons Science and Technology Select Committee as it contributed to the debates and ultimately played a role in enabling the UK to become the first country in the world to legalise clinical use. Mitochondrial donation is a reproductive technology which could allow women with mitochondrial disease to have healthy, genetically related children. From 2011, an extensive process of inquiry was launched in the UK to assess safety, ethics and public attitudes. We analyse video and transcripts of the meeting, and interviews with panellists to explore three themes: contesting scientific interpretation, the labour of alignment and resolution. We demonstrate how micro-interactions during the meeting, and the broader structure of the meeting itself, aligned with the UK sociotechnical imaginary of a permissive but scrutinising approach to human embryo regulation. We conclude that the event was one element of a larger process of review that together worked to render mitochondrial donation as knowable, ethical, desirable and sanctionable.
  PubDate: 2023-02-14
Correction: Core values of genomic citizen science: results from a
qualitative interview study
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  PubDate: 2023-01-27
Challenges facing the clinical adoption of a new prognostic biomarker: a
case study
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  Abstract: Abstract In this article, we show how a particular biomarker comes into being in an emergency department in a hospital in Copenhagen, Denmark. We explore the contextual becoming of this biomarker, suPAR, through interviews with nurses and physicians and through relational ontology. We find that as a prognostic biomarker suPAR is challenged in it becoming as an object for clinical practice in the emergency department by the power of diagnostic practices and the desire for experience-based scripts that quickly enable the clinician to reach the right diagnosis. Although suPAR is enacted as a promising triage strategy suggesting a low or high risk of disease, the inability to rule out specific diagnoses and producing the notion of secure clinical actions make its non-specificity and prognostic character problematic in clinical practices. Specific diagnostic criteria versus prognostic interpretation and non-specificity risk profiling challenges the way healthcare workers in an emergency department understand the tasks they are set to solve and how to solve them. We discuss how the becoming of suPAR is strengthened through enactments of specificity and engagement in triage strategies and we reflect on it’s becoming through new diagnostic practices with the need to accommodate diagnostic ambiguity.
  PubDate: 2023-01-21
Feral pharmaceuticalization—Biomedical uses of animal life in light of
the global donkey hide trade
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  Abstract: Abstract Medical and pharmaceutical uses of animal life have gone through vast changes in the past centuries. Although the commodification of animals and animal parts is by no means an invention of modernity, its procedures and practices have evolved in multiple ways across time. Most notably, the exploitation of non-human animal life has been increasingly segmented, industrialized, and globalized. The collateral expansion of scientific and market institutions has led to specific modes of rationalization of animal breeding, culture, and trade for pharmaceutical purposes. However, this rationalization process has never been immune to its own matter—and the materiality of non-human commodification processes irrigates seemingly ordered and layered practices. Based upon a study on the international trade of donkey hide, this paper offers a characterization of the current pharmaceutical uses of animal life through a series of epistemic and environmental tensions expressing frictions between the market’s absorptive logic and non-human modes of existence. We describe this set of tensions as ‘feral pharmaceuticalization’ and contend that they offer new perspectives on the analysis of the contemporary pharmaceuticalization process. In addition, such tensions showcase the importance of investigating the expansion of technological markets not only as simultaneous knowledge and milieux (or bodies) making, or as simple science and market hegemonic processes, but also as the construction of new stages of conflict.
  PubDate: 2023-01-07
  DOI: 10.1057/s41292-022-00288-2
Negotiating the necessity of biomedical animal use through relations with
vulnerability
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  Abstract: Abstract In the UK, claims are often made that public support for animal research is stronger when such use is categorised as for medical purposes. Drawing on a qualitative analysis of writing from the Mass Observation Project, a national writing project documenting everyday life in Britain, this paper suggests that the necessity of using animals for medical research is not a given but understood relationally through interactions with inherent vulnerability. This paper stresses the ubiquity of ambivalence towards uses of animals for medical research, complicating what is meant by claims that such use is ‘acceptable’, and suggests that science-society dialogues on animal research should accommodate different modes of thinking about health. In demonstrating how understandings of health are bound up with ethical obligations to care for both human and non-human others, this paper reinforces the importance of interspecies relations in health and illness and in the socio-ethical dimensions of biomedicine.
  PubDate: 2023-01-07
  DOI: 10.1057/s41292-022-00295-3
“It gives me time, but does it give me freedom'”: a contextual
understanding of anticipatory decision-making in social egg freezing
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  Abstract: Abstract The ethics of social egg freezing is a much-debated topic, yet there is limited research using contextual approaches to understand the experiences and decision-making of women that have used this novel assisted reproductive technology. Based on a small-scale qualitative study in Belgium, this article explores how women’s social contexts have an impact on conceptions of time and anticipatory decision-making in relation to social egg freezing. We describe three recurrent themes that we identified in our qualitative study: waiting for the right time, planning and manipulating future time, and ambivalence through medical anticipation. Inspired by the analytical framework of Pierre Bourdieu, we discuss how social egg freezing generates a kind of biocapital for higher educated women within current neoliberal societies. The article also illustrates how women’s decisions are accompanied by feelings of ambivalence, and lasting mismatches between subjective expectations and structural tendencies in the fields of intimate relations, work, and medicine. As such the article contributes to a contextual understanding of normative issues concerning social egg freezing, in particular those related to questions of autonomy.
  PubDate: 2022-12-31
  DOI: 10.1057/s41292-022-00297-1
Epistemology of the side effect: anecdote and evidence in the digital age
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  Abstract: Abstract Through the history of rxisk.org, this article explores some of the Web’s effects on the production and circulation of pharmaceutical knowledge. RxISK is an independent website that solicits reports from patients in order to uncover drug-induced harms which clinical trials and national pharmacovigilance schemes fail to identify. The first part of the article locates the origins of the project in the nearly 15-year struggle to obtain recognition and redress for one particular side effect of selective serotonin reuptake inhibitor (SSRI) antidepressants—their ability to trigger violent or suicidal behavior. That struggle, I show, brought to light the ways in which modern evidence-making practices obscure the harms of pharmacological treatment. The second part, based on interviews with the site’s creators, examines how RxISK’s data collection practices seek to convert the Web from a site for the circulation of misinformation into a usable source of new knowledge about drugs. The project’s originality, I argue, lies in its effort to reframe the relation between anecdote and evidence so as to liberate the patient’s voice from the burden of representativeness. Within this reframed epistemology, the project is also freed from the imperative of large-scale data extraction that increasingly dominates the economy of digital health.
  PubDate: 2022-12-22
  DOI: 10.1057/s41292-022-00293-5
The normal is pathological: semi-conscious brains, mindless habits, and
the paradoxical science of mindfulness
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  Abstract: Abstract The article investigates the recent attempts to create a medical technique and a scientific object of knowledge out of ‘mindfulness’, paying particular attention to the paradoxical implications of these attempts for biosocial theorizing. The author compares the scholarly and non-scholarly works of mindfulness therapists to understand how they introduce their practice to the medical/scientific community and their clients. This comparison reveals that ‘mindfulness’ is translated differently in these two realms, as a bio-neurological process in the former and an ethical practice in the latter. Mindfulness therapy is made possible by the linking together of these different translations, which results in a paradoxical relationship to modern medicine and biosocial disciplines. Whereas in most contemporary biosocial theories, ‘mindless’ (automated) processes are considered as being essential to the ‘normal’ functioning of both biologic and social life, in mindfulness therapy ‘mindlessness’ and socially induced habits are viewed as obstacles to one’s wellbeing. Thus, mindfulness therapy challenges some of the fundamental assumptions of biosocial sciences about ‘normality’, while seeking recognition in the world of those very sciences by adopting their methodology. Ultimately, this paradoxical attitude gives mindfulness therapy a capacity to both serve and resist the biopolitical interests underlying modern therapeutic culture.
  PubDate: 2022-12-19
  DOI: 10.1057/s41292-022-00292-6
Psychedelic innovations and the crisis of psychopharmacology
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  Abstract: Abstract In the 2010s, psychopharmacological research and development experienced a crisis: since no genuinely new drugs for the treatment of mental illness had been successfully developed for decades, major pharmaceutical corporations decided to disinvest their neuropsychopharmacology departments. At the same time, however, one branch of psychopharmacology began to boom. The FDA declared psychedelic-assisted psychotherapy a breakthrough therapy and hundreds of start-up companies began to compete for this potentially emerging health care market. The article looks at the case of psychedelic research to examine three different responses to the innovation crisis in psychopharmacology: (1) the resumption of pharmacopsychotherapy as a half-century old but previously marginalized and discontinued practice; (2) the continuation of self-experimentation as a simultaneously repressed and revitalized method of drug development; (3) computational drug design as a cutting-edge approach currently used to create non-psychedelic psychedelics that reduce psychiatric symptoms without any mind-altering effects. These responses point to conflicting imaginaries of innovation that envisage the future of psychopharmacology and thereby provide different diagnoses of its current predicament.
  PubDate: 2022-12-15
  DOI: 10.1057/s41292-022-00294-4
“Black race”, “Schwarze Hautfarbe”, “Origine africaine”, or
“Etnia nera”' The absent presence of race in European
pharmaceutical regulation
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  Abstract: Abstract Current scholarship on race in Europe has described race as an “absent presence”. However, little is known about the dynamics of the absentness and presentness of race, including how various social processes operating at distinct levels (e.g. supranational and national) influence the uses of race and ethnicity concepts. We begin addressing this gap by examining racialised pharmaceutical regulation in the EU and its operationalisation in European countries. We analysed patterns of English-language uses of race and ethnicity terms at the EU level for all new drugs approved in 2014–2018, and systematically compared official translations into 24 languages. We found that “race” was promoted in plain sight and often retained when translated, albeit with much inconsistency across languages, creating peculiar patterns of presentness and absentness of race. Finnish, French, Swedish, and German stood out, as “race” was often translated into ethnicity terms, but even in those languages, “race” lingered despite claims that these countries vehemently opposed “race”. Our findings should inform scholarly and political debates about race, ethnicity, and medicine in Europe that tend to assume, incorrectly, an anti-racialist consensus. There are also policy implications, because prescribers may interpret regulator-approved information about race and ethnicity differently because of inconsistent translations.
  PubDate: 2022-12-14
  DOI: 10.1057/s41292-022-00291-7
Living in the era of codes: a reflection on China’s health code
system
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  Abstract: Abstract This article offers a critical analysis of China’s health code system, a data-powered pandemic control and contact tracing system that supposedly subjects all individuals in the country to its panopticon control, a surveillance system that monitors and categorises the Chinese population into the healthy (green), the dubious (yellow), and the unhealthy (red). The article highlights the pretence of surveillance as care and the digital divide that normalises discrimination against the elderly and other digitally left-behind population. It also illustrates how, from policy making and technological design to user engagement, the health code system is implemented, optimised, and used in everyday life to meet the needs of the vulnerable population. The health code is better taken as a medium of adaptable and communicative process that can reset the relation between the system and the lifeworld. It is the process of interchange between the system and the lifeworld that deserves our critical attention.
  PubDate: 2022-12-01
  DOI: 10.1057/s41292-022-00290-8
Framing regenerative medicine: culturally specific stories of an emerging
technoscience
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  Abstract: Abstract Civic forms of knowledge, tacitly built around scientific knowledge, reflect culturally specific meanings employed that are put to use in public arenas. Science, technology and society scholarship (STS) has developed a theoretical approach to coproduction of science, and postcolonial science studies critique the universalization of Western epistemologies. The present study extends these perspectives in relation to regenerative medicine in Brazil, examining relevant official documents and the understandings of 15 leaders in the local field about scientific progress, international collaboration and intellectual property rights. The majority of these Brazilian stakeholders hold a techno-deterministic view of scientific progress, and lack any thorough critique of Western scientific premises. While most interviewees ascribe legitimacy to Brazilian public research centres, representatives of civic society organizations express distrust about certain attitudes of local scientists, and criticize the communication of scientific discoveries to the lay public. Furthermore, stakeholders’ reflections on international collaboration are distinctly polarized, reflecting the unequal distribution of roles and power among local indigenous and internationalized actors. Although opposition to exclusive patenting is widespread, limited reflection is apparent on such topics as the role of private capital, cell therapy approval and the specificity of ethical and regulatory frameworks.
  PubDate: 2022-12-01
  DOI: 10.1057/s41292-021-00236-6
“The elephant in the room”: social responsibility in the production of
sociogenomics research
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  Abstract: Abstract Sociogenomics examines the extent to which genetic differences between individuals relate to differences in social and economic behaviors and outcomes. The field evokes mixed reactions. For some, sociogenomics runs the risk of normalizing eugenic attitudes and legitimizing social inequalities. For others, sociogenomics brings the promise of more robust and nuanced understandings of human behavior. Regardless, a history of misuse and misapplication of genetics raises important questions about researchers’ social responsibilities. This paper draws on semi-structured interviews with sociogenomics researchers who investigate intelligence and educational attainment. It does so to understand how researcher’s motivations for engaging in a historically burdened field connect to their views on social responsibility and the challenges that come with it. In interviews, researchers highlighted the trade-off between engaging in socially contested research and the potential benefits their work poses to the social sciences and clinical research. They also highlighted the dilemmas of engaging with the public, including the existence of multiple publics. Finally, researchers elucidated uncertainties over what social responsibility is in practice and whether protecting against the misuse and misinterpretation of their research is wholly possible. This paper concludes by offering ways to address some of the challenges of social responsibility in the production of knowledge.
  PubDate: 2022-12-01
  DOI: 10.1057/s41292-021-00239-3
Beyond controversies in child mental health: negotiating autism and ADHD
diagnosis in France and Brazil
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  Abstract: This article explores the local forms that global controversies around autism and ADHD have taken in France and Brazil. Inquiring into the social and historical features of the two contexts makes the abstract, globally circulating ideas meaningful in particular forms, and helps to transcend dichotomies (global/local, biological/relational, mental suffering/disability) through their pragmatic negotiations and integration into the everyday experience of those affected by the conditions. Our research is based on policy reports and regulations, interviews with policy makers, care and school professionals, families, and observations in mental health-care services. We first present inflamed debates in both countries: while autism wars caused the legitimacy of psychoanalysis to be challenged, debates around ADHD focused on the medicalization of social problems. Both controversies impacted policy orientations, the organization of mental health care, and professional knowledge and practices. We discuss the similarities and differences in these transformations in the two countries. We then examine how these controversies unfolded in local configurations of actors and resources. Finally, we call for reflection on how processes of globalization in mental health and local contexts mutually shape each other.
  PubDate: 2022-12-01
  DOI: 10.1057/s41292-021-00234-8
When data drive health: an archaeology of medical records technology
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  Abstract: Abstract Medicine is often thought of as a science of the body, but it is also a science of data. In some contexts, it can even be asserted that data drive health. This article focuses on a key piece of data technology central to contemporary practices of medicine: the medical record. By situating the medical record in the perspective of its history, we inquire into how the kinds of data that are kept at sites of clinical encounter often depend on informational requirements that originate well outside of the clinic, in particular in health insurance records systems. Although this dependency of today’s electronic medical records on billing requirements is widely lamented by clinical providers, its history remains little studied. Following the archaeology of medicine developed by Michel Foucault in The Birth of the Clinic and expanding his methodology in light of more recent contributions to the field of media archaeology, this article excavates some of the underexplored technological conditions that help constitute today’s electronic medical record. If in some contexts, it is true that data drive health, then an archaeology of medical records helps reveal how health insurance records often impact clinical care and, by extension, health and disease.
  PubDate: 2022-12-01
  DOI: 10.1057/s41292-021-00249-1
Molecular sovereignties: patients, genomes, and the enduring
biocoloniality of intellectual property
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  Abstract: Abstract Monoclonal antibodies are revolutionizing cancer treatments, but come at an increasingly problematic price for health services worldwide. This leads to pressing demands for access, as in the case of Kadcyla. In 2015, patients in the United Kingdom invoked the sovereign rights of the Crown in order to demand access to this expensive yet potentially life-saving medicine that had prior been de-listed due to price. This article interprets this campaign as an act of sovereign reassertion against a fundamental exclusion, which, however, ultimately fails to challenge the concrete mechanism enabling this exclusion—intellectual property (IP). By connecting this example to other declarations of molecular sovereignty, the article argues that the use of sovereignty can perpetuate further exclusion. Drawing on the notion of biocoloniality (Schwartz-Marín and Restrepo 2013) it points out that the intellectual property regime contains a deeply embedded fiction of the world as terra nullius, a blank uninhabited canvas ripe for discovery and appropriation. This decontextualised vision of life as property works to exclude populations and patients from playing a significant role in determining the use of technologies and treatments. Instead of countering this fundamental exclusion, the concept of sovereignty further entrenches this assumption and merely contests the assignation of this property.
  PubDate: 2022-12-01
  DOI: 10.1057/s41292-021-00237-5
How opioids became “safe”: pharmaceutical splitting and the racial
politics of opioid safety
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  Abstract: Abstract This article explores how opioid painkillers, known for over a century to be highly addictive, came to be considered a safe treatment for chronic pain. Based on a critical content analysis of industry-sponsored medical education, biomedical opioid research, and opioid marketing strategy it identifies the unacknowledged racialized category distinctions between ‘pain patients’ and ‘opioid abusers’ that have influenced medical opinion on opioid safety since the 1990s. It develops the concept of pharmaceutical splitting to understand how distinctions between ‘pain patients’ and ‘opioid abusers’ drew on racial and class-based imagery enabling prescribers to reconcile long-standing evidence of opioids’ addictive properties with the argument that they were a safe treatment for common chronic pain. Overall, this article contributes to understandings of the cultural and racial politics of pharmaceutical marketing and commercially-sponsored pharmacology.
  PubDate: 2022-12-01
  DOI: 10.1057/s41292-021-00230-y
‘Braining’ psychiatry: an investigation into how complexity is managed
in the practice of neuropsychiatric research
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  Abstract: Abstract Neuropsychiatry searches to understand mental disorders in terms of underlying brain activity by using brain imaging technologies. The field promises to offer a more objective foundation for diagnostic processes and to help developing forms of treatment that target the symptoms of a specific mental disorder. However, brain imaging technologies also reveal the brain as a complex network, suggesting that mental disorders cannot be easily linked to specific brain areas. In this paper, we analyze a case study conducted at a neuropsychiatry laboratory to explore how the complexity of the human brain is managed in light of the project of explaining mental disorders in terms of their neurological substrates. We use a combination of ethnomethodology and conversation analysis to show how previously assigned diagnostic labels are constitutive of interpretations of experimental data and, therefore, remain unchallenged. Furthermore, we show how diagnostic labels become materialized in experimental design, in that the linking of symptoms of mental disorders to specific brain areas is treated as indicative of successfully designed experimental stimuli. In conclusion, we argue that while researchers acknowledge the complexity of the brain on a generic level, they do not grant this complexity to the brains of individuals diagnosed with a mental disorder.
  PubDate: 2022-12-01
  DOI: 10.1057/s41292-021-00242-8
Deploying nationalist discourses to reduce sex-, gender- and HIV-related
stigma in Thailand
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  Abstract: Abstract There is little research on how nationalism is adopted and deployed to foster but also to challenge sex-, gender- and HIV-related stigma in Thailand and other nation states across Southeast Asia. The available literature highlights how self-help groups for Thai people with HIV function as communities of practice, as sites of learning, and for gaining and preserving knowledge (Tanabe 2008, Liamputtong 2009, 2014). This article contributes to the literature by demonstrating how collectives of same-sex-attracted men and male-to-female transgender people living with HIV (PLHIV) in Thailand learn and teach each other how to alleviate social and personal barriers that impede access to health care. The study adopted qualitative research methods and interviewed 22 participants in five cities in Thailand. This article highlights how collective action, which adopts and reinterprets the symbols and metaphors of Thai nationalism, acts as a ‘deviance disavowal’ strategy (Davis 1961). By deploying Thai nationalism, same-sex attracted men and transgender PLHIV reposition ‘spoiled identities’ and break through the stigma they report after HIV diagnosis. Describing mechanisms of ‘deviance disavowal’ in Thailand may provide an opportunity to deploy strategies to manage stigma that interferes with access to health care in Thailand, and in other nation states, and may be applicable to other stigmatised groups and illnesses.
  PubDate: 2022-12-01
  DOI: 10.1057/s41292-021-00238-4
Adjusting the analytical aperture: propositions for an integrated approach
to the social study of reproductive technologies
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  Abstract: Abstract The ever-expanding availability of reproductive technologies, the continued roll-out of ‘family planning’ and maternity services across low- and middle-income settings and the rapid development of the fertility industry mean that it is more likely than ever that individuals, especially women and gender non-conforming people, will engage with more than one RT at some point in their life. These multiple engagements with RTs will affect users’ expectations and uptake, as well as the technologies’ availability, commercial success, ethical status and social meanings. We argue that an integrated approach to the study of RTs and their users not only makes for better research, but also more politically conscious research, which questions some of the ideological precepts that have led to reproduction being parcelled out into biomedical specialisations and a disproportionate focus on particular forms of reproduction in particular disciplines within public health and social science research. We offer this article as part of a wider movement in the study of reproduction and reproductive technologies, which takes inspiration from the reproductive justice framework to address forms of exclusion, discrimination and stratification that are perpetuated in the development and application of reproductive technologies and the ways in which they are studied and theorised.
  PubDate: 2022-12-01
  DOI: 10.1057/s41292-021-00240-w