The October issue of Social Studies of Science 42(5) features several articles about health care and scientific research in such sites as the U.S., U.K., China, Japan, South Korea, Taiwan, and the Netherlands. Katie Ann Hasson’s article, “Making appropriate ‘stick’: Stabilizing politics in an ‘inherently feminist tool,’ examines the project and politics of medical appropriation among lay healthworkers at a feminist clinic in which medical technologies and knowledge have been appropriated by lay women. Sonja Jerak-Zuiderent’s article, “Certain uncertainties: Modes of patient safety in healthcare,” argues that the common mode of conceptualizing patient safety, which centers on reducing uncertainty to prevent errors, is problematic and sometimes “unsafe.” By contrast, she argues that errors are not always opposed to safety and that “a crucial dimension of knowing and acting in healthcare settings is to accept a degree of uncertainty…” Based on ethnographic work with research ethics committees in the U.K., Adam Hedgecoe, in an article entitled “Trust and regulatory organisations: The role of local knowledge and facework in research ethics review,” argues that “interpersonal trust is crucial to regulatory decision-making and intimately bound up with the way in which these oversight bodies work…” such that they contribute to the “trust-based nature of the scientific community.” Finally, “Governance of stem cell research: Public participation and decision-making in China, Japan, South Korea, and Taiwan,” by Margaret Sleeboom-Faulkner and Seyoung Hwang, compares “public” participation in bioethical governance of human embryonic stem cell research across these four Asian nations, and argues for a fuller understanding of public debates about science.
Additionally, this issue contains two more articles: O’Reilly, Jessica, Naomi Oreskes and Michael Oppenheimer. “The rapid disintegration of projections: The West Antarctic ice sheet and the intergovernmental panel on climate change.” And, Faulkner, Alex. “Law’s performativities: Shaping the emergence of regenerative medicine through European Union legislation.”
The following is a select sample of abstracts from this month’s issue of Sociology of Health & Illness 34(7), which features 10 original articles and 4 book reviews.
Leggatt-Cook, Chez and Kerry Chamberlain. “Blogging for weight loss: personal accountability, writing selves, and the weight-loss blogosphere.”
Abstract: Body weight is a key concern in contemporary society, with large proportions of the population attempting to control their weight. However, losing weight and maintaining weight loss is notoriously difficult, and new strategies for weight loss attract significant interest. Writing about experiences of weight loss in online journals, or blogging, has recently expanded rapidly. Weight-loss bloggers typically write about daily successes and failures, report calorie consumption and exercise output, and post photographs of their changing bodies. Many bloggers openly court the surveillance of blog readers as a motivation for accountability to their weight-loss goals. Drawing from a sample of weight-loss blogs authored by women, we explore three issues arising from this practice of disclosing a conventionally private activity within an online public domain. First, we examine motivations for blogging, focusing on accountability. Secondly, we consider the online construction of self, exploring how weight-loss bloggers negotiate discourses around fatness, and rework selves as their bodies transform. Finally, we consider the communities of interest that form around weight-loss blogs. This ‘blogosphere’ provides mutual support for weight loss. However, participating in online social spaces is complicated and bloggers must carefully manage issues of privacy and disclosure.
Funk, Laura, et al. “Legitimising and rationalising in talk about satisfaction with formal healthcare among bereaved family members.”
Abstract: While there is a fair amount of knowledge regarding substantive features of end of life care that family members desire and appreciate, we lack full understanding of the process whereby family members formulate care evaluations. In this article we draw on an analysis of interview data from 24 bereaved family members to explicate how they interpret their experiences and formulate evaluations of end of life care services. Most participants wove between expressing and legitimising dissatisfaction, and qualifying or diffusing it. This occurred through processes of comparisons against prior care experiences and expectations, personalising (drawing on personal situations and knowledge), collectivising (drawing on conversations with and observations of others) and attempting to understand causes for their negative care experiences and to attribute responsibility. The findings suggest that dissatisfaction might be diffused even where care is experienced negatively, primarily through the acknowledgement of mitigating circumstances. To a lesser extent, some participants attributed responsibility to the ‘system’ (policy and decision-makers) and individual staff members. The findings are discussed in relation to the theoretical understanding of satisfaction and evaluation processes and how satisfaction data might inform improvements to care quality.
Mik-Meyer, Nanna and Anne Roelsgaard Obling. “The negotiation of the sick role: General practitioners’ classification of patients with medically unexplained symptoms.”
Abstract: In encounters between general practitioners (GPs) and patients with medically unexplained symptoms (MUS), the negotiation of the sick role is a social process. In this process, GPs not only use traditional biomedical diagnostic tools but also rely on their own opinions and evaluations of a patient’s particular circumstances in deciding whether that patient is legitimately sick. The doctor is thus a gatekeeper of legitimacy. This article presents results from a qualitative interview study conducted in Denmark with GPs concerning their approach to patients with MUS. We employ a symbolic interaction approach that pays special attention to the external validation of the sick role, making GPs’ accounts of such patients particularly relevant. One of the article’s main findings is that GPs’ criteria for judging the legitimacy of claims by those patients that present with MUS are influenced by the extent to which GPs are able to constitute these patients as people with social problems and problematic personality traits.
Montgomery, Catherine. “Protocols and participatory democracy in a ‘North-South’ product development partnership.”
Abstract: Global product development partnerships (PDPs) for new health technologies have become an increasingly important part of the science and development landscape over the past two decades. Polarised positions are adopted by those scrutinising the power and governance of these public–private formations; on the one hand, they are seen as successful social technology innovations, on the other as regressive and imperialistic regimes of neo-colonialism. Answering recent calls for research to examine the actors, governance, context and dynamics of PDPs, this article presents a sociological case study of one particular partnership, the Microbicides Development Programme (MDP). Interviews were conducted with a cross-section of programme staff in the UK and Zambia, and discourses analysed through a Foucauldian lens of governmentality. This article suggests that two tools of government were central to MDP’s cohesiveness: institutional discourses of participatory democracy and capacity building and scientific protocols. Through these material-semiotic tools, the scientific community, junior operational researchers and the funder were successfully enrolled into the programme and governed by a central body based in the UK. This article draws on Nikolas Rose’s work to discuss these socio-scientific discourses as technologies of government, and provides a non-dualistic account of power and governance in a North–South PDP.
Social Science & Medicine Vol 75(7) features a review article – entitled “Social Welfare and the Affordable Care Act: Is it ever optimal to set aside comparative cost?” by Duncan Mortimer and Stuart Peacock. In addition, this volume includes several articles that examine place-based and/or economic influences on health; see articles by Claire Scodellaro, et al., Christopher Browning, et al., Akseli Aittomaki, et al. There is also an article concerning associations between social networks and depressive symptoms among sexual minority youth (Hatzenbuehler et al.), and an article examining media constructions of aging and cosmetic surgery that produce a “will to youth” (Smirnova).
Among the 26 articles in Vol 75(8) are an article on “living and dying with frailty” in old age; an article about perceptions of genetics and stigma among people with eating disorders; a paper investigating the potential harm to ethnic groups of genomics research in Africa; a study of the effects of socioeconomic status on modern and traditional care services in Ghana; and an analysis of same-sex marriage laws and sexually transmitted infections. In addition, a few articles examine issues related to child health/illness: Davison, et al.; Schmeer; and Warren, et al.
This month’s issue of Psychosomatic Medicine includes articles on the physiological, psychological, and/or cognitive aspects of depression, pain, bulimia, and bipolar disorder, as well as articles concerning the physical and emotional effects of different kinds of trauma.
Philosophy, Ethics, and Humanities in Medicine features two open access articles: one research article about the “cultures of care” in a psychiatric service; and a commentary article examining the political pressures and ethical dilemmas faced by practitioners in Bahrain and Syria as they treat political demonstrators.