The current issue of Medical Anthropology is a special issue, entitled “Diversions of Biomedical Technologies in a Globalized World.” As Claire Beaudevin & Laurent Pordié write in their introduction, “Diversion and Globalization in Biomedical Technologies,” the issue’s seven articles confront a series of questions about the drift, detours, uptake, translation, and off-shoots of biomedical technologies:

How can we analyze the contrast between the original use of a biomedical technology and its new, diverted orientation? Can we ‘measure’ the amplitude of diversions in the light of what local biopolitics consider to be a ‘normal’ use? What is the content of the referential norm, the benchmark: is it made of techniques, morality, experience, explicit regulations? Who decreed it? And thus, who is challenged by the escape from this referential, and why? Is there a difference between diversions that go beyond the scope of biomedicine and those that remain within biomedicine? Are diversions always contesting normative biomedical power and setting up new moral orders? Are they sometimes foreshadowing future legitimate uses?

 

Alignments? X-ray Diversions, Haptics, Credibility—With a ‘Bone-Setting’ Clinic in Hyderabad City

Guy Attewell

In this article, I engage with the diversions of technologies conventionally used for diagnostic scanning among practitioners who perform fracture-reduction and related manual interventions around bodily pain, ostensibly outside the mainstream orthopedic sector, in the city of Hyderabad, south central India. I attend to the performative dimensions of a technology-practice assemblage, and show how enactments of fracture reduction as viable and credible, targeted at establishment orthopedic surgeons, have been enabled through a distributive agency, afforded by scanning technologies. The use of X-rays and other medical scanning technologies by nonbiomedical practitioners have not displaced haptic and other technics of embodied knowledge, but they have been mobilized in order to create wider recognition of the practitioners’ skills. This is a process in which a new configuration of medical practice is constituted.

The Detour of an Obstetric Technology: Active Management of Labor Across Cultures

Irene Maffi

Active management of labor (AML) is an obstetric technology developed in Ireland in the 1970s to accelerate labor in nulliparous women. This technology achieved rapid success in Great Britain and in English-speaking countries outside America, which adopted it before many other states around the world. In this article, I explore AML’s technical and social characteristics when it was first designed, and then examine its local inflections in a Jordanian and a Swiss maternity hospital to shed light on the ways its transnational circulation modifies its script. I argue that its application is shaped by local material constraints and specific sociocultural configurations, gender regimes, and hospital cultures. Finally, I make a comparative analysis of AML practices in these two settings and in the foundational textbook to disentangle the technical and sociocultural components modeling its local applications.

Gendering the Gift of Life: Family Politics and Kidney Donation in Egypt and Mexico

Megan Crowley-Matoka and Sherine F. Hamdy

In this article, we demonstrate how living kidney donation is a particularly gendered experience. We draw on anthropologists’ contributions to understanding the globalization of reproductive technologies to argue that kidney donation similarly endangers and preserves fertility, thereby unsettling and reifying gendered familial labor. Based on fieldwork in two ethnographic sites—Egypt and Mexico—we examine how kidney donation is figured as a form of social reproduction. In both settings, kidney recipients rely almost exclusively on organs from living donors. We focus on how particular gender ideologies—as evident, for example, in the trope of the “self-sacrificing mother”—can serve as a cultural technology to generate donations in an otherwise organ-scarce medical setting. Alternatively, transplantation can disrupt gender norms and reproductive viability. In demonstrating the pervasiveness of gendered tropes in the realm of transplantation, we unsettle assumptions about the “family” as the locus of pure, altruistic donation.

Wayward Relations: Novel Searches of the Donor-Conceived for Genetic Kinship

Maren Klotz

Searching and finding supposedly anonymous sperm donors or half-siblings by diverting direct-to-consumer genetic testing is a novel phenomenon. I refer to such new forms of kinship as ‘wayward relations,’ because they are often officially unintended and do not correspond to established kinship roles. Drawing on data mostly from the United Kingdom, Germany and the United States, I argue that wayward relations are a highly contemporary means of asserting agency in a technological world characterized by tensions over knowledge acquisition. I make the case that such relations reaffirm the genetic grounding of kinship, but do not displace other ways of relating—they are complementary not colonizing. Wayward relations challenge the gate-keeper status of fertility clinics and regulators over genetic knowledge and classical notions of privacy.

Translating Population Difference: The Use and Re-Use of Genetic Ancestry in Brazilian Cancer Genetics

Sahra Gibbon

In the past ten years, there has been an expansion of scientific interest in population genetics linked to both understanding histories of human migration and the way that population difference and diversity may account for and/or be implicated in health and disease. In this article, I examine how particular aspects of a globalizing research agenda related to population differences and genetic ancestry are taken up in locally variant ways in the nascent field of Brazilian cancer genetics. Drawing on a broad range of ethnographic data from clinical and nonclinical contexts in the south of Brazil, I examine the ambiguities that attention to genetic ancestry generates, so revealing the disjunctured and diverse ways a global research agenda increasingly orientated to questions of population difference and genetic ancestry is being used and reused.

Innovations ‘Out of Place’: Controversies Over IVF Beginnings in India Between 1978 and 2005

Sandra Bärnreuther

In 1978, the year the first in vitro fertilization (IVF) baby was born in the United Kingdom, a research team in Kolkata reported that it too had successfully produced an IVF baby in India. However, the claim was dismissed at the time, because the experiment was conducted outside authorized institutions and recognized centers of innovation—in short, because it was an innovation ‘out of place.’ Tracing controversies over the case between 1978 and 2005, I show the importance of space or place in processes of knowledge production and recognition. Further, I explain the initial repudiation and subsequent partial recognition of the claim through shifts in the landscape of legitimate spaces of innovation. By discussing this specific case of the production of science and technology in the Global South, I challenge conventional narratives of diffusion that are prevalent in studies on the worldwide proliferation of reproductive technologies.

Neuromodulation Technologies and the Regulation of Forms of Life: Exploring, Treating, Enhancing

Baptiste Moutaud

Deep brain stimulation (DBS) is one of the most innovative treatments for a range of neurological and psychiatric conditions. As the practice spreads worldwide, this invasive neurosurgical technology has become the subject of major social, scientific, and ethical concerns about its regulation. In this article, I describe its implementation in a French neuroscience ward and the different forms of practice that structure and promote the development and circulation of this neuromodulation technology. I explore how alternative experimental uses of DBS and deviations from its original therapeutic objectives both interfere with and promote its dissemination. At first, it appeared that neuroscientists could use DBS as a powerful tool to create reproducible experimental human models of emotional or behavioral symptoms so as to explore the functions of the human brain in vivo. In parallel, implanted patients influenced the care program by viewing DBS as a potential technology of self-enhancement for a wide range of personal situations. These alternative uses of DBS have challenged its modes of regulation and standardization and have raised new medical, scientific, and moral controversies. These concern not only ethical and methodological norms of medical and scientific practices but also the anthropological tensions raised by the forms of life that are emerging from neuroscience and experimental practices.