Annemarie Mol

Ontological politics. A word and some questions

This is a chapter that asks questions about where we are with politics now that actor network theory and its semiotic relatives have reshaped ontology. They have reshaped it by underlining that the reality we live with is one performed in a variety of practices. The radical consequence of this is that reality itself is multiple. An implication of this might be that there are options between the various versions of an object: which one to perform? But if this were the case then we would need to ask where such options might be situated and what was at stake when a decision between alternative performances was made. We would also need to ask to what extent are there options between different versions of reality if these are not exclusive, but, if they clash in some places, depend on each other elsewhere. The notion of choice also presupposes an actor who actively chooses, while potential actors may be inextricably linked up with how they are enacted. These various questions are not answered, but illustrated with the example of anaemia, a common deviance that comes in (at least) clinical, statistical and pathophysiological forms.

Situating Technoscience: An Inquiry into Spatialities

This paper explores the spatial characteristics of science and technology. Originally seen as universal, and therefore outside space and place, studies in science, technology, and society (STS) located it first in specific locations—laboratories—and then in narrow networks linking laboratories. This double location implied that science is caught up in and enacts two topological forms—region and network—since objects in networks hold their shape by freezing relations rather than fixing Euclidean coordinates. More recent STS work suggests that science and technology also exist in and help to enact additional spatial forms. Thus some technoscience objects are fluid, holding their form by shifting their relations. And yet others achieve constancy by enacting simultaneous absence and presence, a topological possibility which we call here fire. The paper concludes by arguing that the ‘global’ includes and is enacted in all four of these topological systems.

Embodied Action, Enacted Bodies. The Example of Hypoglycaemia.

We all know that we have and are our bodies. But might it be possible to leave this common place? In the present article we try to do this by attending to the way we do our bodies. The site where we look for such action is that of handling the hypoglycaemias that sometimes happen to people with diabetes. In this site it appears that the body, active in measuring, feeling and countering hypoglycaemias is not a bounded whole: its boundaries leak. Bits and pieces of the outside get incorporated within the active body; while the centre of some bodily activities is beyond the skin. The body thus enacted is not self-evidently coherent either. There are tensions between the body’s organs; between the control under which we put our bodies and the erratic character of their behaviour; and between the various needs and desires single bodies somehow try to combine. Thus to say that a body is a whole, or so we conclude, skips over a lot of work. One does not hang together as a matter of course: keeping oneself together is something the embodied person needs to do. The person who fails to do so dies.

Proving or Improving: On Health Care Research as a Form of Self-Reflection

As it is, clinical trials are the gold standard of health care research, employed to prove that the care practices they study are good. Here, the author suggests that we would do better to develop research methods that work toward another goal: to improve care practices. This requires that we no longer foreground the effectiveness but, instead, investigate the various effects of interventions. If undesirable, they might then be tinkered with. As a part of this, the effects on bodily parameters and on the intricacies of daily lives should not be separated out but studied in connection. With examples drawn from studies into care practices for patients with diabetes or atherosclerosis, the author argues that instead of trying to turn the clinic into a laboratory, we should strive to support and strengthen clinical ways of working.

The Actor-Enacted: Cumbrian Sheep in 2001

This chapter analyses the question of agency considering the animal agency of Cumbrian sheep in the uprising of foot-and-mouth disease in the UK in 2001. The article explores the conditions required for an actor to be able to act as such. In that direction it shifts the usual meaning of the concept of actor separating it from the anthropocentric model and making it distant from the ideas of “intentionality” and “dominance” to emphasise how actors not only act, but they are habilitated and produced as such as a result of complex relations with other actors. That is, to become actors they have to be enacted. To do so, the article analyses some of the multiple forms in which Cumbrian sheep were enacted in the context of the uprising of foot-and-mouth disease in 2001. Finally the article considers what types of agency perform the Cumbrian sheep in each of them.

Mind your plate! The ontonorms of Dutch dieting

In the Netherlands as elsewhere, the overriding message of most dieting advice is that a person who wants to lose weight needs to overrule the desires of her craving body. Her mind has to put itself in a sovereign position and make ‘good choices’ about what to eat. But there are many ways of doing so. Linking up with different traditions within nutrition science, different dieting techniques enact different versions of food and concern themselves with different bodies. The ideals they strive after and the dangers they warn against are different, too. In short, they incorporate different ontonorms. At the same time, in all the ‘mind your plate’ advice, however varied, bodies figure as endowed with a nature that is problematic under the present cultural circumstances. This is in contrast with advice to ‘enjoy your food’, that targets a body that is not naturally given, but deserves to be cultivated. As I bring out the details of the discrepancies between the ontonorms embedded in different kinds of dieting advice, the term ‘ontonorms’ serves as a methodological tool. It helps to focus the analysis. But this article does not provide a ‘theory of ontonorms’, instead it argues for theoretical fluidity and specificity.

Food matters : arguments for an ethnography of daily care

In public debates about the desirability of force feeding in the Netherlands the inclination of people with dementia to refrain from eating and drinking tends to be either taken as their gut-way of expressing their will, or as a symptom of their disease running its natural course. An ethnographic inquiry into daily care, however, gives a quite different insight in fasting by relating it to common practices of eating and drinking in nursing homes. In a nursing home eating and drinking are important social activities that may be shaped quite differently. And while necessary for survival, food and drink also have other qualities: taste, temperature, texture, smell. Whether we want it or not, in the end we all die. But with different modes of care come different modes of dying and of living.

Dealing with in/dependence: doctoring in physical rehabilitation practice

By now, the laboratory tradition, crafting transportable knowledge that allows for comparison, has been amply studied. However, other knowledge traditions, notably that of the clinic, deserve further articulation. The authors contribute to this by unraveling some specificities of rehabilitation practice. How do laboratory and clinical traditions in rehabilitation relate to independence? The first seeks to quantify peoples independence; the latter attends to qualitatively different ways of being independent. While measuring independence is a matter of aggregating scores on a priori established dimensions, clinical rehabilitation concerns coordinating different ways of being independent. While independence scales map a linear development in time, rehabilitation participants juggle with time, including uncertain futures in their present. In clinical practice, then, independence is neither a single, coherent, fact nor a clear-cut, stable goal. Instead, professionals as well as patients work by creatively doctoring with the large variety of elements that are relevant to daily life with long-term disabilities.

Living with diabetes: care beyond choice and control

Diabetes is managed via a regimen of control. Physicians advise adults living with type 2 diabetes to control blood sugar levels by controlling diet, maintaining regular exercise, and complying with medication. The extent to which individuals are able to adhere to such recommendations varies. In this article, we explore lay perceptions of diabetes and its control, drawing on data from an ethnographic study conducted in Bangkok, Thailand. Between August 2001 and February 2003 the first author spent time with twelve man and women living with type 2 diabetes, their spouses, children and health providers. An additional 21 people were interviewed to extend the data and test for generalisibility. It was found that individual explanations of control, and adherence or resistance to medical advice, are interpreted and adapted in ways consistent with Buddhist philosophy and Thai norms that govern everyday life. Notions of moderation and cultural values of being and behaving, and ideals of interaction, provide a philosophical basis and practical guidelines for control.

Boundary Variations: An Introduction

This introduction to a themed section of Society and Space explores some of the implications that boundaries are enacted rather than given.