Celia Roberts

Ethical implications of home telecare for older people: a framework derived from a multisited participative study

Telecare and telehealth developments have recently attracted much attention in research and service development contexts, where their evaluation has predominantly concerned effectiveness and efficiency. Their social and ethical implications, in contrast, have received little scrutiny.

Calling for Care: ‘Disembodied’ Work, Teleoperators and Older People Living at Home

The provision of ‘distant’ care to older people living at home through telecare technologies is often contrasted negatively to hands-on, face-to-face care: telecare is seen as a loss of care, a dehumanization. Here we challenge this view, arguing that teleoperators in telecare services do provide care to older people, often at significant emotional cost to themselves. Based on a European Commission-funded ethnographic study of two English telecare monitoring centres, we argue that telecare is not ‘disembodied’ work, but a form of care performed through the use of voice, knowledge sharing and emotional labour or self-management. We also show, in distinction to discourses promoting telecare in the UK, that successful telecare relies on the existence of social networks and the availability of hands-on care. Telecare is not a substitute for, or the opposite of, hands-on care but is at its best interwoven with it.

Feminism theorises the nonhuman

We are pleased to offer this Special Issue on the subject of feminism and the nonhuman. Invoking feminism and a nonhuman together raises significant questions for feminist theory and praxis, and each contribution in this issue offers thought-provoking responses to these questions, often inciting further queries. The issue has three parts: an interchanges section, a conversation and articles. The three interchanges pieces – by Eleanor Casella and Karina Croucher, Debra Ferreday, and Nicole Vitellone – resulted from a workshop held in the Centre for Gender and Women’s Studies at Lancaster in July 2010 on ‘Feminism and the Non-Human’. Speakers presented short papers and participants debated the significance of the nonhuman to feminist theory. This workshop also generated a list of questions, which we then sent to two leading scholars, Elizabeth A. Wilson (author of Affect and Artificial Intelligence, 2010) and Vicki Kirby (author of Quantum Anthropologies: Life at Large, forthcoming) for consideration. The questions they reflected upon in their ensuing conversation focused on the nature of contemporary critique, the significance of issues pertaining to women and sex/ gender in relation to the nonhuman, and the status of scientific knowledge within feminist theory. We also asked Kirby and Wilson to situate their responses in relation to their most recent work. Finally, the articles published here by Tora Holmberg, Sarah Kember, Rebecca Scott, and Lucy Suchman, resulted from a Call for Papers on feminism and the nonhuman. We thank all the reviewers of these exchanges, conversations and papers, and especially Jackie Stacey whose insights and expertise were invaluable to this project throughout.

Puberty in Crisis: The Sociology of Sexual Development

Puberty has long been recognised as a difficult and upsetting process for individuals and families, but it is now also being widely described as in crisis. Reportedly occurring earlier and earlier as each decade of the twenty-first century passes, sexual development now heralds new forms of temporal trouble in which sexuality, sex/gender and reproduction are all at stake. Many believe that children are growing up too fast and becoming sexual too early. Clinicians, parents and teachers all demand something must be done. Does this out-of-time development indicate that childrens futures are at risk or that we are entering a new era of environmental and social perturbation? Engaging with a diverse range of contemporary feminist and social theories on the body, biology and sex, Celia Roberts urges us to refuse a discourse of crisis and to rethink puberty as a combination of biological, psychological and social forces.

Installing Telecare, Installing Users Felicity Conditions for the Instauration of Usership

This article reports on ethnographic research into the practical and ethical consequences of the implementation and use of telecare devices for older people living at home in Spain and the United Kingdom. Telecare services are said to allow the maintenance of their users’ autonomy through connectedness, relieving the isolation from which many older people suffer amid rising demands for care. However, engaging with Science and Technology Studies (STS) literature on “user configuration” and implementation processes, we argue here that neither services nor users preexist the installation of the service: they are better described as produced along with it. Moving beyond design and appropriation practices, our contribution stresses the importance of installations as specific moments where such emplacements take place. Using Etienne Souriau’s concept of instauration, we describe the ways in which, through installation work, telecare services “bring into existence” their very infrastructure of usership. Hence, both services and telecare users are effects of fulfilling the “felicity conditions” (technical, relational, and contractual) of an achieved installation.

Early puberty, ‘sexualization’ and feminism

Early onset puberty is increasingly prevalent among girls globally according to many scientists and clinicians. In the medical and scientific literature early sexual development is described as a problem for girls and as a frightening prospect for parents. News media and popular environmentalist accounts amplify these figurations, raising powerful concerns about the sexual predation of early developing girls by men and boys and the loss of childhood innocence. In this article the author frames one feminist approach to early puberty, arguing that feminist theorists should both take scientific work around population changes in sexual development seriously and use their critical skills to unpick and challenge the discourses constituting early development as a matter of concern. The author suggests that contemporary academic and policy debates on the ‘sexualization’ of girls have important resonance for critical explorations of early puberty. These debates currently pay little attention to the physiological aspects of sexual development and could be enriched by so doing. As in the case of ‘sexualization’, issues of class, racialization and agency are central to understanding and challenging normative concerns about girls’ early sexual development.

Getting bigger : children's bodies, genes and environments

Any discussion of genetics is inevitably bound up in discourses of nature – a morally laden concept which is heavy with normative meaning. To do something ‘naturally’ (conception, childbirth, weight loss) is to do it the way it should be done. ‘Natural’, then, elides easily with ‘normal’; it is, as Evelyn Keller (2008: 119) articulates, ‘both a fact and a value’. But what is deemed ‘natural’ can also be understood as something that happens without intervention or environmental infl uence, facilitating the pairing of ‘nature’ with its alliterative opposite, ‘nurture’ – what Francis Galton described as ‘the environment amid which the growth takes place’ (Galton, cited in Keller, 2008: 122). Genetics has provided a primary site for exploring the relationship between nature and nurture; indeed, Keller describes genetics as ‘the central discourse of the nature-nurture controversy’ (Keller, 2008: 121), with nature/nurture forming a fundamental division that is commonly conceptualized as ‘an appropriate starting point’ (Keller, 2008: 122) for aetiological investigations into a range of problematized bodily conditions. Keller argues that the enduring equation of genetics with nature that underpins this ‘starting point’ obscures a much more fundamental question about ‘what is beyond or outside of nature’ (Keller, 2008: 117–24). That is, that which is deemed not natural can be allocated either to the ‘non-natural’ (ie ‘outside or beyond nature, the physical, the internal or the spontaneously formed’ (Keller, 2008: 122–2)) or to the ‘unnatural’ (that which ‘fails to conform not simply to nature per se, but the norms (or expectations) of specifi c natures’ (Keller, 2008: 123)). This connection to the ‘unnatural’, we argue, opens up a space for thinking about the normative or moral context within which demarcations between nature and nurture (genetics and environments) are drawn, and ensuing material (often clinical) interventions developed. Keller’s interrogation of what is included within ‘nurture’ in the naturenurture equation signals a core feature of attempts to delineate genes and environments in disease causation – the expansiveness of the category of

Evolutionary psychology, feminism and early sexual development

As other pieces in this Interchanges section demonstrate, campaigners and social analysts protesting the ‘sexualisation’ of girls claim that contemporary media and popular toys and clothes are stripping children of their inherent sexual innocence and exposing them to modes of age-inappropriate sexuality through clothing, toys, music and electronic and printed media. Such exposure, analysts suggest, produces a range of negative effects for girls including problematic body image and depression and renders them more vulnerable to unwanted sexual contact with teenagers and adults (Bailey, 2011; Graber, Brooks-Gunn and Warren, 1999; Papadopoulos, 2010; Rush and La Nauze, 2006). Feminist critics argue that appeals to childhood innocence are both historically and geographically specific and themselves limiting for children. Descriptions of the sexualising effects of media and consumer objects such as toys and fashion, they contend, falsely figure girls as passive and naive consumers and potential sexual victims (Bray, 2008; Driscoll, this volume; Egan and Hawkes, 2008; Harris, 2005; Hawkes and Egan, 2008; Renold and Ringrose, 2011). As I have recently argued, with few exceptions the public and academic framing of these debates focuses attention on the social aspects of growing up, leaving aside consideration of the biological processes of becoming adult (Roberts, 2013). Although bodies feature in this literature, these tend to be performed, social bodies (wearing particular clothes, dancing, ‘behaving’): physiological bodies are

Tanner's puberty scale : exploring the historical entanglements of children, scientific photography and sex

Globally, increasing numbers of children are thought to be going through early onset puberty. This much debated fact leads to significant concerns about young people’s sexualities, as early developers are thought to be more likely to engage in early sexual activity. Underpinning historical, national and subpopulation (including ‘racial’) comparisons is a standard measurement tool: the Tanner Scale of sexual development. The scale is based on James M. Tanner and R.H. Whitehouse’s ground-breaking longitudinal study of children’s growth undertaken in London between 1949 and 1971. This article explores the largely over-looked and under-theorized significance of the scale’s history, arguing that the study’s focus on children living in an English care institution and its material practices of documenting their growth, including photography, has important ethical and scientific implications for understanding sexual development as a bio-psycho-social process.

Biosensing: how citizens’ views illuminate emerging health and social risks

This article explores material from a citizen’s inquiry into the social and ethical implications of health biosensors. In ‘Our Bodies, Our Data’ a space was afforded for members of the public to examine two forms of health biosensing, and for the authors to research what happens when such examination shifts from the domain of experts to that of citizens. Drawing on data from this inquiry, which form part of a wider research project, ‘Living Data: making sense of health biosensors’, we open up conceptual and methodological questions about how to study innovative health technologies and contribute to debates about the direction of health biosensing by bringing forward the views of a group rarely heard in this domain: the public. The panel of 15 participants was shown examples, handled devices and heard evidence about the development of home ovulation monitoring and direct-to-consumer genetic testing. Citizens identified key areas of concern around the development, design and marketing of these devices, implicating technology companies, public bodies and civil society organisations. The panel articulated serious concerns relating to ethics, trust, accountability, quality and governance of health biosensors that operate ‘outside the clinic’. Their deliberations reflect concern for what kind of society is being made when genetic testing and home reproductive technologies are promoted and sold directly to the public. The panel process allowed us to re-imagine biosensors, wresting their narratives from the individualising discourses of self-optimisation and responsibilisation which have dominated their introduction in Euro-US markets.