Daniel R. Morrison

Two large‐scale surveys on community attitudes toward an opt‐out biobank

Although US research regulations allow for de‐identified biorepositories to be developed without formal informed consent from the patients whose samples are included, it is unknown whether this model will be well‐received by community members. Based on early evidence that such a biobank could be successful if patients who object have the opportunity to opt‐out, Vanderbilt University developed a biorepository named BioVU that follows this model. This study reports the findings from two large‐scale surveys among communities important to this biorepository. In the first, a population‐based phone survey of Nashville residents, we found that approval for BioVU is high (93.9%) and that this approval is similar among all population groups. A hypothetical biobank that does not obtain some form of written permission is much less well received. In the second, an online survey of Vanderbilt University faculty and staff, we found a higher level of support for BioVU (94.5%) among faculty and staff working throughout the university. In this survey, employees least likely to approve of BioVU are those employees who prefer not to receive medical care at Vanderbilt University. These surveys demonstrate the highest level of approval for a genomic biobank ever reported in the literature, even among groups traditionally cautious about such research. This high level of approval may reflect increasing comfort with genomic research over time combined with the effect that trust in a specific institution can have on approval for an operating biobank compared with approval of a hypothetical biobank.

Medical Sociology and Technology: Critical Engagements:

In this selective review of the literature on medical sociology’s engagement with technology, we outline the concurrent developments of the American Sociological Association section on medicine and advances in medical treatment. We then describe theoretical and epistemological issues with scholars’ treatment of technology in medicine. Using symbolic interactionist concepts, as well as work from the interdisciplinary field of science and technology studies, we review and synthesize critical connections in and across sociology’s intellectual relationship with medical technology. Next, we discuss key findings in these literatures, noting a shift from a focus on the effects of technology on practice to a reconfiguration of human bodies.We also look toward the future, focusing on connections between technoscientific identities and embodied health movements. Finally, we call for greater engagement by medical sociologists in studying medical technology and the process of policy-making—two areas central to debates in health economics and public policy.

Insurgent Images: Genre Selection and Visual Frame Amplification in IWW Cartoon Art

The Industrial Workers of the World (IWW, aka ‘Wobblies’) developed a rich, extensive movement culture. Focusing on one genre – cartoons – within the Wobbly cultural arsenal, we extend social movement theory in two interrelated ways. First, by asking why Wobblies were attracted to cartoons as a key cultural form of insurgent media, we open the question of genre selection for social movement scholars. In this, Wobblies deployed cartoon art extensively because it was a form widely available in prevailing popular culture, corresponded well with IWW oppositional culture, and fitted nicely with production, circulation, and consumption considerations. Second, we ask what sort of work cartoons performed for this movement. We highlight the use of visual arts of protest as an important vehicle for extending movement framing work and develop the concept of visual frame amplification. Drawing on more than 300 IWW cartoons printed in the Industrial Worker between 1909 and 1913, we show that Wobblies used cartoons to amplify movement framing in ways that capitalized on the special features of the visual, in general, and cartoons, in particular, to (1) visually personify and concretize abstract ideas; (2) visually dramatize movement ideology, grievances, goals, and tactics; and (3) narrate features of struggle in a compact visual form. Visual caricature and parody provided additional cultural value-added that went beyond both the visual and framing to produce images that were at once uplifting, entertaining, and politically–culturally revolutionary in intent. In general, the cultural form through which movement framing is performed structures and generates genre-specific qualities not apprehended by framing theory or social movement scholarship generally.

Patient awareness and approval for an opt-out genomic biorepository

AIM In this study, we sought to assess patient awareness and perceptions of an opt-out biorepository. MATERIALS & METHODS We conducted exit interviews with adult patients and parents of pediatric patients having their blood drawn as part of their clinical care at Vanderbilt University Medical Center (TN, USA). RESULTS 32.9% of all patients and parents of pediatric patients report having heard of the opt-out biorepository, while 92.4% approve of this research effort based on a brief description. Awareness that leftover blood could be used for research increased among adult patients during the study period, from 34.3 to 50.0%. CONCLUSION These findings will inform ongoing assessments of the suitability of opt-out and opt-in methods as alternatives to written informed consent for inclusion in a biorepository.

Exploring Layers of Meaning with Deep Brain Stimulation Patients

preferences if they change?). The solution of Müller and Christen is to propose a contingent advance directive policy and, more broadly, to bracket these concerns over autonomy by stating that “the ethically decisive question is not whether DBS can alter the personality or not, but whether it does so in a good or bad way.” By default, the answer may come to depend on clinical indication: In DBS for PD with predominantly motor symptoms, clinicians will tend to implicitly privilege the patient’s preoperative personality as more authentic and rational than the postoperative, which is suspicious for a pathological component; in DBS for depression, the reverse will hold true. The dissemination of any more nuanced view will require a public discourse between neurosurgeons and ethicists. As scientific advances in DBS enable treating more patients for more neuropsychiatric conditions, there will be a concomitant impetus for our community to drive the development of neuroethical guidelines and the thoughtful application of philosophy to the everyday concerns of patient autonomy and informed consent.

Postracial Fantasies and the Reproduction of Scientific Racism

In a highly controversial paper published in Hypatia, a leading journal of feminist philosophy, Rebecca Tuvel (2017) defends the concept of transracialism, exploring the potential parallels between...

The Missing Empirical Studies of DBS Recipients' Views of Self

In “I Miss Being me: Phenomenological Effects of Deep Brain Stimulation,” Gilbert and colleagues (2017) have written an important empirical article, offering readers insight into the phenomenon of self-estrangement that some patients experience after they receive the implant. I wish to focus on two significant claims: first, that postoperative neuropsychiatric changes are underdescribed in the literature, and second, that their interviews with 17 deep brain stimulation (DBS) recipients will help remedy this by focusing on the dimensions and drivers of selfestrangement among certain patients. While the authors effectively summarize and cite relevant literature on the phenomenology of DBS effects on identity, including self-estrangement, their engagement with the social science literature in this area is itself underdeveloped. Much of this work places deep brain stimulation and its effects on self and identity in a broader framework. For example, Moutaud’s work on the globalization of DBS (2016), and Moutaud’s previous work (2011; 2015) deploys 4 years of ethnographic research in a French academic hospital unit dedicated to research and practice in clinical neuroscience, including deep brain stimulation, for a variety of motor and psychiatric disorders. Across these papers, Moutaud describes several DBS patients who experienced both rapid improvement in symptoms and unwanted effects such as agitation, atypical levels of energy or lethargy, new and impulsive romantic interests, and the like. In the pediatric context, Gardner (2016) has described a broad clinical gaze that works as a form of disciplining power, shaping both affect and ways of interpreting self after DBS. Gardner, Samuel, and Williams (2015) describe how medical professionals frame potential outcomes from DBS surgery in the pediatric context, often dampening overly optimistic expectations of parents and some children. Sch€ upbach, Gargiulo, and Welter (2006) reported on repeated, unstructured interviews with 29 adult DBS recipients for Parkinson’s disease. Despite improvement in motor symptoms, their study revealed feelings of estrangement, loss of interest, and other psychosocial and social adjustment difficulties that mirror many of Gilbert and colleagues’ findings. My research, including an open peer commentary on M€ uller and Christen’s work on DBS for Parkinsonian patients in this journal (Morrison and Bliton 2011; Morrison 2012), has been devoted to the empirical study of the effects of this intervention on self-identity, affect, and the interaction between implant effects, drug effects, and disease progression. Interdisciplinary medical teams often confront challenges when modifying device settings, altering drug dosages, and assessing disease states among DBS recipients. My dissertation research included interviews with patients pre and post implantation and ethnographic observations at a major university medical center of a multidisciplinary medical team that evaluated patients for surgery. In my analysis of over 30 monthly meetings, I developed a typology of DBS treatment effects that can guide our analysis of Gilbert and colleagues’ findings, and account for the nearly 40% of respondents whose narratives could not be accounted for as either restorative or deteriorative estrangement. In what follows, I present the typology and suggest its relevance for understanding unwanted treatment effects such as the self-estrangement that Gilbert and colleagues discuss. In order to do so, I draw upon the concept of transparency as developed by Ihde in Technology and the Lifeworld: From Garden to Earth, where he writes of “technics embodied” (1990). The term refers to the ways in which material objects, such as our cars, seem to become one with our bodies, such that while driving sports cars, we say that we can “feel the road” in a more immediate way than when compared to, say, in a minivan. In this and other cases, the material object seems to work best when it is unobtrusive. How much more is this the case with an object that is implanted within the body? To capture both desired and unwelcome outcomes post DBS surgery, I also develop the notion of “treatment effects,” which include symptom reduction and psychosocial and personal identity disruptions that follow DBS implantation in time. Refusing to label such treatment effects in the standard biomedical ways (such as “side effects”) allows the analyst to ask more specific questions about how such effects are experienced by DBS recipients. The typology given in Table 1 categorizes treatment effects by implant transparency and symptom visibility. In this table, implant transparency is high when its operations are imperceptible or barely noticeable. Implant transparency is low when patients attribute difficulties in their movement, psychosocial, or behavioral symptoms to the implant, or when the implant as material object interferes

Imperial Technoscience: Transnational Histories of MRI in the United States, Britain, and India

evaluate Wake County within a larger context. Their local data collection provides evidence for their main hypothesis that links public support for neighborhood schools versus diversity to issues of social capital. Briefly stated, lower-income families are burdened with work and commuting demands and find that neighborhood schools help them to manage these demands. In contrast, more affluent households with ‘‘more modest work commitments, strong social networks, and greater trust in government are more likely to have the resources to be accepting of diverse schools and the costs they may bring’’ (pp. xiv–xv). This perspective frames the issues very differently from the way they were presented in the national media at the time. Recall that this was a period when a conservative wing of the Republican Party was ascendant in the House of Representatives and many state legislatures, and stories about their influence in school boards were common. In Parcel and Taylor’s account, though there was inevitably a strong liberal-conservative ideological dimension in the Wake County school board elections, other practical concerns were in play. There had been rapid population growth in the district in the previous two decades, straining budget resources and requiring new schools. With new schools came new attendance zones, so another concern related to neighborhood schools was a continual churning of children’s school assignments. Indeed, when the liberals regained control of the school board in 2011, they focused on stability in school assignments and support for low-performing schools more than on socioeconomic diversity. The End of Consensus is a relatively short book focused mainly on a specific time and place. It is especially successful in demonstrating the complexity of diversity issues in schools and moving beyond the political rhetoric within which public discussion of these issues is often presented. It could be effectively used as a supplementary reading in courses on race and ethnicity, public policy, and education. Imperial Technoscience: Transnational Histories of MRI in the United States, Britain, and India, by Amit Prasad. Cambridge, MA: MIT Press, 2014. 232 pp.

Intersections of Disability Studies and Critical Trauma Studies: A Provocation

39.00 cloth. ISBN: 9780262026956.