Monica J. Casper

Constructivist Perspectives on Medical Work: Medical Practices and Science and Technology Studies Introduction

John Scrove, an oncologist, looks up to his patient, Ms. Martin. She has widely disseminated breast cancer and has decided to accept John’s suggestion to undergo bone marrow transplantation treatment as a last resort. In this therapy, bone marrow is collected from the patient’s pelvic bone and deep frozen. Then the patient is treated with massive doses of chemotherapy; it is hoped that this will kill the tumor cells. Chemotherapy, however, is a blunt tool; the bone

Reframing and Grounding Nonhuman Agency What Makes a Fetus an Agent

Agency: The power of actors to operate independently of the determining constraints of social structure. The term is intended to convey the volitional, purposive nature of human activity as opposed to its constrained, determined aspects. —Harper Collins Dictionary of Sociology, 1991 The concept that the fetus is a patient, an individual whose maladies are a proper subject for medical treatment as well as scientific observation, is alarmingly modern. It was not until the last half of this century that the prying eye of the ultrasonographer rendered the once opaque womb transparent, letting the light of scientific observation fall on the shy and secretive fetus. —M. R. Harrison “The Fetus as a Patient: Historical Perspective”

At the margins of humanity: fetal positions in science and medicine.

This article offers a comparative analysis of experimental fetal surgery and fetal tissue research. The author argues that fetuses are positioned differently across each set of practices, with significant implications for actors in these domains. By empirically charting the ways in which humanity is or is not attributed to fetal work objects, the authors argument challenges contemporary debates in science studies that tend to conceptualize human and nonhuman in dualistic terms. This analysis instead shows the heterogeneous attribution of these categories, as well as the spaces, margins, and positions, which constitute them as distinct.

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.

Global Intimacies: Innovating the HPV Vaccine for Women's Health

According to the Pan American Health Organization’s Silvana Luciani, “New technologies for cervical cancer prevention are revolutionizing public health.” Yet the vaccine for human papillomavirus (HPV) is contested, in part because it evokes politics of contagion that foreground intimate transmissibility (Casper and Carpenter 2008). As a preventive technology, the vaccine promises to reduce rates of cervical cancer by controlling the spread of the causal agent, infectious HPV. It is already reshaping sexual politics and health care relations in the United States and is poised to similarly alter public health practices globally. This essay examines the HPV vaccine’s impact on transnational women’s health, specifically its role in the emergence and consolidation of nongovernmental organizations (NGOs) focused on women’s sexuality and reproduction, its impact on cervical cancer screening, and expectations it arouses regarding pandemic HIV. A tangible object that makes and remakes people, things, and places (Helmreich 2003), the HPV vaccine joins a long list of technologies that have reconfigured health care practices and intervened in women’s health. The birth control pill, for example, fundamentally altered bodies, sexual relations, gender politics, and cultural meanings of reproduction (Watkins 1998). A twenty-first-century technology, the HPV vaccine is being introduced into a clinical, cultural, and geopolitical landscape profoundly shaped by modernist yet shifting notions of sex, gender, embodiment, contagion, health, progress, and empire. Specifically, the vaccine builds on and challenges unequal relations among women across geopolitical zones and between nationstates. The technology mediates this fractured—and fractious—landscape in important ways and facilitates new biopolitical practices and forms of social organization. In tracking transnational migrations of the vaccine, we draw upon Foucault’s notion of biopolitics and on feminist science and technology studies. gLObAL inTimACies: innOVATing The hpV VACCine FOr WOmen’s heALTh

A Tale of Two Technologies HPV Vaccination, Male Circumcision, and Sexual Health

This article brings insights from feminist science and technology studies to bear on recent public debates over the human papillomavirus (HPV) vaccine, which prevents many cervical cancers, and male circumcision as potential HIV preventive. In the United States, attempts to mandate HPV vaccination have activated intense concerns about female “promiscuity,” whereas talk of promoting circumcision against HIV has triggered scant anxiety about American boys’ sexuality. The authors show how intersections among gender, sexuality, race, and age have shaped responses to these two containment technologies—and how the technologies’ deployment both relies on and reproduces meanings of gender and sexuality that constitute the omnipresent “double standard.” The analysis develops an original feminist sociology of containment, explicating how social relations shape the innovation, reinvention, and use of technologies to contain particular sorts of bodies, fluids, and sexual practices—by whom, under what conditions, and for what purposes.

Inscribing Bodies, Inscribing the Future: Gender, Sex, and Reproduction in Outer Space:

This paper examines the ways in which gender, sex, and reproduction in the U.S. space program are represented as social, cultural, and scientific problems. In 1992, a married couple served on the crew of a U.S. space shuttle, prompting a flurry of public curiosity and controversy over the possibility of “celestial intimacy” between these astronauts. Ironically, countless missions prior to this historic flight had not raised similar issues of human desire and fecundity, attesting to the “legitimacy” of the heterosexual paradigm. Drawing on a range of data sources and theoretical perspectives, we analyze discourses and practices through which female bodies in particular are constructed as problematic, a gendered process which, in turn, renders sexuality and reproduction in space as controversial. We argue that contemporary institutional, cultural, and scientific accounts of gender, sex, and reproduction in space inscribe both contemporary and future scenarios, with potentially negative implications.

Preface: Special Issue: Ethnography and Disability Studies

D isability studies is one of the most vibrant interdisciplinary fields in the academy today, offering fresh and compelling insights into important and long-neglected aspects of social, cultural, and political life. Whereas there have been many excellent ethnographies related to disability and/or health and illness, and whereas disability has emerged as an important theme in other ethnographies such as those related to new technologies, the time has come to bring disability studies and ethnography together. That is, critical conversations among ethnographers of disabilities are needed, conversations woven of various threads that engender theoretical elaboration of the category of disability while also interrogating the ethnographic project. In the Call for Papers for this special issue, authors were asked to explore some aspect of disability studies using ethnographic methods or to reframe and challenge ethnographic methods through the lens of disability studies. In this framework, disability is recognized as a social construction made intelligible via social, cultural, and political processes. This contextual definition is indebted to disability studies perspectives that stand in direct contrast to biomedical models that locate disability in the body. As disability studies scholar Rosemarie Garland Thomson (1997, 6) puts it,

Culpability, social triage, and structural violence in the aftermath of Katrina

Hurricane Katrina and its effects are often talked about in terms of what has been made visible, as if the hurricane swept through and stripped away our structural blinders along with the levees, revealing social disparities within. Here, we focus instead on whom and what Katrina and its aftermath have rendered invisible. We are concerned with how the seen and the not seen have influenced the ways the purported tabula rasa of New Orleans has been (re)constructed and marked since 2005. We engage with recent debates in political science about power, agency, structure, and culpability, arguing that efforts to prioritize the pursuit of culpability over critique in power analyses, such as the approach advocated by Steven Lukes, risk perpetuating structural violence. We employ the concepts of an ocular ethic and social triage to understand why the storm of the century that was supposed to reveal all has in the end left much concealed, with shocking levels of human devastation unaddressed. Only through careful excavation of the ruins can we begin to comprehend the sedimented inequality and layers of vulnerability that structure violence.

A Response to the Motion Picture Talladega Nights: The Ballad of Ricky Bobby

Synopsis: National Association for Stock Car Auto Racing superstar Ricky Bobby (Will Ferrell) and his racing partner and best friend Cal Noughton Jr. (John C. Reilly) win at all costs, in positions #1 and #2, respectively. That is, until flamboyant French Formula One driver Jean Girard (Sacha Baron Cohen) challenges the duo and threatens to supplant their racing dynasty. A dramatic wreck, complete with invisible fire and Ricky Bobby stripping down to his underpants, forces the beleaguered racer to confront what his winning record has cost him. After returning to his childhood home, his stern but loving mother (Jane Lynch) and long-absent badass father (Gary Cole) challenge him to question whether his multimillion-dollar endorsements, McMansion, Barbiesque wife, and cheeky kids represent what being a winner is really all about.