Simon Carter

The facts about fictions and vice versa: public understanding of human genetics

How does one draw the boundary between scientific fact and science fiction? As is well-known, this seemingly innocent question belies the complex inter-weavings—and the co-constitution—of the ‘factual’ and the ‘fictional’. For example, over recent years there has been a growth in popular dramas that use developments in the biomedical sciences as central features of their narratives. In many of these dramas the actual content of biomedical knowledge is often little more than a theatrical prop to the psychology of the main protagonist—who has the potential to use knowledge in the furtherance of either good (e.g. The Citadel, 1938, Dr. Finlays Case Book, 1962) or harm (e.g. Frankenstein, 1931). More recently, fictional products, while still using the personality of the medical scientist as a narrative device, have attempted to depict some of the content of the biomedical sciences and associated technologies. For example, the film Gattaca (1997) portrayed a future world obsessed with genetic screening and pre-implantation genetic diagnosis—technologies that have been available for the last 10 years. Indeed, the producers of the film made use of genetics consultants to ‘make sure the science wasn’t absurd’. Originally the film contained a final segment, cut from most versions on general release, that returned the viewer from a ‘fictional’ future to a ‘factual’ past. Stills of modern heroes such as John F. Kennedy and Albert Einstein were shown to emphasis that these individuals might never have been born into a world keen to eliminate all inherited ills. The final on-screen message was to be ‘of course, the other birth that may never have taken place is your own’. After test screenings and focus groups with lay people, this segment of the film was cut because audiences were left feeling ‘personally attacked’ as genetic defectives (Science, 1997).

Pathological Lives: Disease, Space and Biopolitics

Pandemics, epidemics and food borne diseases have, for some at least, become key challenges for contemporary global society. They threaten progress in global health, compromise food security, and, along with climate change and global terrorism, seem to usher in a state of emergency and a radically uncertain future. The central claim of Pathological Lives is that any solution offered to these kinds of emerging and often communicable diseases requires a broad–based geographical scrutiny. The book marks an empirically and theoretically informed contribution to a world seemingly under constant microbiological threat, drawing together and extending empirically based geographical scholarship in human–environment relations, science and society, more than human geographies and spatial theory to understand and evaluate efforts at making life more secure. The focus is on the food and farming sector, where the generation and subsequent transmission of disease can reach pandemic proportions. The authors review current approaches to biosecurity or making life safe within those sectors, analyse underlying drivers and logics to existing programmes and ask whether the resulting solutions can succeed. They follow farmers, retailers and regulators, amongst others, asking how pathological lives can be successfully regulated without making life more dangerous as a result.

The domestication of an everyday health technology: A case study of electric toothbrushes

Using the electric toothbrush as an example, this article examines the growing acceptability of domestic health technologies that blur the traditional boundaries between health, aesthetics and consumption. By using empirical material from individual and household interviews about people’s oral health practices, this research explores the relationships between an everyday artefact, its users and their environments. It investigates the ways in which oral health technologies do, or do not, become domesticated in the home environment. We conclude that the domestication of oral health technologies is not inevitable, with the electric toothbrush often becoming an ‘unstable object’ in the domestic setting.

Leagues of sunshine: sunlight, health and the environment

This chapter explores how, during the 1920s and 1930s, a variety of forces came into play to weave sunlight, as a giver of health, into the fabric of social environments. The use of sunlight, both natural and artificial, was already well-established as a therapy that had been prevalent in Europe since the late nineteenth century.1 The growth of sunlight therapy, however, expanded greatly in the early part of the twentieth century, with heliotherapy (natural sunlight) being used to treat tuberculosis and actinotherapy (via sunlamps) deployed to combat rickets.2 These therapeutic applications, applied in sanatoria and clinics, helped establish an association between sunlight and health. The growth in the use of such sunlight therapies was partially based on the idea of ‘nature’ being curative of the diseased body.3 However, this idea of nature as curative and enhancing health was also being found in non-clinical developments in this period and these helped to produce equivalence between health and the desire to introduce sunlight into the environments used for living and working. It is these developments that this chapter will consider.

Doctors in space (ships): biomedical uncertainties and medical authority in imagined futures

There has been considerable interest in images of medicine in popular science fiction and in representations of doctors in television fiction. Surprisingly little attention has been paid to doctors administering space medicine in science fiction. This article redresses this gap. We analyse the evolving figure of ‘the doctor’ in different popular science fiction television series. Building upon debates within Medical Sociology, Cultural Studies and Media Studies we argue that the figure of ‘the doctor’ is discursively deployed to act as the moral compass at the centre of the programme narrative. Our analysis highlights that the qualities, norms and ethics represented by doctors in space (ships) are intertwined with issues of gender equality, speciesism and posthuman ethics. We explore the signifying practices and political articulations that are played out through these cultural imaginaries. For example, the ways in which ‘the simple country doctor’ is deployed to help establish hegemonic formations concerning potentially destabilising technoscientific futures involving alternative sexualities, or military dystopia. Doctors mostly function to provide the ethical point of narrative stability within a world in flux, referencing a nostalgia for the traditional, attentive, humanistic family physician. The science fiction doctor facilitates the personalisation of technological change and thus becomes a useful conduit through which societal fears and anxieties concerning medicine, bioethics and morality in a ‘post 9/11’ world can be expressed and explored.

Commentary: Facts, opinions and affaires du coeur

It is now over 30 years since Michael Marmot began his comment article with the provocative quotation ‘. . . these are the opinions on which I base my facts . . .’. Here Marmot identifies a central tension found in many branches of the sciences: namely, how is it possible to evaluate and choose between the competing theories or hypotheses that often seek to explain the same phenomena? A concern that is more germane than ever: he asks if, despite all their scientific trappings, the decisions taken by scientists are not simply based on the irrational and the intuitive. And, as Marmot points out, this is not merely an academic argument, it has significance for understanding the causes of disease that are of deep importance to a wider public. He uses a case study of coronary heart disease (CHD) to suggest an answer to the thorny question of how to choose between competing theories. Four accounts, taken from the philosophy of science, were chosen to shed light on this issue: the inductive view; the Popperian view of science; the theories of Lakatos; and Kuhn’s account of revolutionary science. The inductive view, that once sufficient ‘facts’ are gathered a ‘correct’ theory will emerge, was dismissed as essentially hollow—theories do not emerge fully formed from the dry dust of facts and the ‘history of science commonly gets reconstructed from an inductive viewpoint’. The Popperian view that theories are tested by attempts to falsify them, while more attractive is equally doomed because it is always possible to save a theory by the presentation of an ‘auxiliary hypothesis’. Marmot finds the remaining two accounts of science to be more productive. The Kuhnian view is that in periods of ‘normal science’ the work of most scientists consists of tinkering and problem solving—in other words adding footnotes to an established ‘paradigm’. Periods of revolutionary science, in contrast, are marked by the accumulation of anomalies and the breakdown of an existing paradigm and the emergence of a new one. This new scientific knowledge would, according to Kuhn, be ‘incommensurate’ with the old paradigm—like all revolutions those on the losing side would not even be able to comprehend what had overtaken them. Whereas this view may throw light on some developments in scientific knowledge, it is doubtful if it has much to offer in terms of understanding debates concerning CHD—as these, from a Kuhnian point of view, largely represent problem solving within the ‘normal science’ of epidemiology. Indeed, periods of revolutionary science probably occur rather infrequently (one such example might be the increasing influence of modern epidemiology on medicine and public health policy in the 20th century). Marmot finds that the theories of Lakatos provide the most compelling aid to judging between competing research findings. In this view, an account can be retained as long as it remains progressive—a theory that encounters anomalies can be thought of as progressive as long as these point towards new empirical observations. Thus, using Marmot’s example, if one believes a causal factor in CHD is fat intake and one discovers a group with a high fat intake but low levels of CHD, it might indicate that not all types of fat cause disease. In other words, this anomaly points towards a new empirical observation that might allow the theory to remain progressive. This theory, Marmot argues, is a valuable insight from the philosophy of science because it provides some practical help in choosing between competing explanations. One of the central arguments running through the Marmot article is that scientists in general and epidemiologists in particular, can learn valuable lessons from studying the history and philosophy of science. In the period since his article appeared, many anthropologists and social scientists have increasingly turned their attentions towards the natural sciences and scientific practices and given birth to a new sub-discipline—science and technology studies. What insights might be now be added to complement Marmot’s call to take ‘philosophic speculations’ seriously? One of the first is that the nature of knowledge production and consumption has increased quantitatively and altered qualitatively since the mid-1970s— for example, the World Wide Web did not exist in any meaningful way before the 1990s. It is now no longer Department of Sociology, The Open University, Milton Keynes, UK. E-mail: s.d.carter@open.ac.uk Published by Oxford University Press on behalf of the International Epidemiological Association

Green Development: Environment and Sustainability in the Third World

1. The Dilemma of Sustainability 2. The Origins of Sustainable Development 3. The Development of Sustainable Development 4. Sustainable Development: The Rio Machine 5. Mainstream Sustainable Development 6. Countercurrents in Sustainable Development 7. Environment, Degradation and Sustainability 8. The Environmental Costs of Development 9. The Political Ecology of Sustainability 10. Sustainability and Risk Society 11. Mainstreaming Environmental Risk 12. Sustainable Development from Below 13. Green Development: Reformism or Radicalism?