Somatosphere welcomes you to the first part of December edition of “In the Journals.” Scroll through our monthly round up of new research across anthropology, STS and social science journals.
When decolonization is hijacked
Alpa Shah
This article asks how we should reconceptualize decolonization when it is hijacked by authoritarian/fascist forces. It focuses on the notorious Bhima Koregaon case in India in which 16 intellectuals/human rights defenders from across the country were imprisoned without trial as alleged terrorists. It shows how, on the one hand, decolonization is hijacked by the Hindu authoritarian regime and, on the other hand, colonial artifacts are resymbolized by the colonized to oppose oppression by native elites. It urges attention to the questions of who is mobilizing the language of decolonization and why. It argues that the most important anticolonial intellectuals may not use the language of decolonization and may not be in universities, but on the streets, with social movements, and in prison. It proposes that contemporary decolonization debates center processes of domination and oppression created by the state and global capital nexus, processes that are cultural, psychological, political, and economic. These processes are shown to entrench casteist/racist hierarchies, work through Indigenous elites, and create internal differentiation within marginalized communities, eschewing a unitary concept of indigenous ontology/cosmopolitics/worldviews. Calls for an emancipatory politics, such as that of decolonizing anthropology or the university, would be well placed to center these global processes and local nuances.
Calibrating care: Family caregiving and the social weight of sympathy (tình cảm) in Vietnam
Tine M. Gammeltoft
This article explores family caregiving in Vietnamese households affected by type 2 diabetes. Drawing on existential phenomenology and on fieldwork conducted in northern Vietnam, I develop the concept of care calibrations as a tool to understand how family members respond socially and morally to the needs for care that diabetes confronts them with. The concept of care calibrations highlights how chronic care is undertaken as an ethical endeavor within domestic environments characterized by multiple care needs. The article explores how caregivers find their bearings in complex care situations by looking toward dominant moral standards while also adjusting pragmatically to the contingencies of domestic lives, placing themselves in others’ situations. On this ethnographic basis, the article calls for more sustained anthropological attention to the social implications of human capacities for sympathetic co-living and particularly to the intermediate realm between selves and others where capacities for moral imagination reside.
The presence of abandonment: Left to live at the borderland of Lampedusa
Alessandro Corso and Nayanika Mookherjee
Drawing from the extensive literature on the anthropology of borders and border death in and beyond Europe, this article ethnographically explores the processes through which irregular migrants and locals at the borderland of Lampedusa (south of Sicily, Italy) are left to live and die in abandonment. In the process, we highlight the distinct and antagonistic yet shared sense of neglect that both migrants and locals experience in their everyday lives on the island and explore the relationship between abandonment, the everyday, and the law, showing how these are interwoven. By including both irregular migrants and locals in Lampedusa in our analysis, the article importantly establishes how abandonment occurs not in the absence but in the indeterminacy of the law and highlights a chronic failure of the law toward life (deemed as legal and illegal). It moves beyond traditional anthropological critiques on state presence and absence, showing how abandonment pervades everyday life within and beyond borders.
An ethnography of joy: Entrepreneurship among Latinx communities in East Los Angeles
Yana Stainova
How do people living at the intersection of various forms of injury seek out collective experiences of joy? I explore this question through fieldwork with Latinx female and queer artists and entrepreneurs, some of them undocumented, who consciously seek out and enact joy in their communities in East Los Angeles. At the same time, these communities face gentrification, racism, and discrimination. I rest on joy as a conceptual framework that arises out of the analysis and theorizing of my interlocutors, who choose to push back against mainstream representations of their communities as exclusively defined by their suffering. This approach, or what I call “an ethnography of joy,” draws our attention to what joy does in a particular context, how it becomes politically meaningful, and how it intersects and interacts with other phenomena. For example, in this article, I explore the more capacious idea of joy through a particular angle that emerged in my ethnographic research: entrepreneurship, or small business ownership. A focus on entrepreneurship allows me to explore how my interlocutors summon the forces of neoliberalism to seek social mobility, belonging, and community activism.
Discerning personhood through lena-dena: Disability professionals, ethics, and communication
Shruti Vaidya and Michele Friedner
This article looks at practices of discernment in disability spaces in India by analyzing (hierarchical) relational contexts in which disability professionals and disabled people in India interact. We argue that discernment, which we explore through lena-dena (giving and taking), allows us to analyze the ethical stakes of processes of communication, interpreting, and facilitation. Vaidya analyzes how special educators make broad discernments about intellectually disabled people by interpreting their unconventional and nonlinguistic communicative cues. In contrast, Friedner examines how speech and language therapists that work with deaf children make narrow discernments regarding what counts as language and perform the labor of training deaf children to communicate in the normatively correct way—that is, using speech. While disability professionals produce specific kinds of personhood for disabled people through their practices of discernment, they also end up discerning themselves in the process as professionals with difficult yet rewarding jobs. We conclude by discussing a program for individuals with intellectual disabilities where both authors conducted ethnographic research wherein disability professionals discerned disabled people as having social needs and desires on par with nondisabled people and created enabling environments, scaffolded activities, and facilitated conversations to produce and enable complex personhood for them.
Toward an anthropology that cares: Lessons from the Academic Carework project
Nikky Greer PhD, Jill Fleuriet PhD, Rebecca Galemba PhD and Sallie Han PhD
Anthropologists’ cross-cultural studies of kinship, gender, and caregiving have shown how care is fundamental to the human experience. Ironically, anthropologists have been relatively silent about the caregiving we ourselves do. To understand these experiences, we conducted an online survey (N = 492), seven focus groups (N = 31), and seven in-depth interviews of anthropologists in various career stages. We use the term “academic carework” both to describe labor made invisible through caregiving and to recognize caring relations that structure our academic work. We show how carework challenges are experienced along axes of race, gender, class, sexuality, age, and precarious academic status, underscoring how anthropology reproduces itself as a privileged space in the context of the deterioration of working conditions in the neoliberal academy. We proceed to illustrate how the prevailing institutional strategy of temporary accommodation temporally confines caregiving experiences that are ongoing and compounding. An accommodation approach encourages caregivers to interpret structural problems as individual struggles and to discipline themselves accordingly, even as they critique its neoliberal underpinnings. We offer recommendations to address the impacts of carework on professional trajectories. More broadly, however, we look to new anthropologies of care for inspiration to imagine a more inclusive anthropology.
Anticipating and suspending: the chronopolitics of cryopreservation
Thomas Lemke
The article brings together two disparate and so far largely disconnected bodies of research: the critical analysis of cryopreservation technologies and the debate on modes of anticipation. It starts with a short review of the state of the research on the concept of cryopolitics. In the next part I will suggest two revisions. I will problematize the idea of latent life and the focus on potentialities that have been central to the research on cryopolitics so far, proposing to shift the analytic frame to suspended life on the one hand and to modes of anticipation on the other. I argue that cryopreservation practices are part of contemporary technologies of anticipation. They are linked to a politics of suspension by mobilizing a liminal biological state in which frozen organisms or biological material are neither fully alive nor ultimately dead. This seeks to avert and/or enable distinctive futures by extending temporal horizons and keeping vital processes in limbo.
Suspending life, controlling change: cryotechnology, genetic identity, and ecological separation
Leon Wolff
The collection and freezing of plant seeds in gene banks has been an integral part of global biodiversity policy since the early twentieth century. In recent years, the use of cryopreservation technologies (the storage of biological material at temperatures as low as −196 °C) has been advocated as a complement to these strategies. This technology promises that it will be possible to freeze significantly more plant varieties for longer periods of time. The article draws on scientific publications to analyze the current discourse on cryopreservation technology in the field of agricultural plant conservation. It underpins and intensifies biopolitical trajectories that have been inherent in ex situ conservation from the outset. First, cryotechnology submits to a pure line ontology which frames living beings as having an intrinsic genetic identity, and aims to secure this genetic identity against unplanned changes. Second, cryopreservation is linked to an imaginary of ecological separation that implies the idea that biodiversity can ultimately be preserved without a habitat. The article concludes by pointing to the material limitations and unsolved problems cryotechnologies inevitably face.
The politics of suspension suspended: the curious case of a cryopreserved cell product
Ruzana Liburkina
Following recent discussions around suspended life, this paper focuses on an endeavor that sought to arrest biological material in time and space and render it available on demand. It depicts the attempt to establish a collection of cryopreserved donated cells. The study offers rare insights into how this initiative was at odds with familiar politics significant in its field, those of innovation and preparedness, and therefore was suspended itself. In identifying parallels with accounts of unsuccessful biobanks, the paper makes a case for the analytical value of considering ill-fated projects of suspension along with those that prosper and attract public attention. The case of a novel cryo-collection, in particular, demonstrates how the idea and practice of suspension only gathers political momentum when it serves other well-established rationales. As such, it prompts two important conclusions. First, the power to arrest life as it comes with cryotechnologies is much more likely to unravel in entrenched constellations than to carry transformative or disruptive potential. Second, however, the paper also exemplifies that projects of suspension are not necessarily doomed to serve hegemonic ways of governing life. It advocates for preventing such mismatches from falling into oblivion.
Sara Lafuente-Funes
This piece analyzes the way in which women that froze, are considering freezing or are freezing their eggs in Spain think critically about broader reproductive politics in Spain and about assisted reproduction. Drawing partially on previous studies around egg freezing, Thomas Lemke has suggested that cryopreservation practices represent a “politics of suspension” characterized by both reversibility and disposition, and concomitant with broader political inaction (Lemke in Sci Technol Hum Values 48(4):1–27, 2021). Drawing on feminist literature, and on how some of these women think about motherhood, it is relevant to emphasize this ‘suspension of politics’ that takes place along with a “politics of suspension,” meaning that certain matters (such as reproduction and its postponement) are only to be dealt with privately and individually, through marketized fertility preservation programs in this case. Some of the women interviewed describe these programs as useful tools within a problematic context: technologies that give time in a context that leaves them on their own to figure out motherhood (or its absence) in the midst of uncertainty and loneliness. This paper shows their critical views on these matters, while reflecting on how their experiences and desires become increasingly imbricated with the fertility industry in the making of their reproductive biographies (Perler and Schurr in Body Soc 27(3): 3–27, 2021).
Cell freezing and the biology of inexorability: on cryoprotectants and chemical time
Hannah Landecker
What can’t freezing hold still? This article surveys the history of substances used to protect cells and organisms from freezing damage, known as cryoprotectants. Dimethyl sulfoxide (DMSO) has since 1959 been the most widely used of these agents in cryopreservation. Here, its evolution from pulp and paper waste byproduct to wonder drug to all-but-invisible routine element of freezing protocols is used to trace the direct arc from protection to toxicity in theories of how and why cryoprotectants work, from the 1960s to today. The power of these agents to simultaneously protect and degrade is shown to reside in manipulation of chemical time via hydrogen bonding and electron exchange, thereby reframing freezing as a highly active and transformational process. Countering long-held assumptions about cryopreservation as an operation of stasis after which the thawed entity is the same as it was before, this article details recent demonstrations of effects of cryoprotectant exposure that are nonlethal but nonetheless profoundly impactful within scientific and therapeutic practices that depend on freezing infrastructures. Understanding the operationalization of chemical time in the case of cryoprotectants is broadly relevant to other modern technologies dedicated to shifting how material things exist and persist in human historical time.
Afterword: the politics of suspension as an analytical gestalt switch
Klaus Hoeyer
This collection of articles describes how cryopreservation enables particular imaginaries about ‘suspending time’ thereby creating what Lemke terms “a principle of whenever.” These imaginaries come to shape both intimate personal choices relating to fertility, organizational and commercial investments, research and regulatory investments in equipment and risk assessments, as well as major societal prioritizations of ecological conservation. Taken together, these articles thus unfold how mundane freezing technologies interact with profound societal changes and impact everyday lives. The politics of suspension almost seems to circumvent the political or substitute the political with ‘cooling,’ and yet these articles illustrate how these dynamics do not erase politics, but call for new analytical awareness to identify the political stakes. Taken collectively, the articles also illustrate inspiring approaches to three productive tensions running through much scholarship in Science and Technology Studies (STS)—tensions between technological and social determinism; technology optimism and pessimism; and between a focus on micro- and macro-practices. In doing so, the articles can be said in various ways to do the important work of a gestalt switch: shifting our attention from the well-known politics in the foreground to the tacit politics in the background. With this commentary, I suggest that the dynamics they explore can be productively viewed as instances of the ‘infrastructuring’ of the futures available.
The Wrestler and His World: Precarious Workers, Post-Truth Politics, and Inauthentic Activism
Gregory Hollin
In this article, I explore attempts to organize a precarious workforce in a setting that is always-already post-truth: professional wrestling. I focus in particular on a nascent, bottom-up unionization effort in the UK that foregrounds the rights of wrestlers who perform for low wages, in unsafe environments, and in the absence of both the state and traditional trade unions. I show that while many wrestlers agree with this movement’s diagnosis of problematic working conditions, there is also widespread skepticism about activists’ motivations, with many wrestlers suggesting that the organization may be telling a self-interested story about work, rather than engaging in a form of work. I argue that wrestlers’ permanent questioning emerges at the intersection of the self-appreciating, entrepreneurial subject and the post-truth, zany situation and conclude that wrestling affords insight into labor organization under employment conditions emblematic of a contemporary post-truth neoliberalism.
The Afterlife of Sacrifice in the Kurdish Movement
Esin Düzel
What happens when sacrifice is imagined in terms of a debt that can be repaid? In the ongoing conflict begun in 1984 between the Kurdistan Workers’ Party and the Turkish state, Kurdish revolutionary discourse has characterized death as the required price for liberation. After 2002, a shift away from revolutionary violence and an increase in civil politics with more diverse actors allowed for public recognition of sacrifice other than death. This ethnography in Diyarbakır conceptualizes “the afterlives of revolutionary sacrifice” to unearth the multiple temporalities of revolutionary struggle. Rather than viewing sacrifice through the lens of the revolutionary sacred, the article rethinks revolution through the vulnerabilities, relationships of care, and hopes that such temporalities entail. It highlights the afterlives of sacrifice to complicate the traditional narratives of heroism and martyrdom, sheds light on everyday struggles, affects, and relationships, and questions how we value sacrifice for political change.
Resisting Alternative Images: An Ethnography of Visual Disinformation in Brazil
Mihai Andrei Leaha and Roger Canals
The battle against disinformation played a key role during the Brazilian presidential elections of 2022. Supporters of Jair Bolsonaro—and, to a much lesser extent, of Luiz Inácio Lula da Silva—generated and disseminated deceptive and false “informative content” to influence public opinion. To counter the spread of fake news, different initiatives emerged. Based on a multimodal and hybrid ethnography, this essay discusses different modes of resistance to what we call “alternative images.” This term refers to intentionally misleading images with a deceptive referential value that are presented as accounts or reliable metaphors of reality. We describe three modes of countering these misleading images visually: public demonstrations, artistic interventions, and fact-checking agencies. Each one has its own modes of visual assessment and political intervention. The article argues for the importance of carrying out ethnographies of disinformation, capable of contributing to actual efforts against disinformation and alternative facts, along the lines of public and engaged critical anthropology.
“Too Much” Sand, Not Water: A Geostory of Himalayan Riverine Sediments as “Problem”
Saumya Pandey
This article examines how a future about surplus sand entered river-engineering vocabulary as an obstruction to the free flow of Himalayan river systems. It is a historical and ethnographic analysis of sand’s conceptualization as a catastrophic material that caused rivers to spill over, which became conducive to its removal from rivers for economic endeavors. Sand holds a unique place in society, it’s the foundation on which roads, bridges, and buildings are built. Today, a shortage of these sediment particles has been described as a moment of economic and environmental crisis. Against the grain of sand’s desirability and shortage as a resource material, I pay close attention to the destructive articulations of the Himalayan earthly forces that made the political economy of extracting excess sand possible.
Remembering Place: The Temporality of Trauma in Rudraprayag After the 2013 Flash Floods
Gideon Thomas Mathson
The 2013 flash floods reproduced an everyday that was textural, the returning past of the event combined with gestures from within the everyday, to disorient survivors of the event. I attempt in this essay to analyze the return of the event as producing psycho-spatial affects, drawn from the psyche’s own propensity to return while repressing the event that causes the return, described within psycho-analytic literature as “afterwardsness.” Such afterwardsness is conditioned by the sheer incomprehensibility of environmental change that took place in just three days in the Mandakini Valley between June 15 and June 17, 2013. Following the flood, delays with the recovery process, and particularly with the process of compensation, exacerbate this trauma, leading to an extension of the temporality of trauma infinitely forward.
Good Bureaucrats and God: The Ethical Labor of the Public
Maira Hayat
Bureaucracies are typically studied for lessons in structural violence, anti-politics, failures of law, and as foils to the ethical. I, however, argue that they constitute uniquely important sites to theorize the ethical. Conceptualizing ethical labor as a modality of everyday bureaucratic work, I examine this labor as it enrolls law, God, and vernaculars of work, and takes the form of public-private distinction-making. The article expands the anthropology of bureaucracy, ethics, and Islam by going beyond showing that public-private distinctions are immanent to modern secular power, arguing instead that they are actively labored for in everyday bureaucratic work. As a result, who they favor or menace is a function of specific political-legal and historical lineages.
Dissonance: Cartooning in Iran, Humor, and the Study of Things That Don’t Match
Mirco Göpfert
This essay, drawing on research with cartoonists in Iran, explores cartooning as a distinctive mode of engaged knowing through drawing and humor. By unraveling the cartoonists’ capacity to perceive, compose, and amplify dissonance, the study reveals a practice that intertwines perceptive sensitivity, analytical skill, and moral commitment. Embracing dissonance through cartooning and humor not only provides new perspectives on the political present in Iran and beyond but also offers a peculiar mode of knowing the uncomfortable—studying things that don’t match. Unlike cartooning, anthropology seldom embraces humor, yet both share a capacity for navigating dissonance. Humor as an aesthetic and ethical practice can open unconventional paths for research and commitment, providing a means and audacity to understand the unknowable—all with a spirit of humility and critique.
Cristian Montenegro
In Chile, a long and oppressive military regime (1973–1990) dismantled emergent initiatives for the deinstitutionalisation of psychiatric care, imposing a neoliberal constitution that opened public services to market forces and limited the state’s role in health and social care. After being associated with communism and socialism, community-based mental health work was banned, and socialist psychiatrists were silenced through torture or exile. However, some therapeutic initiatives persisted, such as the “Protected Commune” (PC) initiative within the El Peral psychiatric asylum. The PC attempted to mimic a real town inside the asylum’s gated perimeter. It featured an ecumenical chapel, a school, and various “council” departments like recreation, education, waste, economy, and health. Paths received names, wards became districts, and patients and workers were assigned new, democratic roles, all while the authoritarian regime entirely controlled the “outside” world. The initiative ceased with the return of democracy in 1990. Deemed an eccentric and negligible episode, the PC is often seen as an interruption to the radical community-based experiences of the pre-dictatorial era. Drawing on archival research and oral history interviews with participants, this paper examines how the PC harnessed the notion of community to navigate the complex socio-political landscape of the dictatorship. Differing from established accounts of the political uses of psychiatry under authoritarianism, the study positions the PC as a prism for understanding the contradictory ways in which the idea of ‘community’ has been able to transcend radically opposed social and political regimes, becoming a core feature in the vocabulary of mental health reform, despite its ambiguities.
Vaishali V. Raval, Baiju Gopal, Pankhuri Aggarwal, Miriam Priti Mohan, P. Padmakumari, Elizabeth Thomas, Aaron M. Luebbe and M. Cameron Hay
Although the need to train clinicians to provide effective mental health care to individuals from diverse backgrounds has been recognized worldwide, a bulk of what we know about training in cultural competence (CC) is based on research conducted in the United States. Research on CC in mental health training from different world populations is needed due to the context-dependent nature of CC. Focusing on India and USA, two diverse countries that provide complementary contexts to examine CC, we explored graduate students’, practicing clinicians’, and faculty members’ perspectives regarding CC training they received/provided and future training needs using mixed-methods. The data were collected using focus groups (n = 25 groups total: 15 in India, 11 in USA), and a survey (n = 800: 450 in India, 350 in USA). Our data highlight the salient social identities in these countries, and the corresponding constituents of CC training. Participants in India described a practical emphasis to their CC training (e.g., learning about CC through life experiences and clinical practice experiences) more so than through coursework, whereas participants in USA described varying levels of coursework related to CC along with practice. Participants in both countries considered enormity of CC as a challenge, while those in the US also identified CC training limited to a white, straight, male perspective, hesitancy in engaging with diversity topics, and limited time and competence of the faculty. Strengths of CC training in India and USA are mutually informative in generating recommendations for enhancing the training in both countries.
Medical Returnees: Somali Canadians Seeking Psychosocial and Spiritual Care in East Africa
Mohamed Ibrahim
The refugee experience has been associated with increased rates of psychosocial challenges. At the same time, evidence suggests that those who resettled in Western countries including Canada underutilize the formal mental health services in these countries. The low uptake has been attributed to barriers such as language, complexity of the health systems, and differing explanatory models of illness. The same is true for Somali refugees in the West. Studies suggest that Somali refugees prefer spiritual healing for psychosocial illness and that some return to East Africa for such healing. However, little is known about Somali Canadian’s experiences with the Canadian mental health services and transnational health seeking. The study aimed to understand psychosocial challenges faced by Somali Canadians, their health seeking behaviors, and service utilization. Because some sought psychosocial services outside the country, fieldwork was conducted in Kenya to provide new evidence on transnational healing services. Ethnographic fieldwork and in-depth interviews were utilized. Thirty-seven interviews of about an hour each were undertaken. Fieldwork in Nairobi focused on spiritual healing centers and medical clinic. The findings reveal important findings regarding psychosocial challenges experienced by participants. It discusses psychosocial illnesses as variedly experienced, challenges with accessing Canadian healthcare services, and seeking culturally appropriate services in East Africa. The study highlights participants and their families struggle with psychosocial distress, the challenges of accessing culturally appropriate services within Canada, the role of spiritual healers and the existence of transnational health seeking practices.
Sarah Mars, Jeff Ondocsin, Kimberly A. Koester, Valerie Mars, Gerald Mars and Daniel Ciccarone
Uptake of pre-exposure prophylaxis medication (PrEP) to prevent HIV among people who inject drugs (PWID) remains extremely low in the United States. West Virginia’s rising HIV incidence and highest drug overdose rate in the nation makes it an important locus for opioid use and HIV risk interaction. In this pilot study we pioneered the use of Cultural Theory among PWID to understand HIV-related risk perception arising from four contrasting modes of social organization. Carried out during an HIV outbreak, we explored PrEP uptake qualitatively as a window onto risk perception. Of the 26 interviewees, 18 were HIV− and despite the medication’s free availability from the health center where recruitment took place, none had taken PrEP, half considering they were not at risk. Intimate couples who showed characteristics of ‘enclaves’ considered the boundary around themselves protective against HIV, creating a safe space or ‘invisible risk group’. Higher HIV risk was perceived among those who were housed compared to those living homeless. Beliefs about the causation of the local HIV outbreak and the validity of scientific research corresponded with characteristics of the contrasting modes of social organization and the approach is promising for informing public health interventions among PWID.
Stubborn Families: Logics of Care of a Family Member with Borderline Personality Disorder
Maureen O’Dougherty
This study conducted in-depth, largely unstructured interviews with 31 involved family members in a metropolitan area of the United States (US) Midwest on their experiences of BPD in a close relative. Narrative analysis employing concepts from anthropology (the logic of care and family assemblage) was used to examine the nature and quality of care practices and identify human, environmental, and cultural supports needed for family recovery. Findings indicate that these US family caregivers provided intensive and extensive care over the long term. They acted in situations of risk to their relative, and often disconnected from professional support. Parents labored under unforgiving normalizations: judgments (real or perceived) of not properly raising or “launching” their children and norms of parental self-sacrifice. The dearth of housing options for the young person hindered recovery. While duly recognizing the care practices provided by family members for a relative with BPD, I argue that there is a significant omission. Our conceptualizing of supports for family members of a relative with BPD needs to encompass supports for their own recovery. Respite, mental health care for caregivers, housing, support groups, and collaborative care (with professionals, peers and family members) could productively assist recovery of all family members.
Émilie Pigeon-Gagné, Ghayda Hassan, Maurice Yaogo and Thomas Saïas
Stigma has been pointed out as a barrier to mental healthcare in sub-Saharan Africa. Among the manifestations of stigma, the use of physical restraints is condemned as a form of violation of basic human rights. Research on this phenomenon is limited in West Africa and more particularly in Burkina Faso. This study explores the phenomenon of stigma of individuals experiencing mental disorders in Bobo-Dioulasso (Burkina Faso). As part of 8 months of socio-anthropological fieldwork, we interviewed 94 informants (7 focus groups and 25 individual interviews) to document exclusionary practices, their perceptions, and justifications. Exclusionary practices can be divided in five subgroups: ignoring, physically and sexually abusing, abandoning, banning, and restraining. Some practices were linked to a lack of financial and material resources, while others were justified by an inferior moral status. We observed differences in the type of exclusion experienced between men and women. Restrictive, abusive, and exclusionary measures are common in Bobo-Dioulasso. These practices can either be understood as part of families’ adaptative strategies when dealing with chronic conditions, as part of security measures in the case of patients with aggressive behaviors, or as part of punitive measures when transgressions are committed. We conclude the article by addressing the tensions between local and global meanings of stigma.
Re-thinging Embodied and Enactive Psychiatry: A Material Engagement Approach
Lambros Malafouris and Frank Röhricht
Emerging consensus among enactivist philosophers and embodied mind theorists suggests that seeking to understand mental illness we need to look out of our skulls at the ecology of the brain. Still, the complex links between materiality (in broadest sense of material objects, habits, practices and environments) and mental health remain little understood. This paper discusses the benefits of adopting a material engagement approach to embodied and enactive psychiatry. We propose that the material engagement approach can change the geography of the debate over the nature of mental disorders and through that help to develop theoretical and practical insights that could improve management and treatment for various psychiatric conditions. We investigate the potential role of Material Engagement Theory (MET) in psychiatry using examples of aetiologically different mental illnesses (schizophrenia and dementia) in respect of their shared phenomenological manifestations, focusing particularly on issues of memory, self-awareness, embodiment and temporality. The effective study of socio-material relations allows better understanding of the semiotic significance and agency of specific materials, environments and technical mediations. There is unrealised potential here for creating new approaches to treatment that can broaden, challenge or complement existing interventions and practices of care.
The relationship between online searches and suicide
Nicolás Acosta-González, Francisco Gallegos and Diana Mosquera
In this study, we examined the relationship between 131 suicide related Google search terms, grouped into nine categories, and the number of suicide cases per month in Ecuador from January 2011 to December 2021. Significant correlations were found in all categories between Google search trends and suicide rates in Ecuador, with predominantly positive and moderate correlations. The terms ‘stress’ (.548), ‘prevention’ (.438), and ‘disorders’ (.435) showed the strongest associations. While global trends indicated moderate correlations, sensitivity analysis revealed higher coefficients in men, young adults, and the Highlands region. Specific patterns emerged in subgroups, such as ‘digital violence’ showing significant correlations in certain demographics, and ‘trauma’ presenting a unique temporal pattern in women. In general, cross correlation analysis showed an average negative correlation of −.191 at lag 3.
Childhood trauma distribution and behavioural problems among Pakistani adolescents
Zaryab Fatima, Rayna Sadia, Saira Khan and Morteza Charkhabi
Childhood trauma adversely impacts adolescents, and consequently, they develop behavioural problems. Understanding the distribution of childhood traumas and their association with behavioural problems among adolescents is paramount for the preventive efforts. The present research aimed to investigate this association among adolescents. This association was investigated among adolescents (N = 200) between 12 and 18 years. Childhood Trauma Questionnaire and Strength and Difficulty Questionnaire was used to assess the distribution of trauma and internalizing and externalizing behavioural problems among adolescents through purposive and convenience sampling technique. The findings across trauma distribution indicated higher distribution of childhood abuse and neglect across males as compared to females. Males further significantly scored higher on sexual abuse and emotional neglect. Apparently, a large number of adolescents experienced all five sub types of childhood traumas (sexual abuse, emotional abuse, physical abuse, emotional and physical neglect). Additionally, across the severity continuum of childhood traumas, male scored higher on the severe to extreme continuum for all subtypes except physical abuse, where females scored higher. Lastly, logistic regression analysis indicated higher peer problems among those adolescents who have experienced all types of childhood traumas. These findings could be beneficial for intervention-based programs and policies to help trauma-exposed adolescents cope with their lives.
Vishnu Rajan, Yamini Marimuthu, Vikas Menon, Ganesh Kumar Saya, and Ruben Raj
Depression is a major global health concern, particularly in India, where it significantly impacts the population’s well-being. The interplay of various factors, including education, employment status, and spiritual intelligence, contributes to the complex landscape of depressive symptoms among adults. The study underscores the importance of education and employment opportunities in mitigating depressive symptoms among rural adults. It suggests targeted interventions that promote education and employment support to enhance mental health resilience. While spiritual intelligence may influence mental health outcomes, its exact role requires further investigation.
Kalpana Poudel-Tandukar, Caroline Davis, Yuliya Mosijchuk and Krishna C Poudel
Mental health problems are high among refugees due to their traumatic experiences of fleeing war and witnessing disasters and deaths due to violence and conflict. Refugees are exposed to various socio-cultural stressors during their migration journey before, during, and after arriving at the host country, which may increase their risk of mental health problems. Strength-based interventions may be beneficial to address their socio-cultural and psychological stressors by strengthening individual’s strengths to address their problems. The stress, anxiety, and depression were reduced, and coping, self-efficacy, and social support networking skills were improved among Ukrainians after intervention. This program should be replicated in the larger community for a wider benefit.
‘Evangelical Gitanos are a good catch’: masculinity, churches, and roneos★
Antonio Montañés Jiménez
This article explores Christian principles, imagery, and ideas shaping the (re)making of masculine ideals, behaviour, and identities among Pentecostal Gitanos in Spain. Scholarship on Pentecostal masculinities emphasizes that in cultural settings dominated by ‘macho’ and other chauvinistic principles, men find it challenging to comply with Pentecostal standards of manhood, and those who do convert often lose standing before non-converted men as they are accorded an aura of effeminacy. Whereas many converted Gitanos struggle to meet Pentecostal moral standards too, Gitano believers attempt to reform their masculinity following dominant and highly valued ethnic ideals. The connection between masculine pathways of conversion, moral/spiritual commitment, and cultural prestige has significant implications for the ways in which Gitano male believers are perceived and appreciated as potential partners in Gitano cultural and communitarian milieus. The article argues that Pentecostal Christianity’s gendered ideas about how men should behave defines ideals of masculinity, ethical expectations, and couple-making practices among Gitano communities. The article also provides an ethnographic account of the mechanisms involved in generating, reproducing, and sustaining discursive, social, and communitarian frameworks and courting practices (known as roneos) in which Pentecostal Gitano ideals and aspirations about manhood become meaningful and appealing.
The placing of care: ordinary ethics of mobility in the Sino-Tibetan borderlands
Peter Guangpei Ran
This article concerns the migratory experiences of a group of Naxi in the Sino-Tibetan borderlands, framed by the drastic social changes brought about by market reform in the past few decades in rural China. The unprecedented level of mobility of a younger generation leaving home for education or work leads to tension between their deep ties to local lifeworlds and a yearning for prosperity envisioned elsewhere. The article looks at the ethical and existential implications of their routinized movements between home villages and nearby cities, which involve both those moving and those left behind in caring relationships. I argue that such movements negotiate a place-based and gendered relationality that defines people’s responsibilities for each other across space and time – including both humans and ancestral spirits – despite living through the fragmenting effects of displacement and separation.
Shilla Lee
Embedded within Japan’s demographic and economic stagnation, traditional craftsmanship unexpectedly aligns with the discourse of creativity. This study delves into the intricacies of this convergence through ethnographic details, shedding light on how endeavours to preserve local crafts intertwine with the burgeoning discourse of creativity within public policy frameworks, thereby shaping a nuanced understanding of craftsmanship. The study draws on fieldwork conducted in 2018-19 in Tamba Sasayama, Japan, focusing on the participation of Tamba potters in a regional revitalization initiative promoting the slogan of rural creativity. Initially, promotional activities were perceived as distractions hindering their ability to maintain the pace of their work, such as monitoring the changing state of the clay through various stages of the craft (i.e. throwing, drying, and firing), an aspect they considered fundamental to craftsmanship. However, the growing acknowledgement of public support accompanying their engagement prompted a reassessment, transforming distraction into a skill emblematic of flexible ‘disengagement’. The analysis of disengagement as a new virtue of craftsmanship reveals the pragmatic approach the potters uphold and the creative trajectory of traditional craftsmanship amidst the demographic crisis.
Narrative futures of pregnancy sickness: reproduction, disability, animality
Sophie A Jones
In Sarah Hall’s short story ‘Mrs Fox’, a man wakes to find his wife, Sophia, vomiting. When Sophia’s nausea continues, he imagines her wasting from a rare cancer; instead, she mutates into a fox and, after a brief captivity at their home, leaves him for the woods, only to reappear months later with a litter he claims as his progeny. Sophia’s sickness is belatedly revealed as nausea and vomiting of pregnancy (NVP), and her metamorphosis from human into fox seems to have been triggered by conception. NVP, or ‘morning sickness’ as it is colloquially known, tends to appear in culture as plot reveal or punchline but rarely as experience. This narrative marginalisation parallels the condition’s medical status. In its most severe form, hyperemesis gravidarum, NVP can lead to malnutrition and other serious health complications. However, the condition often goes untreated, a situation that has been linked to cultural fears of congenital disability in the wake of thalidomide. Long assumed to derive from the pregnancy hormone human chorionic gonadotropin, NVP is the subject of new genetic research that may hold the potential for new therapeutic interventions. Yet this research may also reinforce the theory that NVP is an evolutionary mechanism designed to isolate pregnant people from pathogens during the first trimester. In this article, I draw on this context to read ‘Mrs Fox’ as an ironic allegory of the ‘evolutionary safety net’ explanation for NVP. Drawing on work at the intersection of disability justice and reproductive justice, I argue that the therapeutic futures opened up by new research into NVP spotlight the need for closer attention to narratives of gestational sickness.
Owen Bullock and Jennifer McFarlane
The value of creative writing as an adjunct to clinical treatment is well-known. Creative writing has been used successfully in a wide range of healthcare and rehabilitation settings, with people suffering from aphasia, dementia, cancer, heart attacks, depression, mental illness, post-traumatic stress disorder and anxiety disorders, and dealing with pain. Poetry, in particular, has been identified as a powerful reflective tool. This project aimed to: facilitate the creation of a safe space in which participants can enjoy open discussion of written works, share readings and offer feedback; give participants the opportunity and basic skills to write expressively and creatively; evaluate whether the writing of poetry can help reframe personal narratives in a controlled setting in ways that facilitate meaningful self-reflection and improve well-being.
The programme was delivered through eight face-to-face creative writing workshops, each lasting 1 hour, from February to May 2023. Fourteen participants engaged with the pilot programme. This paper discusses the practical lessons learnt regarding the staging of a programme outside an educational facility, as well as the specific dynamics of the hospital context, including creative pedagogical discoveries made in this participant-driven environment. The programme was evaluated through a survey, responses to which were overwhelmingly positive, especially in the qualitative comments. Participants welcomed the opportunity to express themselves creatively, both through oral storytelling and written work, in the safe space created during the programme. Interactions were dynamic and raised issues that were important to participants, who gave voice to the uniqueness of their experiences, helping re-establish agency.
Mark Paterson
A growing minority of those with disabilities are people of color (POC), with, for example, autism diagnosis rates now higher for children of color than for white children in the USA. This trend underscores the need for assistive technologies, especially socially assistive robots, to be designed with intersectional users in mind. Outside of Japan, most robots are designed with white synthetic skin and able-bodied features, failing to reflect the diverse users they are meant to assist. This paper explores the concept of the “engineering imaginary,” the historical and cultural influences that shape these designs, and which tend to limit robot embodiment to white, able-bodied forms. Drawing on work from scholars like Lucy Suchman, Jennifer Rhee, Neda Atanasoski and Kalindi Vora, the paper critiques this engineering bias. A key historical moment in the production of the engineered imaginary of artificial humans is provided by Ovid’s myth of Pygmalion and its influence on representations across literature, film, and then robotics. Furthermore, the physicality of the robot, and its role in the production of nonverbal communication (NVC) for more inclusive interaction with humans is explored, seeing these as steps toward what some roboticists are calling Artificial Empathy (AE). Through case studies like Bestic, Bina48, and HuggieBot 3.0, the paper explores what I call the poverty of the engineering imaginary, how current robotics design fails to properly address issues of race, gender, and disability. Ultimately, the paper argues for more inclusive robot designs that accommodate diverse bodies and social dynamics, questioning the pervasive norm of white, able-bodied robotic embodiment.
Sophia Rossmann and Ruth Müller
Science and Technology Studies (STS) research has paid considerable attention to how toxicology produces knowledge on toxicity and how this knowledge has changed. For example, modern toxicological approaches of dose–response and threshold levels and genetic/genomic approaches for tracing exposure-induced DNA damage have been found to yield specific notions of toxicity. However, some of the toxicants’ latent exposure effects have remained invisible with these two established epistemic perspectives. To tackle this issue, environmental toxicologists have recently turned to environmental epigenetics, offering a promising biomolecular perspective to better understand the role of latent exposure effects on health. Analysing environmental toxicology literature on epigenetics and interviews with key researchers demonstrates how an epigenetic perspective yields a novel notion of toxicity as process. This temporal emphasis foregrounds the idea that bodies are not just exposed to toxicants but dynamically respond to the exposures they experience. In particular, environmental toxicologists draw on a specific combination of an epigenetic theory of toxicity and new but compatible methods and technologies, which establish a new epistemic understanding of toxicity. Characterising these developments as a Regime of Im/Perceptibility shows how novel regimes can emerge in both difference and continuity with prior regimes such as modern and genetic/genomic toxicology. The case study on epigenetic research in environmental toxicology adds to STS scholarship on epistemic developments in scientific fields by illuminating how a new epistemic perspective is successfully adopted while co-existing with established regimes of knowledge production in a given field.
Patient engagement in drug development: dialogically problematizing participation
Claudia Egher, Tamás Bereczky, Lisbeth Snede and Olga Zvonareva
For many years, the field of drug development remained insulated from patient engagement initiatives that became commonplace in healthcare, it is currently experiencing a participatory turn. This has been informed by a re-evaluation of the patients’ insights and of the roles they can play in drug development, with both democratising and technocratic arguments invoked in support of their more substantial engagement. This article problematises the democratising potential of drug development through a knowledge co-production process between the authors of this paper – two scholars and two practitioners in this field. It scrutinises what patients can participate in drug development by zooming in on the Patient Expert Training provided by EUPATI, arguably the most influential and reputable patient education provider in Europe currently. Through their dialogue, the authors highlight the considerable epistemic requirements placed upon patients and warn about the risk of the emergence of participatory practices that rely exclusively on a narrow patient elite. They also reflect upon the benefits and challenges of close collaborations between researchers and practitioners and call for the systemic transformations needed for such knowledge co-production initiatives to become commonplace in academia.
Redefining expertise: how proponents and opponents of alternative therapies evaluate expertise
Elina Uutela and Esa Väliverronen
Traditionally, scientific education is considered a main guarantee for expertise. However, new self-taught therapy providers increasingly seek expert status in health and well-being. These ‘field experts’ sometimes challenge the authority of scientific experts, arousing public debates on expertise and expert qualifications. This expansion of expertise, a popular topic in science and technology studies in the last decades, is driven partly by changes in the media environment and increasing consumer interest. Current research on citizen engagement in science often presumes citizens hold a stakeholder position or (aim to) participate in knowledge production. However, ways of participation in expertise and science are constantly changing, partly due to the evolving media landscape enabling new forms of participation. Online debate around alternative therapies by a well-known Finnish health influencer, Maria Nordin, show that citizens and consumers set competing criteria for health and well-being experts and use online discussions to negotiate these criteria. Proponents of alternative therapies highlight consumers’ responsibility for their health in the freedom of choice frame and describe traditional epistemic authorities as corrupt in the distrust frame. Opponents of alternative therapies promote science-based expertise in explaining and treating symptoms in the biomedical frame and criticize alternative experts for misleading consumers in the hoax frame. Citizens and consumers are increasingly involved in contesting and legitimizing experts and negotiating criteria for expertise and, thus, participating in the expansion of expertise.
Terra Manca
Health governance during pregnancy is grounded in cultural norms about good mothering, which centre around self-sacrifice and perceived conflicts between maternal and fetal bodies. Nonetheless, many health choices in pregnancy should have mutual benefits and risks for maternal and fetal bodies, including vaccination during pregnancy. This manuscript presents results from a discourse analysis of 440 texts about vaccines that are recommended in pregnancy in Canada, including inactivated influenza, tetanus-diphtheria-acellular-pertussis, and COVID-19 vaccines. Texts include publicly available online information (e.g., webpages, printouts, posters, videos, and other materials) developed by various authoritative institutions (e.g., public health services, professional organizations, vaccine manufacturers). This study contributes to feminist and risk theorist critiques of public health discourse by exploring how texts deploy emotionally laden technical discourses that govern pregnant individuals towards divergent goals. Specifically, they are governed towards socially desirable health decisions (e.g., vaccination acceptance) and towards agonizing over decision-making as “good mothers.” I analyze how texts pursue this divergent governance in three ways, by deploying discourses that reify conflict between maternal and fetal bodies, organizing the work of making choices around gendered power relations, and activating emotions around mothering responsibilities. My analysis compares how such governance differs across products by available evidence and by the intended purpose of vaccination to protect maternal and/or fetal bodies. I conclude by discussing the value of combining governmentality and cultural approaches to risk theory to understand how the interface of public health and mothering discourses reproduce power relations, and suggest recommendations on how to lessen that reproduction.
“Searching for equity: White normativity in online skin cancer images”
Ashley C. Rondini, Genab Diallo, Foster Bryant and Rachel H. Kowalsky
In this paper, we examine the range of skin tones represented in publicly available online image search results through which non-medical audiences might seek information about skin cancer signs, symptoms, and risks. We use the Fitzpatrick scale, a numerical classification system grouping six human skin tones (or “phototypes”) in dermatology, as a guide for analyzing the skin tones appearing in (n = 1600) Google image search results for search terms related to skin cancer. We find that light skin tones (1,2, and 3 on the Fitzpatrick scale) comprise the significant majority (roughly 96%) of those depicted in Google image searches of information about skin cancer signs and prevention; dark skin tones (4, 5, and 6 on the Fitzpatrick scale) appear with significantly less frequency (roughly 4%) in the same search results. Disparate representation of diverse skin tones—and, more specifically, omission of dark skin images—suggests that racial biases inflect the search results generated by seemingly race-neutral skin-cancer related search terms. This embedded racial bias privileges white normativity to the disadvantage of dark-skinned patients, who are most likely to be racially classified as Black.
Jun-Hong Chen, Jesse J. Helton, Chien-Jen Chiang, Chi-Fang Wu, Melissa Jonson-Reid and Brett Drake
Food insecurity is a key determinant of not only caregiver’s mental health but also children’s emotional problems and hyperactivity symptoms. Although substantial studies have explored such a relationship, it is unclear to us whether this relation would vary when considering that caregiver’s mental health and aforementioned children’s behavioral issues can be the cause and effect of each other. Addressing this research gap is a key to advancing our understanding of how to promote a healthier family dynamic, especially for those facing material needs. This research applies the family stress model to explore how food insecurity affects caregiver psychological distress and child emotional problems and hyperactivity symptoms, while considering the reciprocal relationships between caregiver mental health and these child behavioral issues. Utilizing data from the 2019 Panel Study of Income Dynamic and 2019–2020 Child Development Supplements, this study conducts path analyses applied with propensity score weighting to support causal inference. Results support the family stress model framework, where food insecurity significantly predicts an increase in psychological distress in caregivers, which in turn leads to more severe child emotional problems and hyperactivity symptoms. This study also shows that food insecurity is a risk factor resulting in a reciprocal association between caregiver psychological distress and child emotional problems, where the strength of both directions is similarly harmful to each other. These findings underscore the need to address food insecurity, not only to meet material needs but also to break the harmful cycle of mental health and behavioral issues within families.
Jodie A. Mottram and James A. Dimmock
Although social factors and culture are significant determinants of health in Aboriginal and Torres Strait Islander peoples, little is known academically about key interpersonal and social experiences of this population during the perinatal period, or how early attachments are formed through culture. This study addressed this gap in the literature. Five prominent interpersonal and social themes were identified: maternal-fetal attachment, infant-kinship attachment, caretaking roles/shared caregiving, traditional adoption, and ceremonies and rites of passage. Characteristics of maternal-fetal attachment were aligned with the construct in non-Indigenous literature. Post-utero, caretaking/shared caregiving roles such as ‘big mum/dad’ and ‘small mum/dad’ were identified. Ceremonies and rites of passage were understood to cement cultural roles within the kinship system, and the role of the maternal uncle was highlighted. A cultural obligation to help raise the child for biological mothers’ other siblings, known as ‘mums’ and ‘dads’, was identified.
Equivocal diagnostics: Making a ‘good’ point-of-care test for elimination in global health
Alice Street and Emma Michelle Taylor
What is a diagnostic test for? We might assume the answer to this question is straightforward. A good test would help identify what disease someone suffers from, assist health providers to determine the correct course of treatment and/or enable public health authorities to know and intervene in health at the level of the population. In this article, we show that what a specific diagnostic test is for, the value it holds for different actors, and what makes it good, or not, is often far from settled. We tell the story of the development and design of a rapid antibody test for onchocerciasis, or river blindness, tracking multiple iterations of the device through three configurational moments in the framing of onchocerciasis disease and reshaping of the global health innovation ecosystem. Efforts to build that ecosystem for diagnostics are often premised on the notion that public health needs for diagnostics are pre-given and stable; the challenge is seen to be how to incentivize investment and find a customer base for diagnostics in under-resourced settings. By contrast, we show that for any disease, diagnostic needs are both multiple and constantly in flux, and are unlikely to be met by a single, stand-alone product. In the case of the onchocerciasis Ov-16 rapid test, the failure to recognize and address the multiplicity and instability of diagnostic needs in the innovation process resulted in the development of a rapid point of care test that might be manufactured, procured and used, but is unloved by public health experts and commercial manufacturers alike. The equivocal value of the onchocerciasis rapid test, we suggest, reveals the inadequacy of the current global health innovation ecosystem for developing diagnostic ‘goods’.
Iben M Gjødsbøl, Jeanette Bresson Ladegaard Knox, Lea Skovgaard and Mette N Svendsen
How do precision medicine initiatives (re)organize relations between individuals and populations? In this article, we investigate how the curation of national genomic populations enacts communities and, in so doing, constructs mutual obligation between individuals and the state. Drawing on ethnographic fieldwork in the Danish National Genome Center (DNGC), we show how members of advisory bodies negotiated the inclusion criteria for two different genomic populations: a patient genome population and an envisioned ‘Danish’ reference genome population. The patient genome population was curated through a politics of inclusion, of as many genomes as possible, whereas the reference genome was to be curated through a politics of exclusion, to include only the genomes of ‘ethnic’ Danes. These two data populations configure differently the community of ‘Danish patients’ who might benefit from precision medicine, and thereby prescribe different moral continuities between person, state, and territory. We argue that the DNGC’s patient genome population reinforces reciprocal relations of obligations and responsibility between the Danish welfare state and all individuals, while the proposed Danish reference genome population privileges the state’s commitment to individuals with biographical-territorial belonging to the nation-state. Drawing on scholarship on social and health citizenship, as well as data solidarity in the Nordics, the discussion shows how population curation in national precision medicine initiatives might both construct and stratify political obligation. Whereas STS scholarship has previously deconstructed the concept of ‘population’, in the context of the troubling and violent effects of the management of human populations, we point to the importance of population curation as a vehicle for making the individual legible as part of a community to which the state is responsible and for which it is committed to care.
Hearts and minds: The technopolitical role of affect in sociotechnical imaginaries
Stephen Hughes
Sociotechnical imaginaries (SIs) have emerged as a popular and generative concept within Science and Technology Studies (STS). This article draws out the affective component of SIs, combining a review of relevant literatures with an empirical case study of an anti-fracking imaginary in Ireland to suggest how we might theorize an affective technopolitics of SIs. The literature review identifies three key aspects of SIs that would benefit from a more coherent conceptualization of affect: the utopian, productive, and collectivizing dimensions of imaginaries. Emotions such as desire and fear appear prominently in the SI literature, but in ways that require development. Using empirical examples from my research, I outline what this developed understanding of emotions in imaginaries might look like. I examine the role that emotions played in the development and settlement of an anti-fracking imaginary in Ireland, highlighting how the intensive, multimodal, and dynamic nature of affect underpinned the productive, collective, and utopian dimensions of the SI. I conclude with some remarks about how this developed theory of emotion positions STS researchers to address issues of humanity, representation, and the building of better worlds.
Therapeutic value in the time of digital brainwaves
Megh Marathe
This article examines the value of medical technology through the case of electroencephalograms (EEGs), devices used to visualize brain activity and diagnose seizures. Drawing on ethnographic fieldwork, the article shows that EEGs are valued differently by patients and medical practitioners. While practitioners value EEGs for their clinical utility, i.e., ability to inform clinical decisions, patients value EEGs even in the absence of clinical utility. Indeed, patients derive long-lasting therapeutic effects from this diagnostic technology. These findings intervene in the utilitarian calculus of therapeutic value—a mode of reasoning that equates value with clinical utility—commonly deployed in biomedicine and engineering and call for a recognition of alternative notions such as the therapeutic value of being witnessed and cared for by medical experts via EEGs and other technologies that require time to work. Expansive notions of therapeutic value are imperative for including marginalized patients—especially low-income, disabled, and women patients—in debates on automation and the future of healthcare. Studying how multiple stakeholders value a medical technology provides insight into valuation, objectification, expertise, and other concerns central to science and technology studies.
