This introductory article provides a contextual and theoretical overview to this special issue of Body & Society. The special issue presents five selected case studies – focusing on the contexts of transplantation, psychiatry, amputation and war, and a transvalued media ecology of cancer – to offer meditations on a number of interlinked questions. The first of these is the entanglement of biomedical governance – political/economic as well as self-disciplinary – with the nexus of estrangement, which can denote both the distancing (...) of otherness and self-division. Second is the realm of feeling, of phantasmatic projection and of the ways in which the biopolitical becomes reciprocally, discursively, enmeshed in a wider cultural imaginary. Third is the shifting terrain of gender and feminist politics, a key dimension of which is the necessary reworking of feminist thought in the wake of a radically altered biomedical and biotechnological landscape. Under the rubric of Estranged Bodies, the collection considers themes of dissolution and the fragility of the body/subject read through bodily catastrophe, radical body modification and extreme medical intervention. Also considered is the notion of assemblage – the provisional coming together of disparate parts – which encourages a rethinking of questions of reconstituted, displaced and re-placed bodies. (shrink)

The Oprah Winfrey Show provides an interesting set of contradictions. On the one hand, it appears to challenge common-sense assumptions about relationships, specifically heterosexual relationships (for example, by consistently raising issues of sexual violence within a heterosexual context). Yet, at the same time, Oprah's presentation often works to reinforce precisely the norms she seeks to challenge. Through a close analysis of a selection of programme clips from one particular programme among many about relationships, sexuality and families, this article will consider (...) the ways in which the Oprah Winfrey Show both problematizes and yet normalizes the boundaries of heterosexuality. Here we shall discuss both the resolute exposure and exploration of what could be termed the casualities of normative (and compulsory) heterosexuality and, paradoxically, its recuperation as a ‘rational’ ideal. In exploring the ways in which this recuperation takes place, we shall begin with a brief consideration of two of the key discourses which shape the show: the discourse of therapy and that of kinship. Our analysis of the sexual politics of the Oprah Winfrey Show in these terms will focus on the programme, ‘How to Make Love Last’ (18 January 1993). Like so many other programmes, ‘How to Make Love Last’ intends to highlight and deal with problems within heterosexual relationships as distressing but solvable (through the medium of therapeutic self-help). At another level, however, the programme also (unwittingly) reveals a different order of problems which, ironically, can only be reinforced by the mode of rescue proposed and staged. (shrink)

s This article examines the iconic `Beggars' trilogy by feminist science fiction writer, Nancy Kress. These novels, produced in the early to mid-1990s, take as their `thought experiment' two points of rupture and contemporary cultural contestation: the advent of human genetic engineering and sleep, or, more specifically, the prospect of a sleepless society. I shall begin by situating my analysis of the Kress trilogy in this nexus of fields. I shall consider the interest of Kress's works for the sociology of (...) sleep as well as for a cultural analysis of science. In this context, and drawing in part on the work of Haran, I will suggest the particular value of science fiction as not only a site for, but also a source of, narrativized social theory. I shall introduce the notion of popular episteme as an analytic concept that aims to link the discursive to the social — that is, to theorize the relationship of textuality to materiality. In this context, I shall refer also to the psychoanalytic concept of `phantasy' as a point of convergence for both structures of feeling and structures of knowledge. I shall then introduce the Kress works, focusing particularly on the first novel Beggars in Spain, locating it in a period in which feminist science fiction saw a marked renaissance, and in which speculative theorizations of genetics formed a distinct subgenre. The analysis will then focus on three core themes emergent in the novels that, I shall argue, have profound contemporaneous resonance. These are the questions of: embodied capital; the political economy of what I will term fast time; and paranoia and the human condition. (shrink)

Cancer has long been a cultural touchstone: a metaphor of devastation and a spectre of social as well as bodily anomie and loss. Yet recent years have witnessed significant transformations in perceptions of cancer, particularly in perceptions of the cancer patient. This paper is concerned with the ‘struggles of subjectivity’ emergent in this transvalued cancer culture. Explored from the standpoint of the ‘bad patient’, and drawing on media and cultural methodologies, the paper will consider the convergence of medicine, morality and (...) popular iconography as they are embedded in the imageries, imaginaries and representational economies of the cancer culture industry. Of particular concern in this context are the (re)composures of the patient, as liminal figure, caught between clinical imperative and cultural fantasy. (shrink)

In the summer of 2009, we conceived a special issue of MediaTropes on the theme of “bioconvergence.” We sent out an initial circular to measure interest and solicited abstracts from scholars across disciplines. We received so many engaging and excellent contributions that we decided to publish two volumes of this special issue. Volume I appears here, while the publication of Volume II is anticipated in early 2012. The contributions to this volume examine, from a range of angles, the ways in (...) which living bodies, media, and technologies “converge.” The starting proposition of this special issue is that bodies are technologized and conceived increasingly in technical and biotechnological terms, while correspondingly, techniques and technologies have become increasingly “bodied.” Moreover, both tendencies are pointedly and pervasively mediatized as bodies and technologies constitute intercutting currents of spectacle and digitality in public and cultural life... (shrink)

This paper examines the Bourne trilogy to explore several characteristics of what we term the bioconvergent age. First, we consider the imagined and actual interfaces of bioconvergence—of body, gadgetry, and electronic communications. We explore the ways in which the bioconvergent tendencies represented in and by Bourne reflect and cultivate a cultural unconscious deeply seduced by and imbricated in surveillant governmentality. Second, we consider the ways in which the trilogy achieves its effects through the deployment of both hyperrealism and verisimilitude. In (...) this context, we explore the filmic interpellation of audiences into a fantasy of omnipotence and omni-science, on the one hand, and the underlying phantasy of a zero-sum world that uncouples morality from affect, on the other. Thus, we consider the ways in which Bourne articulates two interlinked phenomena—a distinctively American romance with the sociopathic/heroic subject and a paranoid, dystopic world that is and seems seductively real. Our third theme is the Bourne journey through an obsessional spiral of paranoia, action, and reaction. Here we explore the trilogy as a social description of the expulsive and retentive tendencies of the bioconvergent age, where the demand for instantaneity drives out all other considerations (morality, reason, connection) and where the lost subject, in his interminable quest for himself, remains lost. (shrink)

This study describes the results of a retrospective review of patients' charts who had an advanced directive (AD) and who were hospitalized in a tertiary, acute care teaching hospital. The purpose of the review was to understand from clinical, sociological, ethical and legal perspectives the nature and utility of ADs. Findings and implications of the review are discussed in terms of: patient demographics; diagnoses; quality of ADs; influence of ADs on clinical decisions; and legal aspects of ADs.

A critical review of four recent works that reflect current conflicts and tensions among feminists regarding new reproductive technologies: In Search of Parenthood by Judith Lasker and Susan Borg; Ethics and Human Reproduction by Christine Overall; Made to Order, Patricia Spallone and Deborah Steinberg, eds. and Reproductive Technologies: Gender, Motherhood and Medicine, Michelle Stanworth, ed. Their positions are evaluated against the background of growing feminist dialogue about the future of reproduction and the bearing of reproductive innovations on such related (...) issues as racism, sexuality, motherhood and abortion. (shrink)

This paper is based on a literature review of articles discussing the teaching and learning of philosophy in primary and secondary schools. The purpose of this review was to address two research questions: What 'is 'philosophy? What does philosophy do? This paper addresses the first research question—What 'is' philosophy?—by gathering together the various understandings of the word ‘philosophy’ circulating in the literature. There are ten understandings of what philosophy 'is' that have arisen from the literature: philosophy as a foundational concept; (...) philosophy as thinking—a skill, a disposition, a practice; philosophy as method or process; philosophy as a tool or instrument; philosophy as a creative task; philosophy as inquiry; philosophy as search for truth; philosophy as non-dogmatic teaching and hence the emancipation of thought; philosophy as communal activity; philosophy as a way of life. These ten understandings have been consistent over time, from writing in the field in the 1970s through to the present day. Many commentators hold and work with multiple understandings of what philosophy 'is' in their writing. (shrink)

Rare copy number variants have a prominent role in the aetiology of schizophrenia and other neuropsychiatric disorders. Substantial risk for schizophrenia is conferred by large CNVs at several loci, including microdeletions at 1q21.1, 3q29, 15q13.3 and 22q11.2 and microduplication at 16p11.2. However, these CNVs collectively account for a small fraction of cases, and the relevant genes and neurobiological mechanisms are not well understood. Here we performed a large two-stage genome-wide scan of rare CNVs and report the significant association of copy (...) number gains at chromosome 7q36.3 with schizophrenia. Microduplications with variable breakpoints occurred within a 362-kilobase region and were detected in 29 of 8,290 patients versus 2 of 7,431 controls in the combined sample. All duplications overlapped or were located within 89 kilobases upstream of the vasoactive intestinal peptide receptor gene VIPR2. VIPR2 transcription and cyclic-AMP signalling were significantly increased in cultured lymphocytes from patients with microduplications of 7q36.3. These findings implicate altered vasoactive intestinal peptide signalling in the pathogenesis of schizophrenia and indicate the VPAC2 receptor as a potential target for the development of new antipsychotic drugs. © 2011 Macmillan Publishers Limited. All rights reserved. (shrink)

We report the identification of a recurrent, 520-kb 16p12.1 microdeletion associated with childhood developmental delay. The microdeletion was detected in 20 of 11,873 cases compared with 2 of 8,540 controls and replicated in a second series of 22 of 9,254 cases compared with 6 of 6,299 controls. Most deletions were inherited, with carrier parents likely to manifest neuropsychiatric phenotypes compared to non-carrier parents. Probands were more likely to carry an additional large copy-number variant when compared to matched controls. The clinical (...) features of individuals with two mutations were distinct from and/or more severe than those of individuals carrying only the co-occurring mutation. Our data support a two-hit model in which the 16p12.1 microdeletion both predisposes to neuropsychiatric phenotypes as a single event and exacerbates neurodevelopmental phenotypes in association with other large deletions or duplications. Analysis of other microdeletions with variable expressivity indicates that this two-hit model might be more generally applicable to neuropsychiatric disease. © 2010 Nature America, Inc. All rights reserved. (shrink)

Verbal derogation is not only a linguistic but also, and perhaps more importantly, a political phenomenon. In this paper, I argue that to do justice to the political relevance of derogatory terms, we must not neglect the social practices and structures in which the use of these terms is embedded. I aim to show that inferentialist semantics is especially helpful to account for this social embeddedness and, consequently, the political relevance of derogatory terms. I am concerned with specifying the linguistic (...) and political aspects of terms that are at the core of derogatory language use. I explain them with the help of Brandomian inferentialism which tends to be quickly dismissed or ignored in discussions about the meaning of derogatory terms. My inferentialist account is in line with Lynne Tirrell’s broader inferentialist framework for understanding derogatory communicative practices. I provide the semantic details of her broader inferentialist view and thereby aim to show that inferentialist semantics is a promising theory which cannot be neglected in further discussion of meaning and politics in derogatory language use. (shrink)

Book reviewed in this article: Gays/Justice by Richard Mohr. Death:Beyond Whole‐Brain Criteria, edited by Richard M. Zaner. The Contraceptive Ethos:Reproductive Rights and Responsibilities Edited by S.F. Spicker, W.B. Bondeson, H.T. Englehardt, Jr., Dordrecht, Holland:D. Reidel. Made to Order:The Myth of Reproductive and Genetic Progress Edited by Patricial Spallone and Deborah Lynn Steinberg. Reproductive Technologies:Gender, Motherhood and Medicine Edited by Michele Stanworth. For the Patient's Good:The Restoration of Beneficence in Health Care by Edmund D. Pellegrino and David C. Thomasma. (...) ‘The Physician as Captain of the Ship:A Critical Reappraisal’, Philosophy and Medicine, vol. 29. Edited by Nancy M.P. King, Larry R. Churchill, and Alan W. Cross. (shrink)

The Gendered Cyborg brings together material from a variety of disciplines that analyze the relationship between gender and technoscience, and the way that this relationship is represented through ideas, language and visual imagery. The book opens with key feminist articles from the history and philosophy of science. They look at the ways that modern scientific thinking has constructed oppositional dualities such as objectivity/subjectivity, human/machine, nature/science, and male/female, and how these have constrained who can engage in science/technology and how they have (...) limited our ideas of the possibilities for both humanity and science. Later sections contain readings that present key feminist theories about representation to examine how gender and technoscience are represented in areas of particular contemporary interest: the new human reproductive technologies, science fiction, film and the Internet. The readings constantly ask "Is this for women, for human beings?" Contributors: Alison Adam, Anne Balsamo, Lynda K. Bundtzen, Barbara Creed, Mary Ann Doane, Dion Farquhar, Jennifer González, Evelynn M. Hammonds, Donna Haraway, Fiona Hovenden, Luce Irigaray, Linda Janes, Gill Kirkup, Nina Lykke, Sadie Plant, Rosalind Pollack Perchesky, Londa Schiebinger, Vivian Sobchack, Deborah Lynn Steinberg, Nancy Leys Stepan, Nina Wakeford, Kathryn Woodward. (shrink)

The view from inside : gendered embodiment and the medical representation of sex / Shelley Wall -- The politics of medico-legal recognition : the terms of gendered subjectivity in the UK Gender Recognition Act / Sarah Burgess -- Journeys of choice? : abortion, travel, and women's autonomy / Christabelle Sethna and Marion Doull -- The code of ethics in medicine : intertextuality and meaning in Plato's Sophist and Hippocrates' oath / Twyla Gibson -- Sleeping ethics : gene, episteme, and the (...) body politic / Deborah Lynn Steinberg -- The last temptation of Marion Woodman : the anorexic remainder in bone : dying into life / David L. Clark. (shrink)

Background: The concept of moral distress has been the subject of nursing research for the past 30 years. Recently, there has been a call to move from developing an understanding of the concept to developing interventions to help ameliorate the experience. At the same time, the use of the term moral distress has been critiqued for a lack of clarity about the concepts that underpin the experience. Discussion: Some researchers suggest that a closer examination of how socio-political structures influence healthcare (...) delivery will move moral distress from being seen as located in the individual to an experience that is also located in broader healthcare structures. Informed by new thinking in relational ethics, we draw on research findings from neuroscience and attachment literature to examine the reciprocal relationship between structures and agents and frame the experience of moral distress. Conclusion: We posit moral distress as a form of relational trauma and subsequently point to the need to better understand how nurses as moral agents are influenced by—and influence—the complex socio-political structures they inhabit. In so doing, we identify this reciprocity as a framework for interventions. (shrink)

If people sometimes participate in research because of altruism—because they want to help in the search for treatments—should we revise our views about what kinds of experiments are ethical? If participants act out of altruism, we might let them accept greater risks than we would if they are motivated only by a desire for personal gain. But how can we know when participants are genuinely altruistic?

In this paper, we defend the ethics of clinical research against the charge of paternalism. We do so not by denying that the ethics of clinical research is paternalistic, but rather by defending the legitimacy of paternalism in this context. Our aim is not to defend any particular set of paternalistic restrictions, but rather to make a general case for the permissibility of paternalistic restrictions in this context. Specifically, we argue that there is no basic liberty-right to participate in clinical (...) research and that considerations of distributive fairness justify some paternalistic protections of research subjects. (shrink)

“The Role of the Individual in Evolution” is a prescient yet neglected 1941 work by the 20th century’s most important paleontologist, George Gaylord Simpson. In a curious intermingling of explanation and critique, Simpson engages questions that would become increasingly fundamental in modern biological theory and philosophy. Did individuality, adaptation, and evolutionary causation reside at more than one level: the cell, the organism, the genetically coherent reproductive group, the social group, or some combination thereof? What was an individual, anyway? In this (...) introduction, we highlight two points in a wider historical context. First, recognizing the political context of Simpson’s writing profoundly deepens our understanding of the development of his science as the Modern Evolutionary Synthesis infused biology. Second, this story illuminates the emergence of debates around what would eventually come to be called multilevel selection theory. The organism-centered concept of biological individuality defended by Simpson is situated in relation to the then-emerging Synthesis, in which he was a renowned player, and also in relation to the views he opposed: the “metaphysical” ideas of paleontologists such as Henry Fairfield Osborn, who claimed that some evolutionary trends derived from potentialities already implanted in the germplasm; and the organicist ideas of Ralph W. Gerard and the Chicago School of ecologists, which he derided as all too congenial to totalitarianism. We find parallels between the ways that Simpson thought then about human individuality under totalitarianism and the way he thought about individuality in evolution; not that any causal relationship linked the two, but that commonalities of hierarchical structure exist between single entities and groups in both instances. We then trace the subsequent development of Simpson’s political and philosophical takes on the role of the individual in evolution through the 1960s and lightly sketch out the later fate of the organicist ideas of the Chicago School. Simpson’s paper, originally published in the Journal of the Washington Academy of Sciences, is available as supplementary material in the online version of this article, as part of the "Classics in Biological Theory" collection. (shrink)

We have conducted a retrospective study of deaths on a paediatric medical intensive care unit over a two-year period and reviewed similar series from outside the UK. There were 89 deaths out of 651 admission (13.7% mortality). In almost two-thirds of the cases death occurred with a decision to limit medical treatment or withdraw mechanical ventilation, implying that additional or further therapy was considered futile. We highlight this as a crucially important issue in the practice of intensive care. More comprehensive (...) studies are needed to help clinicians derive consensus on what constitutes a futile intervention, and therefore when such an intervention should be withheld. This will help families and society better understand the limitations of intensive care. (shrink)

Argues that the central cognitive component of ethical virtue for Aristotle is awareness of the value of particulars.

The ethical standards that regulate clinical research have multiple rationales. Among them is the need to protect potential subjects from making imprudent decisions, which extends beyond the soft paternalistic concern to protect people from making uninformed decisions to participate in trials. This article argues that a plausible risk/benefit restriction on clinical trials is presumptively justified by hard paternalism, which in turn is supported by a deeper fairness-based rationale. This presumptive case for hard paternalism in research is not defeated by the (...) alleged right to participate in clinical trials, by concerns about insult or status, by the need to conduct early phase trials that promise little to no benefit to participants, or by the recognition that some potential subjects are altruistically motivated. (shrink)

Is bioethics consultation a profession? Withfew exceptions, the arguments andcounterarguments about whether healthcareethics consultation is a profession haveignored the historical and cultural developmentof professions in the United States, the wayssocial changes have altered the work andboundaries of all professions, and theprofessionalization theories that explain howmodern societies institutionalize expertise inprofessions. This interdisciplinary analysisbegins to fill this gap by framing the debatewithin a larger theoretical context heretoforemissing from the bioethics literature. Specifically, the question of whether ethicsconsultation is a profession is examined fromthe (...) perspectives of trait theory, Wilensky''sfive-stage process of professionalization,Abbott''s interdependent system of professions,and Haug''s deprofessionalization thesis. Whilehealthcare ethics consultation does not meetthe criteria to claim professional status,neither could most professions pass these idealtheoretical standards. Instead of a yes or nodichotomous response to the question, it ismore helpful to envision a professionalizationcontinuum with sales clerks or carpenters atone end and medicine or law at the other. During the past decade healthcare ethicsconsultation has been moving along thiscontinuum toward greater professional status. (shrink)

The growing availability of computer power and statistical software has greatly increased the ease with which practitioners apply statistical methods, but this has not been accompanied by attention to checking the assumptions on which these methods are based. At the same time, disagreements about inferences based on statistical research frequently revolve around whether the assumptions are actually met in the studies available, e.g., in psychology, ecology, biology, risk assessment. Philosophical scrutiny can help disentangle 'practical' problems of model validation, and conversely, (...) a methodology of statistical model validation can shed light on a number of issues of interest to philosophers of science. (shrink)

Recent years have witnessed a growing concern that terminally illpatients are needlessly suffering in the dying process. This has ledto demands that physicians become more attentive in the assessment ofsuffering and that they treat their patients as `whole persons.'' Forthe most part, these demands have not fallen on deaf ears. It is nowwidely accepted that the relief of suffering is one of the fundamentalgoals of medicine. Without question this is a positive development.However, while the importance of treating suffering has generally (...) beenacknowledged, insufficient attention has been paid to the question ofwhether different types of terminal suffering require differnt responsesfrom health care professionals. In this paper we introduce a distinctionbetween two types of suffering likely to be present at the end of life,and we argue that physicians must distinguish between these types if theyare to respond appropriately to the suffering of their terminally illpatients. After introducing this distinction and explaining its basis,we further argue that the distinction informs a (novel) principle ofproportionality, one that should guide physicians in balancing theircompeting obligations in responding to terminal suffering. As weexplain, this principle is justified by reference to the intereststerminally ill patients have in restoration, as well as in therelief of suffering, at the end of life. (shrink)

First published in 1902, William James's Varieties of Religious Experience is considered a classic in religious studies and the psychology of religion. But how has James's classic study weathered decades of development in psychology and behavioral sciences?

We consider Helen Longino's proposal that "ontological heterogeneity", "complexity of relationship", and "the non-disappearance of gender" are criteria for good science and cannot be separated into cognitive and social virtues. Using a research program in neuroendocrinology investigating a hormonal basis for sex-differentiated lateralization as a case study, the authors disagree concerning whether the first two criteria can be construed as criteria for good science. Concerning the non-disappearance of gender criterion, we argue that its appropriateness is context specific, and that its (...) cognitive and social formulations are separable and should be construed as such. (shrink)