Encapsulation: Governing actual uncertainty in the coronavirus pandemic.

The coronavirus pandemic has revived scholarly engagement with the concept of biopolitics, with interpretations diagnosing either the widespread adoption of a classic biopolitical regime or the full-blown emergence of totalitarian repression (or both of these simultaneously). Relying on a close analysis of different interventions taken by Israeli authorities in response to the pandemic, this article argues that, rather than classic biopolitical strategies, such governmental interventions are better understood in relation to a problem of actual uncertainty. The case of Israel demonstrates how state apparatuses responded to actual uncertainty with technologies that are linked to different rationalities and how these technologies enabled the creation and management of a new milieu. The article further argues that, in making and intervening upon this milieu, state apparatuses employed a particular normalisation strategy that is tied to a form of power that we term encapsulation.

'Built for expansion': the 'social life' of the WHO's mental health GAP Intervention Guide.

The focus of this study is the WHO's mhGAP-Intervention Guide (mhGAP-IG) 2.0 (2016), an evidence-based tool and guideline to help detect, diagnose and manage the most common mental disorders, designed for use by non-specialists globally but particularly in low- and middle-income countries. This research is a starting point in tracing the multiple 'doings' of mhGAP-IG - connecting questions of how it is 'done' and what does it 'do' - to the living histories and wider global mental health assemblages that make the tool possible and shape its global circulation. We examine the conditions of possibility that produce and legitimate mhGAP-IG, and the ways these are 'black boxed' through casting mhGAP-IG in technical rather than epistemological terms. The study illuminates how its explicit design for global expansion positions mhGAP-IG as open to questioning from those who are technical 'insiders' and setting the epistemological parameters of its own critique. It analyses mhGAP-IG as an 'inscription device' that inscribes and materialises algorithmic imaginaries of mental health that impact on design and local implementation. This study is one attempt at initiating dialogue with the WHO from perspectives and methodological approaches not usually included in the conversation.

Molecular sovereignties: patients, genomes, and the enduring biocoloniality of intellectual property.

Monoclonal antibodies are revolutionizing cancer treatments, but come at an increasingly problematic price for health services worldwide. This leads to pressing demands for access, as in the case of Kadcyla. In 2015, patients in the United Kingdom invoked the sovereign rights of the Crown in order to demand access to this expensive yet potentially life-saving medicine that had prior been de-listed due to price. This article interprets this campaign as an act of sovereign reassertion against a fundamental exclusion, which, however, ultimately fails to challenge the concrete mechanism enabling this exclusion-intellectual property (IP). By connecting this example to other declarations of molecular sovereignty, the article argues that the use of sovereignty can perpetuate further exclusion. Drawing on the notion of biocoloniality (Schwartz-Marín and Restrepo 2013) it points out that the intellectual property regime contains a deeply embedded fiction of the world as terra nullius, a blank uninhabited canvas ripe for discovery and appropriation. This decontextualised vision of life as property works to exclude populations and patients from playing a significant role in determining the use of technologies and treatments. Instead of countering this fundamental exclusion, the concept of sovereignty further entrenches this assumption and merely contests the assignation of this property.

The Cultivation of Digital Health Citizenship.

Contemporary health policy discourse renders individuals responsible for managing their health by means of digital technology. Seeing the digital as productive of citizenship, rather than facilitative of it, this paper unpacks the contested role of technology in acts of digital health citizenship. Drawing on longitudinal data collected in the English healthcare context, this article shows that digital health citizenship is produced through patients' involvement in the generation of health knowledge, including 'big' health data, digital artefacts, experiential knowledge and service feedback. The paper adds to existing literature by disaggregating the contested role of technology in displays of digital health citizenship, showing that digital health technology can give rise to expressions of altruism, belonging, and demands for recognition and change in healthcare, whilst responsibilising citizens for the care of themselves and others. The discussion shows how, rather than merely facilitating the actions of a free and autonomous subject, this citizenship often becomes algorithmically produced (e.g. through nudges) and remains isolated to separate instances of engagement without a long-term orientation. Our study enriches the growing sociological literature on health citizenship by exploring how digital technology produces health citizenship at the intersection of biosociality and technosociality.

Between empowerment and self-discipline: Governing patients' conduct through technological self-care.

Recent health policy renders patients increasingly responsible for managing their health via digital technology such as health apps and online patient platforms. This paper discusses underlying tensions between empowerment and self-discipline embodied in discourses of technological self-care. It presents findings from documentary analysis and interviews with key players in the English digital health context including policy makers, health designers and patient organisations. We show how discourses ascribe to patients an enterprising identity, which is inculcated with economic interests and engenders self-discipline. However, this reading does not capture all implications of technological self-care. A governmentality lens also shows that technological self-care opens up the potential for a de-centring of medical knowledge and its subsequent communalization. The paper contributes to Foucauldian healthcare scholarship by showing how technology could engender agential actions that operate at the margins of an enterprising discourse.