Revolución sexual y neovitalismo. los servicios gestacionales en la reconfiguración social, como reproductoras, de las personas queer / Sexual revolution and neovitalism. the gestational services in the social reconfiguration, as reproductive, of the queer people

El artículo vincula la revolución sexual con el neovitalismo queer enmarcando ambos en el impulso emancipador que subyace en la cultura europea. Este impulso no implica la confrontación entre la tradición y el progreso, sino la confrontación de la tradición consigo misma. Tras analizar los referentes epistemológicos del 68, se muestra que la conceptualización del deseo como «instancia revolucionaria» y la síntesis de las relaciones entre el lenguaje, el poder y la política, forjaron el mito de la revolución sexual. Y que ésta, al disociar el encuentro sexual de la procreación, inspiró la actual cultura queer, su apelación a la performatividad y la crítica a la heteronormatividad. Relacionando la perspectiva queer con el trans-humanismo, se desvelan las aporías de su corriente neovitalista y se subraya su potencial eugenésico y bio-colonialista. Potencial que se hace patente con el uso del material genético y los cuerpos ajenos como un «producto» al servicio de la reasignación social, como reproductor, del colectivo queer. Se evidencia, así, la contradicción inherente a la revolución sexual, concluyendo que no aportó la emancipación que prometía, sino que implicó una recaída en el estado de naturaleza, en la centralidad instintiva que ordena la praxis al sometimiento del entorno, dando pie a una nueva forma de control social y a un nuevo conformismo

This paper links the Sexual Revolution with queer neovitalism, framing both in the emancipatory im-pulse that underlies European culture. Impulse does not imply the confrontation between tradition and progress, but the confrontation of tradition with itself. After analyzing its epistemological referents of 68, our research shows that the conceptualization of desire as the genuine «revolutionary instance» and the synthesis of the relationships between language, power and politics, forged the myth of the Sexual Revolution. In addition, that this, by dissociating the sexual encounter of procreation, inspired the current gender perspective, the culture of performativity and the critique of heteronormativity. Linking the queer perspective with transhumanism, this work reveals the constroversial nature of its neovitalist current and highlines its eugenics and bio-colonial potential. Eugenic and bio-colonial potential that is evidenced by the use of genetic material and foreign bodies as a «product» for the social reassignment, as procreator, of the queer collective. Finally, the work reveals the inherent contradiction of the Sexual Revolution, concluding that it did not bring the emancipation that it promised, but that it implied a relapse in the state of nature, in the instinctive centrality that orders praxis to the submission of the environment, propitiating a new form of social control and a new conformity

Ethics as ritual: smoothing over moments of dislocation in biomedicine.

Applications of biomedical R&D currently imply substantial societal concerns. This paper explores, based on semi-structured interviews with scientists in Norway, how biomedical researchers experience and tackle such concerns in their daily work. It shows how ritualised routine responses to dislocatory moments help maintain order in the daily work of the interviewed scientists; they do not address directly but instead smooth over concerns by a ritualised way of using ethics. This may foreclose substantive reflection and function as a stabiliser for 'business as usual'. Overall, the current way of responding to concerns as described by the interviewees may contribute to a depoliticisation of important issues. The paper contributes to sociological work on ethics by linking it to recent discussions on Responsible Research and Innovation (RRI) and by the empirical research presented. The insights can also help improve science policies such as RRI.

Screening Out Controversy: Human Genetics, Emerging Techniques of Diagnosis, and the Origins of the Social Issues Committee of the American Society of Human Genetics, 1964-1973.

In the years following World War II, and increasingly during the 1960s and 1970s, professional scientific societies developed internal sub-committees to address the social implications of their scientific expertise (Moore, Disrupting Science: Social Movements, American Scientists, and the Politics of the Military, 1945-1975. Princeton: Princeton University Press, 2008). This article explores the early years of one such committee, the American Society of Human Genetics' "Social Issues Committee," founded in 1967. Although the committee's name might suggest it was founded to increase the ASHG's public and policy engagement, exploration of the committee's early years reveals a more complicated reality. Affronted by legislators' recent unwillingness to seek the expert advice of human geneticists before adopting widespread neonatal screening programs for phenylketonuria (PKU), and feeling pressed to establish their relevance in an increasingly resource-scarce funding environment, committee members sought to increase the discipline's expert authority. Painfully aware of controversy over abortion rights and haunted by the taint of the discipline's eugenic past, however, the committee proceeded with great caution. Seeking to harness interest in and assert professional control over emerging techniques of genetic diagnosis, the committee strove to protect the society's image by relegating ethical and policy questions about their use to the individual consciences of member scientists. It was not until 1973, after the committee's modest success in organizing support for a retrospective public health study of PKU screening and following the legalization of abortion on demand, that the committee decided to take a more publicly engaged stance.

Moving Bioethics Toward Its Better Self: a sociologist's perspective.

The value and belief questions with which bioethics deals have social, cultural, moral, and societal implications that are not confined to certain spheres of biology and medicine, health and illness, and the delivery of medical care. And yet, throughout its history, the field has continued to be focused on a narrow array of medically associated phenomena to which it has applied a limited set of ethical precepts that originate in Western and American philosophical thought. It has done so in an intellectual atmosphere that has not been characterized by vigorous debate. This paper reflects on these attributes of bioethics, offers some suggestions about how it might expand its topical, ethical, cross-cultural, and international orbit, and invites participants in the field to bring this about through a self-critical process.

Bushido and medical professionalism in Japan.

Medical professionalism has become a core topic in medical education. As it has been considered mostly from a Western perspective, there is a need to examine how the same or similar concepts are reflected in a wider range of cultural contexts. To gain insights into medical professionalism concepts in Japanese culture, the authors compare the tenets of a frequently referenced Western guide to professionalism (the physician charter proposed by the American Board of Internal Medicine Foundation, American College of Physicians Foundation, and the European Federation of Internal Medicine) with the concepts of Bushido, a Japanese code of personal conduct originating from the ancient samurai warriors. The authors also present survey evidence about how a group of present-day Japanese doctors view the values of Bushido.Cultural scholars have demonstrated Bushido's continuing influence on Japanese people today. The authors explain the seven main virtues of Bushido (e.g., rectitude), describe the similarities and differences between Bushido and the physician charter, and speculate on factors that may account for the differences, including the influence of religion, how much the group versus the individual is emphasized in a culture, and what emphasis is given to virtue-based versus duty-based ethics.The authors suggest that for those who are teaching and practicing in Japan today, Bushido's virtues are applicable when considering medical professionalism and merit further study. They urge that there be a richer discussion, from the viewpoints of different cultures, on the meaning of professionalism in today's health care practice.

Ethical challenges and lessons learned from Inuulluataarneq - "Having the Good Life" study: a community-based participatory research project in Greenland.

We present the ethical challenges and lessons learned over the course of a four-year community-based participatory research (CBPR) project conducted on sexually transmitted infections (STIs) in Greenland. Specifically discussed is Inuulluataarneq-the "Having the Good Life" study. Inuulluataarneq is an interdisciplinary international, collaborative CBPR study involving the University of Toronto in Canada, the Greenlandic Medical Research Council, the Centre for Primary Care in Nuuk, the University of Greenland, local health partners and communities in Greenland, the Statens Serum Institut in Denmark, and Montana State University in the United States. Inuulluataarneq is the first CBPR project implemented in Greenland. Ethical issues discussed are: (1) the complexity of working with multiple institutional review boards on an international health research project using a CBPR framework; (2) unexpected influences on health policy; and (3) the dynamic of balancing community decision making and practices with academic research requirements and expectations. Inuulluataarneq's primary contribution to understanding ethical issues when conducting research in the Arctic involves an acceptance of the time, patience, and dedication of researchers and community partners it takes to discuss, understand, and process differing ethical viewpoints and procedures.

Neuroscientists' everyday experiences of ethics: the interplay of regulatory, professional, personal and tangible ethical spheres.

The ethical issues neuroscience raises are subject to increasing attention, exemplified in the emergence of the discipline neuroethics. While the moral implications of neurotechnological developments are often discussed, less is known about how ethics intersects with everyday work in neuroscience and how scientists themselves perceive the ethics of their research. Drawing on observation and interviews with members of one UK group conducting neuroscience research at both the laboratory bench and in the clinic, this article examines what ethics meant to these researchers and delineates four specific types of ethics that shaped their day-to-day work: regulatory, professional, personal and tangible. While the first three categories are similar to those identified elsewhere in sociological work on scientific and clinical ethics, the notion of 'tangible ethics' emerged by attending to everyday practice, in which these scientists' discursive distinctions between right and wrong were sometimes challenged. The findings shed light on how ethical positions produce and are, in turn, produced by scientific practice. Informing sociological understandings of neuroscience, they also throw the category of neuroscience and its ethical specificity into question, given that members of this group did not experience their work as raising issues that were distinctly neuro-ethical.

On the nature and sociology of bioethics.

Much has been written in the last decade about how we should understand the value of the sociology of bioethics. Increasingly the value of the sociology of bioethics is interpreted by its advocates directly in terms of its relationship to bioethics. It is claimed that the sociology of bioethics (and related disciplinary approaches) should be seen as an important component of work in bioethics. In this paper we wish to examine whether, and how, the sociology of bioethics can be defended as a valid and justified research activity, in the context of debates about the nature of bioethics. We begin by presenting and arguing for an account of bioethics that does justice to the content of the field, the range of questions that belong within this field, and the justificatory standards (and methodological orientations) that can provide convincing answers to these questions. We then consider the role of sociology in bioethics and show how and under what conditions it can contribute to answering questions within bioethics. In the final section, we return to the sociology of bioethics to show that it can make only a limited contribution to the field.

The ethics of trauma: re-traumatization in society's approach to the traumatized subject.

The paper starts from a question about the subconscious needs and anxieties which may underlie society's current responses to trauma. In particular, the author argues that the interest in the trauma of torture and man-made violence is a reaction to the increasingly dehumanizing and death-denying culture we live in. After proposing that the various categories of societal responses-the author focuses on evaluation, treatment, and advocacy-to traumatized subjects hide defenses of denial, distortion, refusal, with respect to the challenge of mortality, meaning-making, and mourning, the author then makes the thesis that they can derail and corrupt the project of post-traumatic repair. The paper proceeds with an examination of the ethics and politics that are implicit in contemporary North American society's current approach to trauma. The central argument is that the current approach may contain a collective acting out that often ends up being re-traumatizing to the traumatized subjects.

Goffman: contribuições para a Sociologia da Saúde / Goffman: contributions to health sociology

Com uma obra que trouxe inegáveis contribuições, Goffman inovou a pesquisa etnográfica nos estudos socioantropológicos. Esta marca pode ser observada desde os seus primeiros trabalhos nos quais aborda a apresentação do self na vida diária, os manicômios, o estigma e são, por sinal, aqueles que mais referências receberam nos estudos sociais sobre a doença, instituições e práticas de saúde. Neste artigo são analisadas essas contribuições e a importância que tiveram para a construção da sociologia da saúde. O texto destaca alguns conceitos que se tornaram fundamentais para os estudos sociológicos da doença e do paciente, como carreira do paciente, instituição total, interação estratégica e organizações formais instrumentais.

Author of a work with undeniable contributions, Goffman brought innovation to ethnographic research in socio-anthropological studies. This characteristic may be already observed in his first works - where he approaches the presentation of 'self' in daily life, asylums, and stigma -, which are those more cited in social studies about the disease, institutions and health practices. This study analyzes these contributions and their importance for the development of the field of health sociology. The text highlights some concepts considered fundamental for sociological studies on the disease and the patient, such as the patient's career, the whole institution, the strategic interaction, and instrumental formal organizations.

The afterbirth of the clinic: a Foucauldian perspective on "House M.D." and American medicine in the 21st century.

Mirroring Michel Foucault's The Birth of the Clinic (1963), which describes the philosophical shift in medical discourse in the 19th and early 20th centuries, the Fox television series House M.D. illustrates the shift in medical discourse emerging today. While Dr. Gregory House is Foucault's modern physician made flesh -- an objective scientist who has perfected the medical gaze (le regard) and communicates directly with diseases instead of patients -- his staff act as postmodern foils. They provide a parable about the state of biomedicine, still steeped in modernity but forced into a postmodern, managed care world. House M.D., however, is more than a mere depiction of the modern-postmodern tension that exists in today's exam rooms. It is an indication of a transition period in American medicine. House M.D. nostalgically celebrates what once was and simultaneously questions what currently is, while what is about to be is in the midst of becoming.

The embryo as moral work object: PGD/IVF staff views and experiences.

We report on one aspect of a study that explored the views and experiences of practitioners and scientists on social, ethical and clinical dilemmas encountered when working in the field of preimplantation genetic diagnosis (PGD) for serious genetic disorders. The study produced an ethnography based on observation, interviews and ethics discussion groups with staff from two PGD/IVF Units in the UK. We focus here on staff perceptions of work with embryos that entails disposing of 'affected' or 'spare' embryos or using them for research. A variety of views were expressed on the 'embryo question' in contrast to polarised media debates. We argue that the prevailing policy acceptance of destroying affected embryos, and allowing research on embryos up to 14 days leaves some staff with rarely reported, ambivalent feelings. Staff views are under-researched in this area and we focus on how they may reconcile their personal moral views with the ethical framework in their field. Staff construct embryos in a variety of ways as 'moral work objects'. This allows them to shift attention between micro-level and overarching institutional work goals, building on Casper's concept of 'work objects' and focusing on negotiation of the social order in a morally contested field.

'He is now like a brother, I can even give him some blood'--relational ethics and material exchanges in a malaria vaccine 'trial community' in The Gambia.

This paper explores social relations within the 'trial community' (staff and volunteers) of a Malaria Vaccine Trial (MVT), implemented by the Medical Research Council (MRC) in The Gambia between 2001 and 2004. It situates ethical concerns with medical research within the everyday life of scientific fieldwork. Based upon discussions with volunteers and staff, we explore processes of mediation between scientific project and study population, and between formal ethics, local ethical debates and everyday practice. We observe that material contact and substantial transactions, notably of blood and medicine, are central to the construction of the MVT. These transactions are guided by a concrete and relational form of ethics, which contrasts with the abstract and vertical formal ethical principles underwriting the scientific study protocol. The success of the MVT owed much to these kinship-like ethics. One possible conclusion from these observations is that research ethics should be understood, not just as a quasi-legal frame but also as an open, searching movement, much in the same way that kinship is not merely a juridical institution and a prescriptive frame of rules, but a network made through relational work. However, this conclusion raises new problems: by contrasting formal, abstract principles to intimate, immediate relations, and economic justice to personal morality, we accept that the order of medical research is moved further out of the public and political, and into the domains of either quasi-legal claims or of private morality. Irrespective of the undeniable importance of clear-cut rules and of good face-to-face relations, a third essential foundation of medical research ethics is the democratically constituted public sphere, including equitable health services, and transparent institutions to facilitate open debate and regulate particular interests. Ultimately, the ethics of global science can rely neither on principles nor trust but requires citizenship and democratic government.

Ethics and the ethnography of medical research in Africa.

The ethics of medical research have grown as an area of expertise and debate in recent years, with two broad approaches emerging in relation to transnational research: (1) the refinement of guidelines and strengthening of review, processes primarily to protect the right of individual research participants and strengthen interpersonal relations at the micro-level; and (2) considering more centrally, as crucial ethical concerns, the wider interests of whole populations, the functioning of research institutions, the processes of collaboration, and the ethics of inequitable international relations. We see the two areas of debate and action as complementary, and believe that social science conducted in and around transnational medical research environments can bring these two perspectives together in a more 'situated ethics' of research. To explore this idea for medical research in Africa, we organized a conference in December 2005 in Kilifi, Kenya. In this introduction we outline the two emerging approaches to medical ethics, summarise each of seven papers selected from the conference for inclusion in this special issue on ethics and ethnography, and finally highlight two areas of lively debate at the conference itself: the appropriateness and value of ethics guidelines and review boards for medical research; and the ethical review of social science research. Together, the papers and debates point to the importance of focusing on the ethics of relationships and on justice in both biomedicine and social science research, and on giving greater voice and visibility to the field staff who often play a crucial and under-supported role in 'doing ethics' in the field. They also point to the potential value of social science research on the range of relationships operating at different levels and time scales in medical research, including those surrounding community engagement activities, and the role and functioning of ethics review boards. We conclude by highlighting the ethical priority of capacity strengthening in medical research, social science and research ethics in Africa to ensure that local and national priorities and concerns are considered at both the micro and macro levels.

Beginning community engagement at a busy biomedical research programme: experiences from the KEMRI CGMRC-Wellcome Trust Research Programme, Kilifi, Kenya.

There is wide acknowledgement of the need for community engagement in biomedical research, particularly in international settings. Recent debates have described theoretical approaches to identifying situations where this is most critical and potential mechanisms to achieve it. However, there is relatively little published experience of community engagement in practice. A major component of the Kenya Medical Research Institute (KEMRI) Wellcome Trust Research Programme is centred on Kilifi District General Hospital and surrounding community of 240,000 local residents. Documented community perceptions of the research centre are generally positive, but many indicate a low understanding of research and therapeutic misconceptions of its activities. As in other settings, these misunderstandings have contributed to concerns and rumours, and potentially undermine ethical aspects of research and local trust in the institution. Through a series of consultative activities, a community engagement strategy has been developed in Kilifi to strengthen mutual understanding between community members and the Centre. One important component is the establishment of a representative local resident network in different geographic locations commonly involved in research, to supplement existing communication channels. Early implementation of the strategy has provided new and diverse opportunities for dialogue, interaction and partnership building. Through the complex social interactions inherent in the community engagement strategy, the centre aims to build context specific ethical relations with local residents and to strengthen understanding of how ethical principles can be applied in practice. Evaluations over time will assess the effectiveness and sustainability of these strategies, provide generalisable information for similar research settings, and contribute to debates on the universality of ethical principles for research. This paper aims to summarise the rationale for community engagement in research, drawing on published literature and local findings, to outline the process of community engagement in Kilifi and to describe issues emerging from its development and early implementation.

Informed consent: interpretations and practice on social surveys.

This paper discusses interpretations and practical requirements for fulfilling informed consent on social surveys, particularly in the health field, in order to achieve a balance between two competing principles: the public good of carrying out high-quality survey research which requires unbiased representative participation; and respect for individuals' rights to refuse to participate. It examines the appropriateness of different practical procedures aimed at getting agreement to voluntary participation consistent with the requirements of informed consent. It seeks to raise awareness of the principles and practicalities of carrying out social surveys in the health field, which can inform judgements of what is appropriate ethical practice, which in turn can inform judgements of ethical review committees.