Health & Society Archive (2013-2014)
Please see below for archived 2013-2014 events.
THE DIMINUTIVE HOMOLOGUE TO THE PENIS: THE CLITORIS, AMERICAN MEDICINE, AND THE VAGINAL ORGASM THEORY, 1900-1966
Sarah Rodriguez, Research Assistant Professor in Medical Humanities and Bioethics, Feinberg School of Medicine, Northwestern Universit
Research Assistant Professor in Medical Humanities and Bioethics, Feinberg School of Medicine, Northwestern University
THE MATERIALITY OF THE BRAND: FORM, FUNCTION, AND THE PHARMACEUTICAL TRADEMARK
Professor Jeremy A. Greene, Associate Professor of Medicine and the History of Medicine at Johns Hopkins University School of Medicine
After its patent expires, which qualities of a brand-name drug are still be considered to be private property? Which parts fall into the public commons as fully copiable by generic competitors?
This talk explores the limits of patents and trademarks in the sphere of pharmaceutical intellectual property, and illuminates a century of controversy over the clinical, public health, and financial value of “look-alike drugs”: a set of generic pharmaceuticals that imitated their brand-name counterparts down to exact parameters of size, shape, and color.
This dispute invoked thorny epistemological questions about pharmaceuticals as therapeutic technologies. Was the active pharmaceutical ingredient (API) the only public, knowable part of a drug, while other parts–binders, fillers, dyes, scores, and bevels—could be kept as trade secrets? Did these other physical parts of a pill bear some clinical function as well? Could the color of a capsule affect its therapeutic effects?
Professor Jeremy A. Greene, Associate Professor of Medicine and the History of Medicine at Johns Hopkins University School of Medicine, will present results of his ongoing historical investigation into the science, politics, and ethics of generic drugs.
This historical analysis sheds light on alternate regimes of monopoly in medicine that stretch well beyond the patent.
A light lunch will be provided for those who preregister for the program, at firstname.lastname@example.org. Registrations will be confirmed.
SEXUAL HEALTH AS BUZZWORD: COMPETING STAKES, PROLIFERATING MEANINGS, AND THE POLITICS OF NICHE STANDARDIZATION
Steven G Epstein
Professor of Sociology and John C. Shaffer Professor in the Humanities
In recent decades the idea of “sexual health” has gone from obscurity to ubiquity. The explosion of discourses, practices, and products that reference this goal can be traced through many of the usual markers of institutionalization in the worlds of public health and biomedicine, including the birth of journals, research centers, professional associations, and training programs. Yet the convergence around the term masks a remarkable diversity of scientific, political, economic, and cultural agendas. Through an analysis of both emergence and dispersion, I describe the contexts in which the recent emphasis on sexual health has arisen and the consequences of attempts to lay claim to it. On the basis of content analysis of documents, I identify 12 distinct “threads” of sexual health discourse and practice, and I characterize this proliferation of sexual health projects as an example of “niche standardization,” in which the cultural potency of a polysemous term is fueled by its being differentially standardized across multiple social worlds, both expert and lay. I examine the consequences of this niche standardization with respect to the biomedicalization and commodification of sexuality and the place of sexuality within practices of governance. Yet I argue that the effects of the invention and dispersion of sexual health are diverse and relatively uncontained, and that no social actor or institution has succeeded in establishing ownership. These findings also provide insight into the character and functions of buzzwords, and I suggest steps toward the development of “buzzword studies.”
RISK ACROSS BORDERS: SHIFTS IN SOCIAL CONTEXT AND THE PRODUCTION OF HEALTH RISKS
Héctor Carrillo, Associate Professor of Sociology and Gender & Sexuality Studies, Northwestern University
In spite of growing awareness about the influence of structural and social factors on health, many health promotion programs continue to emphasize individual behaviors in explaining health risk taking, thus making individuals responsible for their health risks. Alternatively, in addressing racial health disparities, public health efforts often rely on cultural explanations for risk and behavior that lump together large groups of people, thus emphasizing cultural difference over other factors, including individual ones, in explaining health risks.
In this talk, I examine the apparent tension between individual and cultural/group-based approaches to health promotion. I base my analysis on research on the HIV risk of Mexican gay and bisexual immigrant men. I discuss the effects of the sudden shifts in social contexts that these immigrants experience when they move to the United States—shifts that challenge the notion that risk-taking behavior is produced solely by individual factors. At the same time, I also discuss the role of intragroup diversity among these men in their experiences of incorporation into U.S. gay life and their HIV risk post migration, challenging the ways in which “cultural difference” tends to be understood by public health and the health sciences.
FROM ANONYMOUS BODY TO ACTIVE PARTICIPANT: THE HISTORY OF GYNECOLOGICAL TEACHING ASSOCIATES AT THE UNIVERSITY OF ILLINOIS AT CHICAGO
Doctoral Candidate, UIC Department of Sociology
Abstract: In one decade, the 1980s, the way in which medical students learned to perform the pelvic exam was radically altered with the introduction of gynecological teaching associate (GTA) programs. Prior to this transformation, most medical students performed their first pelvic exam on a clinic patient, who was often used as a passive object. In contrast, GTAs are paid laypeople who use their own bodies to teach medical students how to perform a comfortable, competent, and patient-friendly pelvic exam. This paper considers how it was that pelvic exam went from being taught on “anonymous vagina[s]” to being taught by women who talked back. I consider instruction of the pelvic exam as a set of practices in order to draw from a rich theoretical tradition in science studies on how networks, assemblages, and entanglements alter technoscientifc practice. I use one Chicago medical school as a case study to explore how it was that the pelvic exam became a target of feminist politics, and how feminist projects about control and self-discovery became interlocked with concerns in biomedicine over standardization and the rationalization of work (Berg, 1997). I argue that the pelvic exam was reassembled as feminists involved in the Women’s Health Movement allied with reformers of medical education to develop the GTA program as this medical school. As the program became successful, it was reassembled again through medical educationist efforts to standardize and quantify its value. This led to a program that lost its overt political impetus, but remains linked to its feminist history.
THE TRIALS OF GLEEVEC: INTELLECTUAL PROPERTY RIGHTS AND PHARMACEUTICAL POLITICS IN CONTEMPORARY INDIA
Kaushik Sunder Rajan
Associate Professor of Anthropology and Social Sciences, University of Chicago
In this talk, I explore the place of intellectual property in contemporary Indian bio-medicine. I use the case of the anti-cancer drug Gleevec as my empirical entry point. Developed by the Swiss pharmaceutical company Novartis in 2001, Gleevec provided the first test case of how a new, World Trade Organization (WTO)-compliant patent regime would be interpreted in India. This resolved as a complicated interplay between the technical and the normative, as considerations of the grounds of patentability, but also of distributive justice and public good, came to play a role in the debate. The technical rested on the adjudication of issues ranging from therapeutic efficacy to the nature of invention to the ontology of molecules themselves. And different normative orders were called upon, in ways that questioned simple dichotomies between market-driven value generation and state-ensured public good. I explore how in the process questions concerning the nature of rights and the definition of health came to be at stake.