Somatosphere welcomes you to the September edition of “In the Journals.” Scroll through our monthly round up of new research across anthropology, STS and social science journals.
The Problem with the Sex Toy Narrative: Design and Medical Intent in Early Vibrators
Dianya Mia Hua
This article challenges the dominant interpretation of early twentieth-century vibrators as inherently sexual objects. Rather than reading vibrators retrospectively through the lens of the modern sex toy industry, it examines hand-cranked and early electric devices from the perspective of design, use, and medical context. Drawing on artifacts, manuals, advertisements, and medical literature from Britain and the United States, the article argues that early vibrators were shaped primarily by therapeutic and cosmetic practices linked to massage medicine, gynecological therapy, and orificial philosophy. Attachments later interpreted as “phallic” or sexually suggestive emerged from clinical assumptions about circulation, nerve stimulation, and rectal or vaginal treatment rather than from explicit erotic design. By foregrounding design logic over retrospective meaning, the article reframes the vibrator as a medical and consumer technology whose sexual associations developed historically rather than existing from the outset. In doing so, it argues for a more historically grounded approach to technologies whose meanings shifted over time.
Theory, Culture & Society
Metabolo-politics: Bovine Metabolism and Environmental Biopower
Jonathon Turnbull, George Cusworth, Adam Searle, Else Vogel, François Thoreau, and Catherine Oliver
More-than-human metabolic processes increasingly constitute the locus of contemporary biopower, often responding to industrially-altered biogeochemical cycles. We conceptualise ‘metabolo-politics’ to examine the targeting of bodies and populations via interventions in the biochemical surroundings and ecologies that shape them; and simultaneously, the administration and modulation of materials in the environment via interventions in the bodies and populations that ingest, digest, and excrete them. Focusing on the governance of environmental crises related to carbon and nitrogen pollution, particularly in livestock sectors in the Global North, we offer three analytics for theorising metabolo-politics as a form of governance oscillating between bio-politics and anatomo-politics. They are: the dispositive, which grapples with the relations of matter and discourse that shape emergent problematisations of metabolism; the milieu, which is the more-than-human scene of intervention; and technologies, which are the diverse means through which power is operationalised metabolically and through which bodies, populations, and environments are governed.
Affective Eugenics: Education, Political Polarization, and the Affective Sorting of Futurity
Petra Mikulan and Michalinos Zembylas
This conceptual-speculative article examines political polarization as a deliberate strategy of affective governance in an age defined by mass dispossession and ecological collapse. We argue that polarization should not be treated as a temporary crisis to be resolved but as a governing technology that organizes fragmentation, consolidates elite power, and deflects attention away from demands for structural transformation. To theorize this dynamic, we introduce the concept of affective eugenics, describing how affective governance legitimizes privatized futures for the few while rendering the many surplus through a sentimentalist and biopolitical sorting of affective capacity. Within education, this affective sorting materializes as a triage of feeling: elite institutions cultivate planetary crisis managers, middle-class students are conditioned for resilient compliance, and underfunded schools are left to manage disposability. We conclude by outlining the educational implications of affective eugenics and calling for praxes of affective de-settlement, refusal, and opacity that unsettle these hierarchies.
Patrice Whitehorne-Smith, Kunal Lalwani, Ben Milbourn, Wendel Abel, Robyn Martin, and Sharyn Burns
Globally, people with serious mental illnesses (SMIs) experience significant challenges with healthcare access. This increases their risk of developing chronic physical illnesses (CPIs) and results in negative health outcomes and shorter life expectancy. The Jamaican public mental health service has undertaken several transformations to increase the accessibility of mental health services and improve outcomes for people with mental illnesses. Despite this, there is an absence of research exploring the prevalence of CPIs among people with SMIs and their experiences accessing healthcare in Jamaica. This study seeks to address the dearth of research by exploring the prevalence of CPIs among people with SMIs, as well as their experiences and their caregivers’ experiences of healthcare access. The study utilised a convergent mixed-methods design with a dominant qualitative strand. Surveys were conducted with 306 people with SMIs attending mental health clinics across Jamaica. In-depth interviews were also conducted with 23 people with SMIs and with five of their caregivers. The findings of the study revealed that approximately 29% of people with SMIs also had one or more CPI. Three themes outlined key influences of healthcare access for this patient population: 1) money, family, and social support, 2) emphasis on the medical model, and 3) healthcare culture and expectations. The findings of the study indicate that social and cultural factors underpin the healthcare access experienced by this population and call for multi-sectoral and inter-disciplinary strategies to address the healthcare access needs of people with comorbid SMIs and CPIs.
U.S. Clinicians’ Recognition and Diagnosis of Cultural Concepts of Distress
Yunjung Lisa Chung, Shea Wenzler, Emma Headley, Gabriella Scalzo, Waverley Vesely, and Jared W. Keeley
In an increasingly diverse world, it is important for mental health professionals to be familiar with symptom presentations from a variety of cultures, including cultural concepts of distress. This study aimed to evaluate how U.S. clinicians diagnosed two cultural concepts of distress—hwa-byung and ataque de nervios—and whether the clinicians’ cultural values or competence influenced their diagnosis. A sample of 84 mental health professionals viewed three case vignettes in random order depicting hwa-byung, ataque de nervios, and Generalized Anxiety Disorder. The clinicians provided an unprompted free-response diagnosis and a forced-choice diagnosis from a predetermined list for each vignette. Clinicians provided a wide range of diagnoses for the hwa-byung and ataque de nervios vignettes, with only a minority of participants correctly labeling the cultural concepts of distress. Prompting diagnoses by providing a list of options improved the likelihood of selecting a cultural syndrome. The most common mental health diagnoses selected did not adequately capture the symptom profiles of the cultural concepts of distress. Clinicians appeared to be more familiar with Latinx cultural presentations than East Asian. U.S. clinicians could likely benefit from additional training and exposure to varying cultural presentations of psychopathology. Labeling a cultural syndrome with a psychiatric diagnosis may lead to decreased rapport and insufficient or ineffective treatment options.
Personal Recovery of People with Schizophrenia in Martinique: A Qualitative Study
Coralie Bourzeix, Manon Salvetax, Christelle Samot, Julie Gilles De La Londe, Jean-Sébastien Cadwallader, Marie Koenig, and Marie-Aude Piot
The personal recovery approach in mental health draws on people’s own experiences to build care policies. Models of personal recovery constructed in recent decades have been based on studies in Anglo-European cultural settings. No study has been conducted in Martinique, where Creole culture is prevalent. Our work aimed to explore the recovery experiences of people with schizophrenia in Martinique. We carried out a qualitative study. Fifteen people participated in a face-to-face interview, with collection of sociodemographic data. Three themes emerged from the analysis: self-work; evolving illness role; and rebuilding identity. Our results described a recovery process in which strong importance is given to social norms, involving difficult adjustments among multiple therapeutic approaches and overcoming psychological trauma. Access to employment, housing, and financial autonomy was related to social recognition. These results suggested the value of different approaches to aid recovery, including: support from relatives, peers, and caregivers; valuing their experiential knowledge; support for psychological trauma; fighting against the stigmatization of schizophrenia in Martinique; social support for work and housing empowerment; and recognition of the complementarity of the biomedical, religious, and traditional health care sectors.
Experiences of Bicultural Mental Health Clinicians Working Within Australian Mental Health Settings
Erin Joyce, Komal Khan, Dominic Hwang, Anna Browne, Taff Ruvaro, Bindu Joseph, and Michael Olasoji
Access to mental health services for people from culturally and linguistically diverse (CALD) backgrounds remains problematic owing to a variety of factors that contribute to low engagement with mental health services. There is also a need for our mental health systems to be more culturally safe to effectively and equitably support their diverse consumer population. Several initiatives have been explored to increase access to mental health services and improve help-seeking behaviours among CALD populations. One of these measures is the use of bicultural workers (BCWs). This study aims to explore the experiences of bicultural mental health clinicians working in tertiary and community-based mental health services. An exploratory, descriptive qualitative study was undertaken. Data were collected through semi-structured interviews involving n = 18 mental health clinicians in area and community mental health services. Participants were recruited using purposive convenience sampling. Data were analysed using thematic analysis. The findings of this study highlighted three key themes: (a) A shared understanding of the world (subthemes: ‘The lived experience of biculturalism’, ‘Having a different perspective’ and ‘Building rapport and managing boundaries’); (b) Working with other colleagues; and (c) Establishing a BCW model. Participants discussed their ability to use their biculturalism to understand consumers’ perspectives from CALD backgrounds. A shared understanding of the world was also seen as valuable. They reported varied experiences regarding whether their biculturalism was valued within their teams. Many participants felt that establishing a dedicated BCW role model within mental health settings could benefit consumers.
The Outsiders: Principled Withdrawal, Whiteness, and Power in the Los Angeles Food Justice Movement
Hanna Garth
This article draws on understandings of whiteness and the misconstrual of South Central Los Angeles to analyze the power dynamics between “outsider” activists and residents of South Central as they worked toward a more equitable food system. As concerns over the “obesity epidemic” and the push for “real food” in the 2000s coincided with a surge in GIS data on “food deserts,” a new cadre of activists, often white and middle-class, began intervening in South Central Los Angeles as part of the food justice movement. Residents had already been organizing around broader social justice issues and food retail equality. Though food justice brought these groups together in multiracial organizing, there were divergent visions about the problem and the goals of food justice work. In some cases of conflict, in a process I call “principled withdrawal,” residents withdrew from project situations that they did not align with ideologically, morally, or practically.
Containing Histories Past and Present: Making Samples in the “Huntington Collection” (1893–1921)
Alanna L. Warner-Smith
The Huntington Anatomical Collection (1893–1921) includes the skeletal remains of immigrants, migrants, and lifelong New York City residents. The collection’s formation was coeval with the formalization of physical anthropology, and the collection was made to serve research aims centered on race and origin. This early focus on race has materially shaped the collection, and, in turn, researchers’ ongoing engagements with it. When delineating research questions and forming samples, researchers (even those critical of race science and the collection’s history) tend to do so along race- and place-based categories prioritized by early curators and physical anthropologists. Treating these categories as the primary axis of difference flattens the complex life histories, movements, and social relations of the people in the collection, thus occluding a view of life courses as lived. Drawing upon archival evidence, I argue that such separation practices have profound implications for how we view belonging, social relations, and kinship in the past. These concerns extend into present questions regarding descendant engagement, as practitioners and institutions define communities of care and navigate future consultation and return.
Lumila Paula Menéndez, Sophie Veigl
The evolutionary study of human dispersal is a key topic in biological anthropology. However, recent research has revealed inconsistencies between molecular and anatomical data across different timescales and geographic regions. Despite increased interdisciplinary dialogue, these discordances are rarely analyzed in depth or interpreted for their biological significance. We present two case studies: human diversification in Southeast Asia and the Americas, which highlight persistent conflicts between morphological and genetic interpretations. Drawing on recent calls for extending the conceptual tools of evolutionary theory, we argue for a pluralist explanatory framework that can account for developmental plasticity, environmental responsiveness, and multiple trajectories of inheritance. We show how treating different datasets as epistemically equal—rather than subordinating anatomical data to molecular “controls”—allows for more comprehensive and nuanced explanations of evolutionary phenomena. This approach not only offers new insights into past human variation but also addresses long-standing issues of disciplinary fragmentation.
Perfecting Exit: The Politics of Quitting Among Migrant Care Workers in the United States
Cati Coe
Quitting tends to be overlooked in studies of resistance and labor because of its individual and private character, its ineffectiveness in changing conditions of labor, and the difficulty of studying it, in favor of more organized and public protests and strikes. This paper examines why quitting is so popular among African immigrant home care workers in the United States, arguing that exit was attuned to the diffuse power relations of fissured workplaces in which home care workers care for individual clients through the mediation of brokering agencies. Quitting was not entirely individualized and private, as it became a collective strategy nurtured through circulating stories and a widely shared worldview of anti-Black racism and anti-immigrant sentiment. In exploring the complexity, possibilities, and limitations of quitting, I point to the continuum of modes and degrees of resistance, rather than compartmentalizing some as private and some as public. The variability in the degree of privacy and individuation makes these forms of maneuver in relation to diffuse power adaptive to different degrees of scaling up and organizing. As anthropologists attend to the dynamism of resistance in relation to power, they should not overlook the phenomenon of quitting.
Catarina Barata, Chiara Pussetti
This article explores how the mistreatment of women in health care facilities in Portugal takes on particular forms for Black migrant women, shaped by essentialist ideas about race and miscegenation. In line with academic production on processes of racialization and discrimination against minorities and the medicalization of reproductive processes and biocontrol, this paper focuses on how these phenomena are reflected in the gynecological and obstetric care of Black women of Brazilian and African origin in Portugal. The women interviewed within the authors’ research on the ethnopolitics of citizenship and on obstetric violence speak of discrimination based on their ethno-racial, national, and migration status, as well as perceived ideas about their sexuality, behavior, and preferences in maternity and childbirth. Afro-descendant women’s interactions with workers of the health and social care sectors in Portugal are often informed by stereotypes about their bodies and their presumed (in)capacities to be good mothers. By focusing on the experiences of Black migrant women and their perceptions of public health and maternal care, this paper builds on previous work by the authors to address the issue of gynecological and obstetric violence in Portugal.
Campaneando: Surveilling With the Dead in Bogotá’s Drug Markets
Andrés Romero
This article offers a literary ethnography of one of Bogotá’s ollas or drug markets where centuries of violence ripple across the ambiance. It tells the story of the work undertaken by the campaneros, the lookouts who work for criminal governance to protect the olla, and how they cultivate collective attunements for surveilling the place. To perceive, intuit, or forebode threats, the campaneros create a sentineled structure that communicates across corners, while also drawing on drug-induced states of paranoia, clairvoyance, or necromancy. Drawing on extended ethnographic fieldwork (2012–2018) and methods of fabulation, I propose a necromantic ethnography that, by constellating multiple sources, perspectives, forces, and voices, aims to conjure the resonating and palpable force of history and the dead across the olla.
“We Do This Too”: Alternative Futures of Black Motherhood
Patricia Hamilton
In this paper, I draw on black mothers’ engagements with attachment parenting to meditate on this moment of crisis in black reproduction and black mothering. Using Jennifer Nash’s critique of this crisis framing and its consequences for black feminism, I argue that attending to the “ordinary” in black mothers’ experiences may yield alternative visions of black motherhood that depict them as neither dupes nor revolutionaries. The paper is based on a wider sociological project that involves interviews with 19 black mothers living in the UK and Canada. The project’s focus on attachment parenting, a popular but controversial parenting philosophy that rests on both historical and contemporary racialized ideals of good mothering, provides a unique opportunity to generate new perspectives made possible by the diversity of responses the philosophy elicits
Jane Thomas, Sean Tunney & Adam Cox
Community empowerment projects aimed at improving health and wellbeing have tended to be ‘place-based’. But they may also be based on ‘communities of interest’. This paper advances an original conception of health-related empowerment by focusing on the work of trade unions, which we treat as being among such communities. Organised labour improves health and reduces inequalities through processes including collective bargaining, even as public health actors have shown resistance to engaging with unions. We focus on an unresearched area of unions’ andragogy that is central to empowerment: that of motion writing and resolution-related mobilisation, arguing this has direct and underexploited implications for public health. Drawing on triangulated data from a UK-wide survey of unions representing more than 2 million members, in-depth interviews and website analysis, we consider how resolution-associated practices can form bridges between people’s individual concerns and collective decision-making. Such ‘micro-meso-macro’ connections can support initiatives that other empowerment projects have failed to establish. This generates a new resolutions-based conceptual model: the multi-level empowerment pathway. Our research contests the prevailing public health paradigm. We build on previous union–health research to help reconsider action on health determinants operating as global challenges, suggesting an internationally applicable infrastructure for participatory action.
Priority-setting in health care: A challenge to solidarity?
Katharina Kieslich
This article explores the relationship between the principle of solidarity and the challenge of setting priorities in health. It addresses an analytical gap that arises from frameworks for fair priority-setting that are inundated with discussions of technical and ethical criteria to help prioritise services, but that do not explicitly consider notions of solidarity. The article employs a categorisation scheme as a heuristic device to descriptively explore the identified research gap. Priority-setting decisions are divided into three categories to reflect the outcomes of prioritisation processes: (1) To fund a treatment, service or infrastructure project; (2) Not to fund or prioritise a treatment, service or infrastructure project; (3) To disinvest or stop funding a treatment, service or infrastructure project. Using Prainsack’s and Buyx’s practice-based definition of solidarity, the article discusses the extent to which different categories of priority-setting outcomes can be labelled acts of solidarity, or not. It concludes that while solidarity is an important principle for designing and financing health care systems, it is not a concept that helps address the complexities of priority-setting because the sacrifices and losses patients are asked to accept are often too high to be justified from a solidaristic point of view.
Maja Klausen & Stine Lomborg
As healthcare becomes increasingly datafied, public healthcare systems are becoming more deeply entangled with commercial digital infrastructures. While existing research has examined the political, ethical and infrastructural implications of these developments, less attention has been paid to how patients themselves experience and evaluate health data flows. This article investigates how Danish patients living with chronic illness understand data movement within public-private health infrastructures and explores methodological approaches for eliciting such perspectives. Drawing on five workshops with patients and informed by infrastructural analyses of mobile health apps, we combined written statements, an “attitude compass,” and appscapes (visualisations of app data flows) to facilitate sharing of lived experience, evaluative reasoning and speculation. Analytically, we mobilise the concepts of sticky, leaky and flowing data to characterise patient experiences. Participants frequently described data as “sticky,” becoming stranded across devices, institutions and systems, thereby preventing meaningful circulation to healthcare professionals. Concerns about “leaky” data emerged primarily in relation to speculative reflections on commercial third-party access enabled by digital infrastructures. The findings suggest that contextual legitimacy weighs more heavily than abstract concerns about privacy or public value: When data sharing is perceived as meaningful and potentially life-saving, itis understood as necessary and legitimate.
Reading disgust: a critical gerontological examination of a Hindi-language short story
Tannistha Samanta & Vinay Suhalka
Senescence in fiction has been rarely studied in the cultural gerontological tradition in India. While later life associated with intergenerational authority, or enhanced religiosity or as a cultural process of worldly renunciation, have been themes in the phenomenological corpus of gerontology in India, studying the aging feminine body has remained outside the intellectual sensibilities of this field. In this paper, we analyze the short story, Boodhi Kaki (old aunt) by noted Hindi and Urdu writer, Munshi Premchand (1880–1936) to explore the cultural construction of the abject, an ambiguous liminal stage that is distinct from notions of “Third” or “Fourth” age in life-course studies. As such, by focusing on food and (a devouring) appetite of the older female protagonist, we complicate the entanglements of desire and disgust in aging studies. Ultimately, we explore the transgressive potential of the abject as a self-reclaiming device that upends cultural understandings of age(ing) and gender.
P. Omkar Nadh
The invention of the human papillomavirus (HPV) vaccine occurred at a moment when academic life science research was becoming increasingly reoriented toward market-driven goals. This transformation, shaped by policy shifts promoting the commercialisation of academic research, altered traditional forms of scientific competition. Economic value came to structure not only research agendas but also the institutional logic of academic practice. Intellectual property rights played a key role in materialising this shift, with powerful market actors influencing the outcomes of scientific contests to secure monopolistic control. The case of the HPV vaccine illustrates how upstream innovation processes, especially decisions about ownership, licensing, and legal structuring, determine downstream outcomes such as pricing and access. This challenges prevailing approaches in public health that treat access inequalities as isolated or downstream issues, instead highlighting how the architecture of biomedical innovation itself shapes the terms of inclusion and exclusion in global health.
Reframing health security: from national protectionism to human solidarity in the COVID-19 era
Arda Gucler
In global studies, the Covid-19 pandemic has been associated with the return of national protectionism at the expense of a human rights-based approach to health. While this may be partially true, this article will shed light on a different aspect of national security. Context plays a key role here. In the context of Western liberal democracies, a securitized approach to health is seen as detrimental to basic constitutional rights such as right to work and mobility. However, from the perspective of low-income countries, national security implies the urgency of a global solidarity in the name of enhanced human rights such as right to food and shelter. This article develops this argument by comparing national security to other competing policy frameworks such as human security, human rights, and global goods in the context of the Covid-19 pandemic.
Chains of exchange: The iterative process of resource-health conversion
Cayley Ryan-Claytor & Jonathan Daw
Existing sociological theories of the positive relationship between resources and health emphasize the fundamental causes and social-structural forces that shape health outcomes, but focus less on intervening mechanisms and the processes by which those resources ‘become’ health. We present the theoretical framework of ‘chains of exchange’: iterative processes of transformation that resources undergo along a causal pathway to ultimately affect embodied health for better or for worse. The choice to pursue a particular chain of exchange is conceptualized as a function of several interactive factors: the inherent characteristics of resources, the individual’s life course history and resource endowment, the gatekeeping practices of institutions, and the social desirability of the exchange. The chains of exchange framework explicitly incorporates countervailing mechanisms and choice architecture into the resource-health relationship by emphasizing individual agency in the process of selectively using resources to affect health. Our aim is to provide a tool, for social determinants of health research and practice, to facilitate the investigation of how interventions at different points of resource exchange and causal proximity to health can have varying levels and kinds of success in shaping health outcomes.
Guillermo Ruiz-Pérez
The integration of peer support workers (PSWs) in mental healthcare challenges not only the prevailing medical model in practice but also its underlying attitudinal structures. This paper develops a theoretical framework based on Ortega y Gasset’s philosophy of belief to conceptualize disease models as attitudes that shape how stakeholders perceive mental health issues, and secondarily, act with regard to them. Understanding the medical model as an embodied system of beliefs allows for an analysis of resistance to PSWs, as beliefs regarding their usefulness may conflict with stakeholders’ previous attitudes and therefore force attitudinal transformation. We argue that PSW integration can foster a shift from a hierarchical, deficit-based system to a co-productive model that values lived experience and recovery and loosens fixed medical categories. However, this process may not only require structured training, institutional support, and collaborative engagement, but also necessitate professionals to self-reflect on their own attitudes and belief systems. Our proposed theoretical framework posits that attitudinal change, rather than policy reform alone, is key to making peer support a meaningful component of mental healthcare.
Clare Herrick
While hospital beds are at the heart of healthcare delivery, they have received little conceptual attention within the social sciences. Instead, the focus has tended to be on explaining their changing numerical characteristics and the consequences of this for patient care, health systems functioning and the practices of the healthcare professions. While the number of beds is certainly of critical importance, this paper pushes beyond this to examine the work that these numbers do and perform. In so doing, it argues that beds are best thought of as a barometer in both a material and figurative sense. As such, beds can gauge system pressure, they act as ‘sentinel’ or warning devices should this change and are responsive to the viscosity (or flow) of health systems. And, in a figurative sense, they are reflective of shifts in prevailing public or political opinion, as well as economic or biomedical trends. Beds are therefore woven into a tight web of system inter relationships and interdependencies which makes the calculation of any ‘optimum’ number of beds, either now or in the future, fraught with challenge.
Decolonising medicine: what role will sociology and sociologists play?
Brigit McWade & Dawn Goodwin
In response to calls for medicine, sociology, the university, and healthcare to be decolonised, this article considers the role of sociologists working in medical education in decolonising medicine. Efforts to decolonise medicine have largely focussed on biomedical knowledge and practice, while work to decolonise sociology has under-explored issues of health or medicine. Sociology in medical education sits between these two lines of work and has yet to be thoroughly scrutinised through a decolonial lens. Consequently, we respond to (Bhambra’s in Critical times 4(1):73-89, 2021 and Meghji’s in Sociology 56(1): 131-147, 2021) invitation for all forms of scholarship, regardless of how critical they perceive themselves to be, to examine their histories and entanglements with colonialism and racism. We grapple with the history and contemporary practice of medical sociology, reviewing its disciplinary identity and relationships with medicine, sociology and medical education. We argue that, as sociologists in UK medical education, we have been socialised into an embattled position as ‘critical friend’ to medicine, and an ‘applied’, ergo lesser, form of sociology, requiring us to continually assert our relevance. In turn, this preoccupation has, until recently, prevented us from confronting our own colonial roots and entrenched white solipsism.
Strategic certainties: epistemic habitus and the performance of knowledge in psychiatric practice
Ángel Martínez-Hernáez
Uncertainty is a structural condition of psychiatry, yet it is routinely concealed by practices that transform ambiguity into apparent clarity. Diagnostic categories remain provisional and culturally variable, but health systems demand resolution. This article develops the concept of strategic certainties to describe how institutions perform knowledge where doubt persists but cannot be admitted. Complementing McGoey’s notion of strategic ignorance, the concept highlights a parallel logic of legitimacy: ignorance manages accountability by suppressing knowledge, while certainty manages authority by asserting it under conditions of indeterminacy. Drawing on two ethnographic studies in Catalonia (community-based care for psychosis and psychiatric responses to workplace harassment) the analysis shows how certainty is enacted through diagnostic anchoring and pharmacological routines in the first case, and through the reframing of structural violence as individual pathology in the second. Across both settings, strategic certainties operated as expressions of an epistemic habitus that channels ambiguity into forms compatible with institutional order and social control. They render action possible and sustain institutional order but often foreclose recognition. The findings show that strategic certainties are patterned institutional mechanisms rather than isolated errors. Understanding certainty as a socio-epistemic practice opens possibilities for care cultures able to sustain uncertainty ethically.
Conspiracy theory as a component of religious biopolitics
Kiarash Aramesh, Federico Germani & Giovanni Spitale
The biopolitics of identity-centered religious movements has been a primary source of conspiracy theories in recent decades. This paper explores the shared characteristics of three examples of identity-centered religious and political movements with biopolitical agendas from three different parts of the world: Christian nationalism in the United States, Hindu nationalism in India, and political Islam in Iran. All these political religious movements rely on and advocate for pro-fertility norms and lifestyles, propagate health disinformation and conspiracy theories, and pursue political power to promote their biopolitical agendas. During the COVID-19 pandemic it became evident that such biopolitical agendas and their conspiracy theories can become popular and cause severe damage. Civil society and bioethical institutions can address this issue as a part of the problems posed by infodemics, resulting from the propagation of disinformation and conspiracy theories at local, national, and global levels.
Jorge Luis Crespo Suarez
In this paper, I examine key milestones in the expansion of mental health care in Chile, showing how it has evolved within the public health system and gained broader visibility and influence in society. To do this, I draw on historical primary and secondary sources, alongside scholarship from historians and other disciplinary specialists, and relevant official policy documents. I analyse how mental health care has changed in meanings, practices and places. From an explicitly coercive response, directed at groups of people seen as disrupting the social and classified using a limited set of medical labels, to a response increasingly framed around the professional responsibility to care for mentally ill persons, drawing on an ever-expanding range of diagnostic categories and experts. From being located in asylums and later in closed psychiatric institutions, to being situated within community-based institutions, and particularly within public primary health care. I argue that these different problematisations of mental health have contributed to the expansion of medical jurisdiction in everyday life. This has mainly occurred through the development and entrenchment of a top-down, expert-led strategy. Although reconfigured across changing normative frameworks, such epistemic, institutional, and clinical solutions have evolved and endured in Chilean policy and are reflected in formal mental health care provision. Consequently, there remains an ongoing risk that epistemological and cultural diversity may be marginalised or selectively reformulated in ways that align with a dominant framework – one that tends to absorb political contestation into an individualised, biomedical approach.
Me, Myself, and IE: describing the actualities of undertaking institutional ethnography
Oliver Birch, Peter Adams, Bruce Cohen & David Newcombe
Through Institutional Ethnography (IE), one can explicate how people’s lives are being socially organised. The ethnographer creates an empirical account of what happens within a complex of institutional order, moving iteratively between data collection methods to see how the ‘institution’ occurs through people’s work, how texts are used to coordinate it, and how these texts reproduce ideology. They follow findings as they arise, with reference to the perspectives of ‘standpoint informants’. However, because this process is iterative, descriptions of IE studies vary greatly. Guidance on how to undertake IE’s methods is often specific to the institution being studied. To aid prospective ethnographers, the article describes a step-by-step process through which IE was interpreted and implemented in practice in a healthcare setting. Though it references research at an Opioid Substitution Treatment (OST) service, the account is not prescriptive; rather, it illustrates how one might undertake IE-informed data collection and analysis while being consistent with what is expected of an IE.
Dispersed HLA variability and the making of solidarity in umbilical cord blood collection in Italy
Lorenzo Beltrame
Umbilical cord blood (UCB) is a source of hematopoietic stem cells used as an alternative to bone marrow transplantation for the treatment of hematological malignancies, blood disorders, and bone marrow failure. UCB is particularly valuable for patients from ethnic minorities who are underrepresented in international bone marrow donor registries. In response, national public UCB banking systems have developed strategies to increase the number of UCB units with human leukocyte antigen (HLA) haplotypes compatible with those of minority populations. This article examines the social implications of the strategies adopted in Italy to capture HLA variability through UCB banking. It argues that the country’s dispersed, territorially distributed network of UCB collection sites operates on a principle of generalized solidarity that enables the capture of HLA variability while mitigating the biases associated with residential segregation and healthcare inequalities. The article ultimately demonstrates that the UCB collection network is not merely a biomedical infrastructure, but a socio-political one.
Ahtisham Younas
Addressing health and social care disparities is an individualistic, organizational, and systemic endeavor. The root cause of disparities is collectively our individualistic unjust behaviours towards others, structural determinants, and systems of power, resulting in oppression of populations. The purpose of this paper is to propose social intersectional compassion framework for promoting social justice in health and social care. Drawing from intersectionality theory and literature about compassion, social intersectional compassion is defined as identifying, understanding, and alleviating individuals’ suffering through intentional and shared examination of their intersecting multiple identities and the impact of social systems and institutional structures on their well-being. The actionable ways to practice social intersectional compassion are: (a) understanding the meaning of suffering from individuals’ perspectives, (b) recognizing the root intersecting identities, structures, and processes contributing to suffering, (c) developing a relational connection with the individuals to attempt to alleviate suffering, and (d) embracing self-vulnerability to be affected by individuals’ suffering. The proposed framework of social intersectional compassion attempts to offer direction on how to alleviate individuals’ suffering and promote social justice and equity during individual interactions and when interacting with underserved communities in everyday life.
Medical gaslighting: conceptual and theoretical foundations
Emma Noble
Medical gaslighting is a term that is frequently found in gray literature but rarely found in formal literature. However, Gaslighting is a term that has been examined in scientific literature, typically in relation to intimate partner relationships. I compare the concepts gaslighting and medical gaslighting in literature to identify critical distinctions and develop the following conceptual definition for medical gaslighting: Medical gaslighting is an interpersonal phenomenon involving a healthcare professional and a patient within which the healthcare professional trivializes, psychologizes, or dismisses the patient’s subjective bodily symptoms and health concerns. This leads to delays in care, medical mistrust, doubt in the reality of one’s bodily experiences, and medical trauma. Habermas’ Theory of Communicative Action and Foucault’s conceptualizations of power are proposed as theoretical underpinnings to the phenomenon of medical gaslighting in order to contextualize the antecedents which make the phenomenon possible and lay the groundwork for future studies that I hope will aim to quantify and mitigate its effects on the health of marginalized populations.
Antonio Montañés Jiménez
Based on long-term ethnographic research among Roma/Gitano Pentecostal communities in Madrid, Spain, this article examines how Pentecostal Gitano men articulate their moral engagement and struggles within the urban context. It provides an ethnographic account of how rhetoric, archetypes, and references to storytelling—including biblical Christian gendered principles and prevailing heteronormative notions of manliness in barrios—shape the construction of urban Gitano masculinities. The article contributes to the expanding literature on the intersection of masculinity and Christianity, specifically investigating how public expressions of masculine piety and virtue relate to urban experiences, ethics, and reflexivity. Rather than merely documenting behavioral changes, the analysis centers on how Spanish Pentecostal Gitano men narrate profound transformations in their relationships with other Gitano men, their inner emotional lives, and the urban environments they inhabit, following spiritually transformative encounters with the Holy Spirit. A substantial portion of Pentecostal Gitano narratives concerning moral cultivation and masculine moral behavior is articulated through holistic Christian concepts such as los frutos del Espiritu Santo (the fruits of the Holy Spirit). Specific fruits, including amor (love), docilidad (gentleness or docility), and dominio propio (self-control), serve as key idioms that render moral cultivation intelligible, meaningful, and valued within communitarian and institutional Gitano contexts. This article advances scholarship on urban religious masculinities by analyzing how dominant cultural stereotypes inform the construction of Christian public personae in settings characterized by asymmetric cultural power relations, and by linking the emergence of masculine moral and redemptive themes to Christian moral apologetic traditions that emphasize Christianity’s potential to reconstitute social orders and generate societal benefits through the proliferation of Christian churches.
Killing the River to Build the Border: Ecological Violence, the Rio Grande, and the US-Mexico Border
Chilton Tippin
This article advances ecological violence as a theory to describe multiple forms of violence along the Rio Grande in the El Paso, Texas-Cd. Juarez, Chihuahua borderlands. Ecological violence denotes a modality of violence entangling people, more-than-human beings, and the enlivened places they co-produce. This concept complements other theories of violence applied in the US-Mexico border context while insisting that structural harm tethers to land-and-water relations, discursive erasures, and white settler colonialism. I ground these claims in ethnographic research conducted along the Rio Grande in 2024. Fieldwork included multiple longform interviews with a key interlocutor at Ysleta Del Sur Pueblo—a tribe whose ceremonial relationships with the river have been obstructed by the border wall and other infrastructures of exclusion and surveillance—as well as participant engagement with first responders and migrant advocacy groups. In 2024, the El Paso Sector became the deadliest zone for migrants along the entire US-Mexico border, with drowning a leading cause of deaths. These drownings occur as the US has hardened the border, drawing the Rio Grande’s waters into a series of lethal, moat-like canals. This article thus argues that building the border entails a gradual killing of the river, as well as the disruption of Indigenous lifeways and systematized migrant deaths—all of which illustrate ecological violence’s presence in the borderlands.
The Corporeal Humanity of the Kashmiri Militant: Body, Image, Song
Mohamad Junaid
“Kashmiri militant” has been a historically opaque, shape-shifting figure in the Indian nationalist imagination. Represented as a threatening symbolic impurity within the national body politic, the Kashmiri militant is seen variously as dangerously nihilistic, nonpolitical, and incomprehensibly violent; impressionable yet uncompromisingly death-deserving; and embodying an unassimilable Muslim masculinity (in contrast to a desirable Kashmiri femininity). In the visual culture of the Indian occupation in Kashmir, police and military photographers circulate pictures of dead Kashmiri militants, disheveled and bloodied with torn clothes and limbs out of joint, presenting them as wild, hunted felons. For Kashmiris, however, who mourn and memorialize their death, the Kashmiri militant is a polyvalent personhood narrated as bridegroom, child, lover, saint, warrior, and martyr. Based on visual counterculture centered on and inaugurated by Burhan Wani, a young militant whose death led to weeks-long protests in 2016, this article examines the political lives and afterlives of the figure of the “militant” in Kashmir. Situating Wani’s images within the broader history of violence against Kashmiri bodies, the article argues that the “Kashmiri militant,” as a spectral presence in the Indian colonial-nationalist imagination and as an embodiment of moral resistance to Indian control in Kashmiri memory, defies a neat conceptualization of which bodies deserve humanistic consideration. I argue that the militant body as death-deserving is the effect of how the Indian state symbolically and violently polices the borders of nationalism and humanity, as well as of the liberal calculus of innocence and guilt.
BioSocieties
Microbial eccentricity: more-than-human creativity in anthropoeccentric worlds
Valentina Marcheselli
By looking at the study of microbial metabolism in a molecular biology laboratory, this paper aims to explore how the agency attributed to microbes is built into scientific practice and discourse. I mobilize the word eccentric to unpack the creative, ingenious, and unconventional nature that is assumed of microbes. Because of their expected and yet always surprising chemical capabilities, microbes are understood not only as potentially dangerous pathogens, but also as instrumental in fixing the anthropogenic problems to which humans are struggling to find a solution. The paper then moves on to examine the strategic use of microbial potentialities at the interface between the bio- and the geo- and how this recasts human–microbial relations: the anthropos, finding themselves incapable of facing epochal problems, discover their dependency on other entities, but remain a measure of the extent to which a state of affairs is problematic and in need of repair. I call this partial displacement of the anthropos from the microbiologists’ cosmos “anthropoeccentrism” and invite a reflection on the way that the study of microbial metabolism substantiates and redistributes power and agency across scales.
Regulating synthetic biology by naturalizing it: the mis-classification of a GE mosquito
Zahra Meghani
A recently developed genetically engineered (GE) mosquito with synthetic DNA has been categorized by the Secretariat of the Convention on Biological Diversity as a synthetic biology organism. In contrast, a key regulatory agency has construed it as a natural biopesticide. This paper identifies the non-epistemic concern that appears to have motivated that classification decision. It is argued that the mis-classification of a product by a regulatory agency may mean that it undermines its own categorization framework.
“Thanks Piggie”: the emotional practices of killing livestock pigs in organ research experiments
Sofie á Rogvi & Anja M. B. Jensen
Every day research animals of different species are made to live and die in research facilities as part of biomedical research. This article looks at the killing of livestock pigs for organs to be used in transplant science; a science driven by goals to save human lives by improving the use of donated organs. Based on an ethnographic study carried out in Denmark and the US, we explore how people engage in killing pigs and what it takes for humans to kill pigs for research, beyond the technical and procedural work. The article investigates the experiences and reflections related to killing pigs for organ research in three different contexts: the barn, the operating room and the slaughterhouse. The article proposes that killing pigs for organs in scientific contexts is an ethico-emotional practice where both emotions and ethics unfold through negotiations of nearness to the pig, the pig’s organs and the overall purpose of the research. Through three killing stories we show how emotions are evoked, calibrated and redirected to make killing legitimate, doable and bearable for those doing it.
The concept of metabolism in ocean biogeochemistry: departures, consistencies, and implications
Elis Jones & Erin M. Bertrand
‘Metabolism’ is a term commonly defined as the sum total of chemical processes happening within some living entity which sustains that entity. Biogeochemists use this concept somewhat differently. A stark example comes from marine contexts, where biogeochemists sometimes refer to ‘ocean metabolism’. From the standard biomedical perspective, the ocean does not seem to be the kind of thing which can possess metabolism; it does not seem to be a single living entity that is sustained by chemical processes. In the light of this puzzle, this paper does three things: first, we flesh out a distinct biogeochemical sense of metabolism, exploring how this differs from, but retains connections to, biomedical definitions of metabolism. Second, we use this to explain how the ocean can be considered metabolic without needing to be considered an organism. Finally, we explore the consequences and implications of this sense of metabolism–in scientific, epistemic and social dimensions – and of recognising biogeochemical systems, such as oceans or parts of them, as metabolic.
Lorenzo Beltrame, Fabio Gasparini & Erik Hernaamt
In this article, we introduce the notions of algorithmic gaze and nested multifocality as analytical categories for investigating the production of evidence in contemporary biosciences. Drawing on an ethnographic study of a translational medicine project involving the clinic, the wet lab, and bioinformatic work—as well as interviews with bioinformaticians and computational biologists—we show how evidence emerges through the situated negotiation of different gazes, ‘professional visions,’ and ‘styles of reasoning.’ We define the algorithmic gaze as an emergent computational mode of seeing and rendering biological phenomena intelligible through pattern recognition, visualization, and algorithmic procedures. Its epistemic legitimacy, we show, is negotiated through its relation to clinical and molecular gazes within ‘biomedical platforms.’ The concept of nested multifocality accounts for an epistemic condition in which evidence is not only relative to ‘epistemic cultures’ and specific research situations, but also emerges through a broader multifocal vision that accommodates different gazes and ‘professional visions’
Taking medicines out of the market: public hospital-based phage therapy in Belgium and France
Koichi Kameda & Charlotte Brives
As antimicrobial resistance (AMR) intensifies and antibiotic innovation stalls, phage therapy is gaining renewed interest. However, its development is hindered by regulatory, scientific, and economic frameworks that are tailored to the standardised production of chemical drugs. This article examines two non-commercial models of phage therapy in Europe that challenge the mainstream pharmaceutical development paradigm. Based on in-depth interviews (22), as well as analysis of relevant regulatory and scientific materials, we compare the magistral phage model developed at the Queen Astrid Military Hospital in Belgium with the GMP-certified API model of the Hospices Civils de Lyon in France. Both initiatives mobilise public health facilities to produce and deliver phage therapies outside the marketing authorisation pathway. While their regulatory strategies differ, both resist commodification and highlight the role of public institutions in therapeutic innovation. However, they both face similar challenges, such as financial sustainability and regulatory alignment. We propose that hospital-based phage therapy not only serves as an effective last resort treatment option, but also offers a conceptual and institutional blueprint for re-evaluating drugs as a public good. These cases illustrate how public infrastructures can support more equitable, ecologically responsible forms of innovation in a context of global health crisis and therapeutic scarcity.
From genome to voiceome: the quest for voice-based biomarker technologies in health research
Tanja Knaus & Susanne Bauer
With the advent of datafication and AI-mediated analytics, computer scientists and health researchers have begun to target voice data as potential biomarkers. This paper follows the technoscientific and speculative strategies for deploying voice data as biomarkers in health research. Contributing to infrastructure studies, biomedical science studies, and social studies of AI, we describe and analyze emergent knowledge infrastructures involved in translating and enacting the human voice into a set of biomarker variables. This includes start-ups pursuing standardization of voice samples as referential ‘ground truth’ datasets and developing AI techniques as products for clinical trials. Conceptually and strategically, developers of vocal biomarkers have coined the notion of the ‘voiceome’ to draw on omics infrastructures. They use those existing omics platforms as available templates for how to proceed to study voice features as markers of health and disease. Adding machine listening to digital phenotyping and precision medicine, vocal biomarker research may transform psychiatric practices in specific ways under certain erasures and anticipated value, building on infrastructures that are not (entirely) new, but rather complemented and afforded by automation and predictive screening.
Sara Attinger, Ian Kerridge, Claire Tanner, Claire Hooker, Megan Munsie, Tamra Lysaght, Christopher Rudge, Alan Petersen & Wendy Lipworth
In recent years, regulatory processes governing the approval of new health technologies have undergone changes aimed at expediting access. Some of these changes involve the adaptation of established standards of evidence for safety and efficacy, which we refer to as evidence-adapted regulatory pathways (EARPs). While EARPs have provided more timely access to potentially beneficial interventions, critics argue that reducing evidentiary thresholds threatens regulatory integrity, compromises safety, and undermines evidence-based medicine. In this article, we argue that regulatory processes and the therapeutic choices they enable are deeply socially constructed, and that discourse—particularly promissory discourse—plays a constitutive role in shaping regulation and its outcomes. We offer a typology of existing pathways to access health technologies, examine the growth of EARPs internationally and identify some recurring themes in the associated scholarly and public-facing discourses. We show that EARPs are often portrayed in a ‘promissory’ manner that obscures risks and uncertainties. We argue that this promissory discourse can (i) distort patients’ and clinicians’ understandings of evidence and decisions about clinical use and (ii) create undue pressure on funders. We suggest avenues for further research and policy development that could help regulators, in collaboration with clinicians and consumers, to promote socially responsible discourse around EARPs.
Seth M. Holmes
The term, liberation medicine, as proposed by Nancy Scheper-Hughes (1992) serves as the productive, critical, and inspiring frame around which this special issue is organized. The collection is on the one hand wonderfully broad – from critique to aspiration and everywhere in between – and on the other hand wonderfully tied-
together. The guest editors of the collection Julia Vorhölter and Amand-Gabriel Führer, must be commended for choosing an ideal floating signifier (e.g., Levi-Strauss, 1950; Laclau, 1996; Hall, 1997) capable of pulling together and allowing space for such diverse scholars, research questions, and geopolitical sites. It is telling that the special issue guest editors come from sociocultural anthropology and social medicine – one grounded primarily in anthropology and the other primarily in medicine, yet both oriented toward the nexus of social processes, social inequities, health, medicine, bodies and the possibilities of the otherwise. And Nancy Scheper-Hughes must be commended for her creative intellect, brilliant turns of phrase, and galvanizing sociopolitical imagination that serve as the jumping-off point for this collection (2026) that may help, in her own words, “provide a space where new ways of addressing and responding to human misery are worked out” (1992).
These reflections on liberation medicine illustrate not only how “floating” is this signifier – understood in relation to quite different referents, but also how provocative, if not, at least for some, inspiring, it is. The 2024 workshop, “Liberation Medicine: Past, Present, Future”, and the articles making up this special collection consider this term for the ways it informs critiques of biomedical epistemology and practice, provides lenses to pay attention to and analyze existing examples of alternative practices in the world, and encourages and instigates action on the levels of practice, program, policy and social movements. Before considering the articles in the collection, I would like to explore briefly some of the key terms.
Patricia Camillo
Moral distress has been documented in clinical nursing, but far less attention has been given to morally troubling experiences within academic healthcare settings. This study examines how conflicts between professional values and organizational culture may give rise to moral ambiguity, evolve into moral distress, and contribute to moral injury over time. Guided by a critical, transformative theoretical framework, this longitudinal autoethnography explores these experiences across a 45-year nursing career in academic settings. Data were generated through sustained self-observation and reflexive writing between 2013 and 2023, using thematic analysis, along with external documents for triangulation. The analysis identified three academic scenarios in which concerns related to student safety, tenure standards, and racism created ethically troubling situations. Across these scenarios, moral ambiguity emerged at the intersection of personal values, professional obligations, and institutional expectations. Moral distress developed when actions taken in response to these situations were unsupported, ineffective, institutionally silenced, or professionally costly. Moral injury became visible retrospectively through the enduring emotional, embodied, professional, and financial consequences of these unresolved moral events. Subthemes included faculty incivility and racism. Recognizing this progression changed how these experiences could be understood. What had long been interpreted as personal failure, poor coping, or professional inadequacy could instead be seen as part of a larger moral struggle shaped by organizational culture. This study suggests that moral ambiguity may be an early and often unnamed part of that struggle and that when it remains unresolved or unsupported, it can move into moral distress and, in some circumstances, moral injury. Bringing these experiences into view may help academic nursing better recognize and respond to the moral consequences of institutional life.
A Fire and Altadena: Biographical Diffraction and Climate Disaster Loss
Elizabeth McKibben
This paper develops a conceptualization of biographical diffraction via a creative autoethnography of climate disaster grief. In January 2025, the Eaton Fire devastated Altadena, California killing 19 people and destroying over 9,000 structures. Among them was my family home. Having lived abroad in Aotearoa New Zealand for 5 years, I return to Altadena after the fire, navigating loss from sites of distance and proximity. Drawing upon Barad’s concept of diffraction and the void, I grapple with the asymmetries of grief, privilege, belonging, and self that emerge with the loss of “home.” To do so, I craft a narrative with audio recordings of my footsteps walking around the debris of the Eaton Fire burn scar. By weaving together sensory vignettes, evocative writing, images, and reflections I consider how climate disaster grief is an embodied and emplaced phenomenon both historically entangled and unequally distributed. I then draw upon cross-cultural learnings to explore how Indigenous knowledge can, and cannot, inform healing of place and self from positions of settler-colonialism. Biographical diffraction is thus presented as a tool for attending to the layered emotional, material, and political dimensions of climate disaster, particularly when “home” becomes an unrecognizable site of trauma, memory, and transformation.
…And Breathe! Wellness, the Nation, and Holistic Reproductive Practitioners in India
Adhvik Shetty
Garbh Sanskar (GS) is an Indian holistic reproductive programme that claims roots in ancient Ayurvedic and yogic traditions while drawing upon contemporary wellness practices and international health policy. GS centres offer breathwork, guided meditation, and counselling to expectant and hopeful couples. This article draws upon interviews with GS practitioners across nine Indian cities to examine how these practitioners use wellness discourses to articulate strategies of individual and national improvement. I argue that GS practitioners seek to interweave soteriological and wellness logics to produce enriched reproductive subjects for a therapeutic vision of nation-building. This project uses wellness to assuage the anxieties of modernity, suggest civilisational exceptionalism, and articulate aspirations for the nation. Together, GS illustrates the emergence of a bio-spiritual therapeutic politics where wellness is part of reproductive governance.
Elsa Davidson
This paper draws on an ethnography of care for social–emotional differences in middle-class North American childhood to explore the relation between care practices employed by parents of neurodivergent, or neuroatypical, children, and emergent ethics of care. Focusing on a single case of asymmetrical care, that between a mother and a neurodivergent child, I draw on video-recorded interviews as well other ethnographic material to highlight how practices of care emphasizing forms of bodily and emotional connection, and labors of attunement to embodied states and forms of expression, enable shifts in the caretaker’s perception of, and affective orientation toward, embodied states. In doing so, I show how moments of partially shared feeling across bodies (interembodiment) and intercorporeal connections can engender the parent–caretaker’s perception of enhanced intersubjective understanding, and authentic insight into the child’s embodied experience, particularly with regard to anxious and excited states. As such, I describe the caretaker’s perceptual shift from an individualizing evaluation of her child’s “sensory issues” to a relational understanding of “anxiety” as a collaboratively engendered embodied emotional state that can be altered, felt, shared, and alleviated through non-verbal tactile communication. In turn, I argue that it can be seen as a “gift” of ethical self-transformation that has implications for the care of neurodivergent childhood. In doing so, I suggest that such insight engenders care for a neurodivergent “other” that may come closer to preserving the other’s singularity. Moreover, I argue that such insight rejects a stereotyped understanding of embodied neurodivergent selfhood as bounded, brain-based, and impermeable.
Working in Pairs: The Dialogic Distribution of Clinical Responsibility
Lauren Cubellis
At an innovative site of psychiatric crisis care work, dialogically trained clinicians in Berlin, Germany transformed the skills learned from the Open Dialogue approach into a means for building solidarity in the face of precarious health structures. Learning to sit with unknowing and tolerate uncertainty, at first developed as techniques to support clients in crisis, became a way by which these clinicians navigated a shifting and unsteady health insurance landscape. In the face of budgetary restrictions and increased oversight by health insurance companies, which challenged the terms of their work and ethical commitments, they supported each other by reconfiguring the terms of clinical responsibility: they dispersed the authoritative gaze most often cultivated in institutional psychiatry and risk management approaches, and developed a means for attending to the uncertainty of crisis by sharing the burden of unknowing with each other. They did this through their unwavering commitment to working in pairs.
Witnessing the Theatre of Self-Harm Among South Asian Women: Expression, Performance, and Hot Tea
Anamika Shrimali
This Cultural Case Study examines how self-harm becomes meaningful within particular South Asian moral worlds, drawing on intergenerational family oral histories and autoethnographic reflection spanning Kashmir, Andhra Pradesh, Tehran, and the United States diaspora. Read alongside South Asian ethnographic and clinical scholarship, these narratives show that bodily self-injury can function as a form of situated agency and relational communication when verbal self-assertion is constrained. Building on prior work that interprets suicide and self-harm as gendered forms of communication in South Asia, I focus on the social variability of response: when self-harm compels witnessing and moral recognition, and when it instead meets habituation, ridicule, exhaustion, or strategic inattention. I argue that treating self-harm solely as psychopathology risks misreading its moral and interpersonal stakes and can undermine clinical assessment. A culturally attuned approach requires mapping the moral audiences, relational constraints, and idioms of personhood that structure how suffering becomes legible.
“I Really Feel Heard by AI”: A Cultural Case Study of AI-Mediated Listening Across China and the UK
Xin Zhan
The increasing use of generative AI for emotional support has prompted growing debate about the future of mental health care. This article suggests that such reliance is better understood not simply as a technological shift, but as symptomatic of a wider crisis in the politics of listening. This cultural case study examines the experiences of Lily, a 24-year-old Chinese migrant woman navigating emotional distress across uneven care infrastructures in China and the UK. Drawing on person-centred ethnography, it shows how AI chatbots come to function as provisional sites of care under conditions of precarity, gendered obligation, and moralised endurance. The analysis conceptualises these chatbot interactions as a care-patch: a temporary form of digital holding that emerges where human listening is scarce, delayed, or experienced as burdensome. Rather than treating AI use as a matter of technological adoption, the case situates AI-mediated listening within culturally specific moral relations of obligation and responsibility. In doing so, it reframes therapeutic automation as an index of the erosion of listening as a shared social good and redirects attention to the political and ethical challenge of rebuilding infrastructures of human listening capable of absorbing distress without extracting it, outsourcing it, or returning it as blame.
Palliative Obstinacy: When Care Becomes a Constraint at the End of Life
Gustavo Ortiz-Millán
This paper develops the concept of “palliative obstinacy” to describe situations in which palliative care, rather than alleviating suffering in accordance with the patient’s wishes and values, becomes a new form of clinical paternalism at the end of life. Drawing on a case narrated by Elyse Ona Singer and Norma Alicia Ordóñez-Vázquez of a patient with cancer requesting physician-assisted death, the paper argues that some models of palliative care unjustifiably pathologize the desire to die by treating it exclusively as a symptom of untreated suffering, depression, or inadequate care. Building on the analysis by Singer and Ordóñez-Vázquez, the paper examines the paradox whereby palliative care expands certain end-of-life choices while simultaneously rendering others—especially physician-assisted death—morally or conceptually unthinkable. It argues that denying the rationality of some requests for hastened death risks undermining patient autonomy and imposing a singular moral framework concerning suffering and dying. The paper concludes that palliative care and physician-assisted death should be understood as complementary rather than mutually exclusive options within end-of-life care.
Datafied Kinship: Individuating Identity in Pakistan
Zehra Hashmi
Pakistan’s National Database and Registration Authority (NADRA) produces the country’s national identity card and runs one of the world’s largest biometric-based identity databases in the world. To be registered in the database, individuals are linked through their kin relations to other uniquely identified individuals—a practice that this article terms “datafied kinship.” Datafied kinship demonstrates how individuals are not atomized bodies, ready to be captured by NADRA’s identity database. Rather, individuals are digitally constructed as a function of their relations with others. This article argues that NADRA’s reliance on kinship reconfigures our understanding of modern identification: individual identity is produced and tracked through relatedness, not biometrics alone. It ethnographically examines how identifiable individuals are produced through identity registration, focusing on the treatment of “system independents”—individuals unconnected to others in the database. In turn, it shows how such a relational logic of identification comes to condition the lives of those it identifies.
Lalaie Ameeriar
This article examines the lethal consequences of delayed obstetric care through the lens of maternal temporalities. Drawing from ethnographic fieldwork and autoethnographic narrative, I trace how racialized patients are asked to endure uncertainty, dismissal, and bureaucratic delay even as their medical conditions worsen. Focusing on my experience of an ectopic pregnancy alongside interviews with Black and Brown birthing people, I argue that waiting is not a neutral temporal state, but a racialized and gendered form of harm. Situating these experiences within the anthropology of reproduction, I show how waiting becomes both a medical directive and a disciplinary demand that erodes trust, safety, and survival. The article contributes to debates on obstetric racism, maternal mortality, and refusal by foregrounding waiting as an analytic of harm and a site of ethnographic witnessing.
When Men Do Care: Masculinity and Labor in Northwest Pakistan
Hadia Akhtar Khan
How do men claim recognition and compensation for their care labor? When a rural economy shifts from agriculture toward international migration, joint households send some sons abroad to work and ask others to stay in the village to take care of the household’s land, women, and kinship obligations. The men who stay argue that this work of “taking care” should be recognized and compensated with half of a migrant brother’s earnings. Drawing on ethnographic research with transnational households in migrant-sending villages in northwestern Pakistan, I examine how men who stay in the village invoke caste, gender, and kinship to claim recognition and compensation for their care labor. While these claims may resemble feminist critiques of the undervaluation of care labor vis-à-vis waged labor in capitalism, the article shows the limits of the politics of recognition of care as labor.
We Keep Us Safe: De-escalation, Working Time, and Abolitionist Praxis at The Sanctuary
Jake Nussbaum
This essay explores “de-escalation,” the embodied practice of intervening in interpersonal conflict and crisis without resorting to police or carceral tactics. Drawing on eighteen months of ethnographic research at The Sanctuary, a non-profit organization in Philadelphia that provides free social services, clothing, and food to vulnerable populations, I show how de-escalation practitioners use their bodies to manipulate both time and space into non-carceral outcomes. I focus on four overlapping techniques: suspension, the open hold, bridging, and collectivity. Unlike much of the clinical and psychological research on de-escalation, I situate these techniques within Black feminist, performance studies, and anthropological analytics that insist on the embodied nature of political struggle and the malleability of time and temporality. I argue that de-escalation at The Sanctuary creates a space-time in which abolitionist horizons of a future without police or prisons are negotiated through intimate, quotidian social interactions.
Solar Pioneers: The Frontier Entrepreneurialism of a Sluggish Energy Transition
Myles Lennon
Scholars, activists, and politicians attempt to provoke urgent climate action by christening 2050 as the decisive date by which the United States must transition from fossil fuels. But I contend that calendrical teleologies do not actually motivate the everyday people, activists, and workers leading the U.S. energy transition. This article explores another temporal schema seemingly unrelated to climate: the American pioneer settling the frontier, realizing his destiny through individual initiative. I contend that this origin story works in tandem with contemporary entrepreneurialism to affectively animate a market-based approach to energy transitions that is anything but rapid. Thus, consideration of frontier temporalities can contextualize the sluggish pace of decarbonization. While many studies identify various catalysts of renewable energy adoption, my analysis of “the renewable energy frontier” suggests that these inquiries overlook the insidious individualism of energy transitions in a capitalist context, in which “the market” is misunderstood as an accelerator of change.
Encounters at the Edge of Night: An Ethnography of the Weird
Andrew Alan Johnson
When doing ethnography, ethnographers often hear stories that cannot be. Explanations that shelve away such “weird” stories into cultural boxes or reframe them as metaphors for something familiar close the door not only on the theoretical possibilities of openness, but also do not do justice to their interlocutors’ own inquiries about the world. Here, I draw upon stories of ghosts and unsettling dreams taken from my fieldwork in Thailand, both from my interlocutors’ and my own experience, as a way to contradict evidentiary regimes. Taking up the idea of “the weird” from literary studies and the Buddhist philosophy of Nagarjuna, I understand such stories not as representations of the mundane workings of economy or psychology, nor as culturally-bound narratives, but instead as a co-creation of a world always unfinished and unfixed. Seeing Nagarjuna’s notion of contradiction as a method, I argue that a productive, dialogic engagement with the weird can destabilize not only the ethnographic encounter, but also the way that the world works.
