The epigenome and nature/nurture reunification: a challenge for anthropology

Slowing down decay: biological clocks in personalized medicine

This article discusses so-called biological clocks. These technologies, based on aging biomarkers, trace and measure molecular changes in order to monitor individuals' "true" biological age against their chronological age. Drawing on the concept of decay, and building on ethnographic fieldwork in an academic laboratory and a commercial firm, we analyze the implications of the development and commercialization of biological clocks that can identify when decay is "out of tempo." We show how the building of biological clocks rests on particular forms of knowing decay: In the academic laboratory, researchers focus on endo-processes of decay that are internal to the person, but when the technology moves to the market, the focus shifts as staff bracket decay as exo-processes, which are seen as resulting from a person's lifestyle. As the technology of biological clocks travels from the laboratory to the market of online testing of the consumer's biological age, we observe shifting visions of aging: from an inevitable trajectory of decline to a malleable and plastic one. While decay is an inevitable trajectory starting at birth and ending with death, the commercialization of biological clocks points to ways of stretching time between birth and death as individuals "optimize" their biological age through lifestyle changes. Regardless of admitted uncertainties about what is measured and the connection between maintenance and future health outcomes, the aging person is made responsible for their decaying body and for enacting maintenance to slow down decay. We show how the biological clock's way of "knowing" decay turns aging and its maintenance into a life-long concern and highlight the normative implications of framing decay as malleable and in need of intervention.

A biosocial return to race? A cautionary view for the postgenomic era

Recent studies demonstrating epigenetic and developmental sensitivity to early environments, as exemplified by fields like the Developmental Origins of Health and Disease (DOHaD) and environmental epigenetics, are bringing new data and models to bear on debates about race, genetics, and society. Here, we first survey the historical prominence of models of environmental determinism in early formulations of racial thinking to illustrate how notions of direct environmental effects on bodies have been used to naturalize racial hierarchy and inequalities in the past. Next, we conduct a scoping review of postgenomic work in environmental epigenetics and DOHaD that looks at the role of race/ethnicity in human health (2000-2021). Although there is substantial heterogeneity in how race is conceptualized and interpreted across studies, we observe practices that may unwittingly encourage typological thinking, including: using DNA methylation as a novel marker of racial classification; neglect of variation and reversibility within supposedly homogenous racial groups; and a tendency to label and reify whole groups as pathologized or impaired. Even in the very different politico-economic and epistemic context of contemporary postgenomic science, these trends echo deeply held beliefs in Western thinking which claimed that different environments shape different bodies and then used this logic to argue for essential differences between Europeans and non-Europeans. We conclude with a series of suggestions on interpreting and reporting findings in these fields that we feel will help researchers harness this work to benefit disadvantaged groups while avoiding the inadvertent dissemination of new and old forms of stigma or prejudice.

Caring for biosocial complexity. Articulations of the environment in research on the Developmental Origins of Health and Disease

The research field of Developmental Origins of Health and Disease (DOHaD) provides a framework for understanding how a wide range of environmental factors, such as deprivation, nutrition and stress, shape individual and population health over the course of a lifetime. DOHaD researchers face the challenge of how to conceptualize and measure ontologically diverse environments and their interactions with the developing organism over extended periods of time. Based on ethnographic research, I show how DOHaD researchers are often eager to capture what they regard as more 'complex' understandings of the environment in their work. At the same time, they are confronted with established methodological tools, disciplinary infrastructures and institutional contexts that favor simplistic articulations of the environment as distinct and mainly individual-level variables. I show how researchers struggle with these simplistic articulations of nutrition, maternal bodies and social determinants as relevant environments, which are sometimes at odds with the researchers' own normative commitments and aspirations.

Milk's Flows: Making and Transmitting Kinship, Health, and Personhood

Milk provides a way of thinking about how the body is enacted in science, policy and popular culture. This paper follows the currents of moral and biomedical epistemologies circulating around milk, including via notions of inheritance, the practices of wet nursing, and emerging scientific knowledge about the health-related benefits of breastfeeding. By situating milk's flows historically and culturally it shows how constructions of milk production, lactation, and infant feeding have long served as a 'cultural signal' of prevailing conceptions of bodies and social identities. In so doing, it explores the simultaneous power of milk as both a source of dispositional and somatic health, and an index of customary forms of unity and division. A focus on breast milk further contributes to augmenting and expanding recent debates about the biology-society nexus in science and technology studies (STS), anthropology, and sociology. Seen within biomedicine today as a carrier of somatic signals about the environment, the article reflects on how milk is bound up in the responsibilisation of women's bodies and the internalising of potential risks to the health of their offspring. This implies an unlimited agency for women in averting health risks and in future-proofing their children to be better than well, elides the socioeconomic, and environmental forces pragmatically limiting this assumed agency, and the distinct lack of material and inter-personal support for the perinatal period in many nations.

Who's afraid of epigenetics? Habits, instincts, and Charles Darwin's evolutionary theory

Our paper aims at bringing to the fore the crucial role that habits play in Charles Darwin's theory of evolution by means of natural selection. We have organized the paper in two steps: first, we analyse value and functions of the concept of habit in Darwin's early works, notably in his Notebooks, and compare these views to his mature understanding of the concept in the Origin of Species and later works; second, we discuss Darwin's ideas on habits in the light of today's theories of epigenetic inheritance, which describe the way in which the functioning and expression of genes is modified by the environment, and how these modifications are transmitted over generations. We argue that Darwin's lasting and multifaceted interest in the notion of habit, throughout his intellectual life, is both conceptually and methodologically relevant. From a conceptual point of view, intriguing similarities can be found between Darwin's (early) conception of habit and contemporary views on epigenetic inheritance. From a methodological point of view, we suggest that Darwin's plastic approach to habits, from his early writings up to the mature works, can provide today's evolutionary scientists with a viable methodological model to address the challenging task of extending and expanding evolutionary theory, with particular reference to the integration of epigenetic mechanisms into existing models of evolutionary change. Over his entire life Darwin has modified and reassessed his views on habits as many times as required by evidence: his work on this notion may represent the paradigm of a habit of good scientific research methodology.

When more data means better results: Abundance and scarcity in research collaborations in epigenetics

Drawing upon ethnographic findings from an epigenetics research laboratory in the United Kingdom, this paper explores practices of research collaborations in the field of epigenetics, and epigenomics research consortia in particular. I demonstrate that research consortia are key scientific infrastructures that enable the aggregation of masses of data deemed necessary for the production of results and the fostering of epistemic value. Building on STS scholarship on value production, and the concept of asset, I show that the production of valuable research within epigenomics research consortia rests on the active organisation and management of abundance and scarcity. It involves shaping and standardising the masses of data gathered in consortia, while it also entails research teams enclosing their data within their laboratories' walls. As they do so, research teams construct data into scarce and monopolised assets, which they can put to productive use in collaborative endeavours against a revenue. In addition to contributing empirical and critical insights into the ways epigenetics knowledge is formed and negotiated in specific research contexts, this paper offers conceptual tools to examine and problematise knowledge production practices in data-intensive research more broadly. In particular, it points out that while contemporary big biology is marked by the generalised imperative to 'share' data and 'open' science, collaborative endeavours within research consortia are built around forms of exclusions.

Communicating science: epigenetics in the spotlight

Given the public interest in epigenetic science, this study aimed to better understand media representations of epigenetics in national newspaper coverage in various regions in North America, Europe, and Asia. Content analysis was used to study media messages about epigenetics, their policy focus, and the balance of the reporting. We identified several recurring themes in the news reports, including policy messages relating to individual and societal responsibilities. We also found shortcomings in the media's portrayal of epigenetic science, and sought to identify potential causes by considering the underlying scientific evidence that the media reported on. A case study analysis showed that the results of epigenetic studies were often overstated in academic research publications due to common experimental limitations. We suggest that defining standardized criteria with which to evaluate epigenetic studies could help to overcome some of the challenges inherent in translating complex epigenetic research findings for non-technical audiences, and present a Press Kit template that researchers can adapt and use to aid in the development of accurate and balanced press releases.

Building on the biocultural syntheses: 20 years and still expanding

Building a New Biocultural Synthesis: Political Economic Perspectives in Human Biology called for an integration of political economy with ecological and adaptability perspectives in biocultural anthropology. A major goal of this volume was to explore the utility of including political-economic and sociocultural processes in analyses of human biological variation, nutrition, and health. A second goal was to enhance collaboration among subfields and work against the "chasm" that separated complementary perspectives in cultural and biological anthropology. Twenty years hence, new ways to link social inequalities and human biology have emerged in part through contributions of developmental origins of health and disease, epigenetics, microbiomes, and other new methods for tracing pathways of embodiment. Equally important, notions of "local/situated biologies" and "reactive genomes," provide frameworks for understanding biology and health at the nexus of ecologies, societies, and histories. We review and highlight these contributions toward expanding critical approaches to human biology. Developments over the past two decades have reinforced the central role of social environments and structural inequalities in shaping human biology and health. Yet, within biocultural approaches, a significant engagement with historical, political-economic, and sociocultural conditions remains relatively rare. We review potential barriers to such analyses, focusing on theoretical and methodological challenges as well as the subfield structure of anthropology. Achieving politically and socially contextualized and relevant critical biocultural approaches remains a challenge, but there is reason for optimism amid new theoretical and methodological developments and innovations brought by new generations of scholars.

Adolescent Sex and Psyche in Brazil: Surveillance, Critique and Global Mental Health

Drawing on a historical ethnography conducted in Southern Brazil, this article explores how public health programs for adolescent reproductive and mental health have emerged in Brazil and begun to intersect with the growing field of "global mental health" (GMH). The story I recount begins not in the 2010s with the rapid rise of expert interest in adolescent health within GMH, but in the 1990s, the decade when young teens in Brazil were first coming into contact with practices and approaches in research, schools and clinics that have both underpinned and critiqued the production of an adolescent mental and reproductive health sub-field. In parsing what young women's encounters with the then newly-emerging questionnaires, measurement tools, school-based programs and clinical practices came to mean to them, I use a genealogical approach to consider how histories of education reform, population control, psychoanalysis, social medicine, the transition to democracy, feminism and grass-roots politics all entered the fold, shaping the way adolescent sex-and-psyche materialized as a contested object of expertise. I end by exploring what this case can teach global mental health advocates and social theorists about practices of critique.

Epigenetics, ethics, law and society: A multidisciplinary review of descriptive, instrumental, dialectical and reflexive analyses

Epigenetics, defined as 'the study of mitotically and/or meiotically heritable changes in gene function that cannot be explained by changes in DNA sequence', has emerged as a promissory yet controversial field of scientific inquiry over the past decade. Scholars from many disciplines have formulated both optimistic and cautionary claims regarding its potential normative implications. This article provides a comprehensive review of the nascent literature at the crossroads of epigenetics, ethics, law and society. It describes nine emerging areas of discussion, relating to (1) the impact of epigenetics on the nature versus nurture dualism, (2) the potential resulting biologization of the social, (3) the meaning of epigenetics for public health, its potential influence on (4) reproduction and parenting, (5) political theory and (6) legal proceedings, and concerns regarding (7) stigmatization and discrimination, (8) privacy protection and (9) knowledge translation. While there is some degree of similarity between the nature and content of these areas and the abundant literature on ethical, legal and social issues in genetics, the potential implications of epigenetics ought not be conflated with the latter. Critical studies on epigenetics are emerging within a separate space of bioethical and biopolitical investigations and claims, with scholars from various epistemological standpoints utilizing distinct yet complementary analytical approaches.

The role of biocultural approaches in assessing interventions for maternal weight and gestational weight gain

Public health and other researchers express growing concern for the role of maternal adiposity and gestational weight gain in driving the obesity epidemic and health disparities based on race and class. Biocultural scholars must continue to contribute to conversations on how best to address issues of population health including the developmental context of obesity, drawing from both evolutionary and social theory. I discuss a number of intervention studies designed to address gestational weight gain in low-income and minority women and consider the degree to which they address the social, political, and economic context, and developmental history of mothers. I further examine the potential for these interventions, focused on the individual behavior of mothers, to contribute to stigma based on socially defined race, class, and body shape and size, and to draw attention away from the powerful economic interests that contribute to and benefit from the obesity epidemic. I end with a discussion of the value of developmental systems theory for thinking critically about obesity and other health interventions.

Situating biologies of traditional Chinese medicine in Central Europe

Since the concept of 'local biologies' was proposed in the 1990s, it has been used to examine biosocial processes that transform human bodies in similar and different ways around the globe. This paper explores understandings of biosocial differentiation and convergence in the case of Traditional Chinese Medicine (TCM) in the Czech Republic. Specifically, it examines how Czech TCM practitioners view TCM as universally applicable while fine-tuning it to situated biosocial conditions, experimenting with the compatibilities of various human and plant bodies as part of their generalised, clinical practice. Drawing upon ethnographic research among TCM practitioners in the Czech Republic, it suggests that in addition to the individualization of TCM therapeutics to suit particular patients, Czech TCM is characterised by collective particularization, shaped by local concerns over ethnic, environmental and cultural differences. By looking critically at TCM practitioners' sensitivities to localised biological similarities and differences it aims to contribute to understandings of the expansion of TCM in Central Europe, as well as more broadly to current social science debates over the risks and opportunities inherent in abandoning the assumption of a universal human body and biology.

Multidisciplinarity in Microbiome Research: A Challenge and Opportunity to Rethink Causation, Variability, and Scale

This essay, written by a biologist, a microbial ecologist, a biological anthropologist, and an anthropologist-historian, examines tensions and translations in microbiome research on animals in the laboratory and field. The authors trace how research questions and findings in the laboratory are extrapolated into the field and vice versa, and the shifting evidentiary standards that these research settings require. Showing how complexities of microbiomes challenge traditional standards of causation, the authors contend that these challenges require new approaches to inferences used in ecology, anthropology, and history. As social scientists incorporate investigations of microbial life into their human studies, microbiome researchers venture into field settings to develop mechanistic understandings about the functions of complex microbial communities. These efforts generate new possibilities for cross-fertilizations and inference frameworks to interpret microbiome findings. Microbiome research should integrate multiple scales, levels of variability, and other disciplinary approaches to tackle questions spanning conditions from the laboratory to the field.

The First Thousand Days: Motherhood, Scientific Knowledge, and Local Histories

Since 2013, South African nutrition policy focuses on "the first thousand days," (conception to two years), informed by Developmental Origins of Health and Disease research. Drawing on ethnographic research, we show how policy foregrounds certain categories of persons and casts "the maternal" as a time frame for interventions to secure future health and argue that this constitutes a "knowledge effect" - the outcome of framing questions in a particular way and with specific knowledge horizons.

Solidarity after nature: From biopolitics to cosmopolitics

What is sustaining the divide between nature and nurture, even though sciences like epigenetics have been challenging it for at least two decades? Evelyn Fox Keller asked this question and considered it a logical problem rooted in terminological confusion within the sciences. In this article, we propose a complementary diagnosis of the problem: the nature-nurture divide is (re-)mobilized when society faces questions of inclusion and solidarity. With examples stemming from the fields of insurance and health care, immigration policy and epigenetics, we demonstrate how the nature-nurture divide is performed through techniques of classification for a politics of solidarity. We identify a common operation to these different examples that we coin 'biopolitical imputation'. We use this term to draw attention to how (Western) societal institutions, including science, create solvable problems out of complex situations, defining human actors and their agency along the lines of the nature-nurture divide as a moral guide. We argue that the tenacity of the nature-nurture divide is therefore not only a logical problem needing better scientific concepts, but also a cosmopolitical problem asking for a more profound reflection on the ontology and ethics of solidarity in order to move beyond the biopolitics of nature versus nurture.

Expectations and boundaries for Big Data approaches in social medicine

It seems no longer possible to produce knowledge, even biological knowledge regardless of social, cultural and economic environments in which they were observed. Therefore never the term "social medicine" or more generally "social biology" has appeared more appropriate. This way of linking the social and the biological exceeds the sole social medicine by involving also other medical disciplines. As such, forensics, whose an important activity is represented by clinical forensics in charge of types of violence (physical, psychological, sexual, abuse) and persons held in custody could see its practice heavily modified through the use of various data describing both the clinical situation of patients but also their context of life. A better understanding of mechanisms of violence development and potentially a better prevention of these situations allow forensics not to be restricted (or seen as limited to) a "descriptive medicine", but to be seen also as a preventive and curative medicine. In this evolution, the potential contribution of Big Data appears significant insofar as information on a wide range of characteristics of the environment or context of life (social, economic, cultural) can be collected and be connected with health data, for example to develop models on social determinants of health. In the common thinking, the use of a larger amount of data and consequently a multiplicity of information via a multiplicity of databases would allow to access to a greater objectivity of a reality that we are approaching by fragmented viewpoints otherwise. In this light, the "bigger" and "more varied" would serve the "better" or at least the "more true". But to be able to consider together or to link different databases it will be necessary to know how to handle this diversity regarding hypotheses made to build databases and regarding their purposes (by whom, for what bases have been made). It will be equally important to question the representativeness of situations that led to the creation of a database and to question the validity of information and data according to the secondary or tertiary uses anticipated from their original purpose. This step of data validity control for the anticipated use is a sine qua non condition, particularly in the field of public health, to guarantee a sufficient level of quality and exploit in the best way the benefits of Big Data approaches.

An Epigenetic Prism to Norms and Values

In this article, we ask to what extent the specific characteristics of epigenetics may affect the type of questions one can ask about human society. We pay particular attention to the way epigenetic research stirs debate about normative and moral issues. Are these issues implied by scientific evidence as an outcome of research? Or do moral and normative issues also shape how research is done and which problems it addresses? We briefly explore these questions through examples and discussions in (social-) scientific literature. In the final section, we propose an additional dimension and a refocusing of attention from issues of scientific evidence alone (asking what kind of evidence epigenetics produces and how it does so) to a broader picture on epigenetics as a mode of attention that encourages relational and process-oriented thinking with entities, values and scales that may not yet fit within conventional problem-frames that inform research funding and policy-making. We argue that the task of (post-)ELSI approaches is to take inspiration from the ecological complexity of epigenetics in order to bring more relations, relief and gradient in our ethical and political questions.

City and cosmology: genetics, health, and urban living in Dubai

In light of increasingly high rates of diabetes, heart disease, and obesity among citizens of the Arabian Gulf, popular health discourse in the region has emphasised the emergent Arab genome as the primary etiological basis of major health conditions. However, after many years of public dissemination of genomic knowledge in the region, and widespread acceptance of this knowledge among Gulf Arab citizens, the rates of chronic illness continue to increase. This paper briefly explores the clash between indigenous Islamic knowledge systems and biomedical knowledge systems imported into the United Arab Emirates. It presents vignettes collected from interviews and participant observation in Dubai as part of nearly four years of ethnographic research, completed as part of the author's doctoral work on 'Anxiety and Identity in Southeast Arabia'. Rather than radically informing health seeking behaviours among many UAE citizens, the emphasis on the 'Arab Genome' has instead reconfirmed the authority of Bedouin cosmological understandings of disease, reshaping the language that people use to engage with their bodies and their health. Local cosmology remains a powerful discursive element that often operates in contention, in sometimes powerfully subtle ways, with novel health initiative regimes. For many people in the region, genomic information, as it is often discussed and propagated in the UAE, shares an intimate relationship with ideas of fate and national identity, and sometimes serves to mitigate the increasingly uncertain terms of engagement that people share between the body, their health, and rapidly changing urban landscapes.

Entangled local biologies: genetic risk, bodies and inequities in Brazilian cancer genetics

Engaging recent social science work examining the truth making claims of science and biomedicine, this paper explores how biology is being localised in Brazilian cancer genetics. It draws from ethnographic fieldwork in urban regions of southern Brazil working with and alongside patients, families and practitioners in cancer genetic clinics. It examines how different sorts of 'local biologies' are articulated in the context of research, clinical practice and among implicated patient communities and the way these can 'recursively' move across different spheres and scales of social action to extend and transform the meaning of the biological. It shows how the mattering of the biological in Brazilian cancer genetics is fundamentally informed by questions of inequity and care, even while multiple local biologies may obscure rather than reveal the biopolitics of cancer. In an era of epigenetics this raises new opportunities and challenges for anthropological analysis as intervention.

Causal explanations of miscarriage amongst Qataris

BACKGROUND

Despite its commonality, there is a paucity of literature on miscarriage in non-Western societies. In particular, there is little understanding of how people ascribe cause to miscarriage. This research sought to gain an in-depth understanding of notions of miscarriage causality and risk amongst Qataris.

METHODS

The study adopted an exploratory descriptive qualitative approach and collected data during 18 months of ethnographic research in Qatar, including semi-structured interviews. The sample includes 60 primary participants (20 pregnant women and 40 women who had recently miscarried), and 55 secondary participants including family members, health care providers, religious scholars and traditional healers. Informed consent was obtained from all participants. Primary participants were interviewed in Arabic. The interviews were audio recorded, transcribed and translated into English. Data was analysed using an inductive thematic approach, which involved identification and application of multiple codes to different text segments. Data were encoded manually and examined for recurrences across the data set. Similar quotations were grouped into subcategories and further categorized into main themes.

RESULTS

A number of key themes emerged, revealing Qatari women attributed miscarriages to a number of factors including: supernatural forces, such as God's will and evil eye; lifestyle, such as physical activities and consuming particular substances; medical conditions, such as diabetes; and emotional state, such as stress, and emotional upset. Resting, avoiding stress and upset, maintaining healthy diet, and spiritual healing (ruqyah) are seen as a means to avoid miscarriage.

CONCLUSION

Practices and beliefs around miscarriage are embedded in social, cultural, religious and medical frameworks. Understanding the socio-cultural context and understandings of explanatory theories can enhance health care providers' understandings, resulting in improved communication and care.

The Ethics of Translational Science: Imagining Public Benefit in Gene-Environment Interaction Research

Biomedical research is increasingly informed by expectations of "translation," which call for the production of scientific knowledge that can be used to create services and products that improve health outcomes. In this paper, we ask how translation, in particular the idea of social responsibility, is understood and enacted in the post-genomic life sciences. Drawing on theories examining what constitutes "good science," and interviews with 35 investigators who study the role of gene-environment interactions in the etiology of cancer, diabetes, and cardiovascular disease, we describe the dynamic and unsettled ethics of translational science through which the expected social value of scientific knowledge about complex disease causation is negotiated. To describe how this ethics is formed, we first discuss the politics of knowledge production in interdisciplinary research collectives. Researchers described a commitment to working across disciplines to examine a wide range of possible causes of disease, but they also pointed to persistent disciplinary and ontological divisions that rest on the dominance of molecular conceptions of disease risk. The privileging of molecular-level causation shapes and constrains the kinds of knowledge that can be created about gene-environment interactions. We then turn to scientists' ideas about how this knowledge should be used, including personalized prevention strategies, targeted therapeutics, and public policy interventions. Consensus about the relative value of these anticipated translations was elusive, and many scientists agreed that gene-environment interaction research is part of a shift in biomedical research away from considering important social, economic, political and historical causes of disease and disease disparities. We conclude by urging more explicit engagement with questions about the ethics of translational science in the post-genomic life sciences. This would include a consideration of who will benefit from emerging scientific knowledge, how benefits will accrue, and the ways in which normative assumptions about the public good come to be embedded in scientific objects and procedures.

Epigenetics, Media Coverage, and Parent Responsibilities in the Post-Genomic Era

Environmental epigenetics is the study of how exposures and experiences can turn genes "on" or "off" without changing DNA sequence. By examining the influence that environmental conditions including diet, stress, trauma, toxins, and care can have on gene expression, this science suggests molecular connections between the environment, genetics, and how acquired characteristics may be inherited across generations. The rapid expansion of research in this area has attracted growing media attention. This coverage has implications for how parents and prospective parents understand health and their perceived responsibilities for children's wellbeing. This review provides insight into epigenetic research, its coverage in the media, and the social and ethical implications of this science for patients and clinicians. As epigenetic findings continue to elucidate the complex relationships between nature and nurture, it becomes critical to examine how representations of this science may influence patient experiences of risk and responsibility. This review describes some of the social and ethical implications of epigenetic research today.

What is nature capable of? Evidence, ontology and speculative medical humanities

Expanding on the recent call for a 'critical medical humanities' to intervene in questions of the ontology of health, this article develops a what we call a 'speculative' orientation to such interventions in relation to some of the ontological commitments on which contemporary biomedical cultures rest. We argue that crucial to this task is an approach to ontology that treats it not as a question of first principles, but as a matter of the consequences of the images of nature that contemporary biomedical research practices espouse when they make claims to evidence, as well as the possible consequences of imagining different worlds in which health and disease processes partake. By attending to the implicit ontological assumptions involved in the method par excellence of biomedical research, namely the randomised controlled trial (RCT), we argue that the mechanistic ontology that tacitly informs evidence-based biomedical research simultaneously authorises a series of problematic consequences for understanding and intervening practically in the concrete realities of health. As a response, we develop an alternative ontological proposition that regards processes of health and disease as always situated achievements. We show that, without disqualifying RCT-based evidence, such a situated ontology enables one to resist the reduction of the realities of health and disease to biomedicine's current forms of explanation. In so doing, we call for medical humanities scholars to actively engage in the speculative question of what nature may be capable of.

The ambiguous nature of epigenetic responsibility

Over the past decade, epigenetic studies have been providing further evidence of the molecular interplay between gene expression and its health outcomes on one hand, and the physical and social environments in which individuals are conceived, born and live on the other. As knowledge of epigenetic programming expands, a growing body of literature in social sciences and humanities is exploring the implications of this new field of study for contemporary societies. Epigenetics has been mobilised to support political claims, for instance, with regard to collective obligations to address socio-environmental determinants of health. The idea of a moral 'epigenetic responsibility' has been proposed, meaning that individuals and/or governments should be accountable for the epigenetic programming of children and/or citizens. However, these discussions have largely overlooked important biological nuances and ambiguities inherent in the field of epigenetics. In this paper, we argue that the identification and assignment of moral epigenetic responsibilities should reflect the rich diversity and complexity of epigenetic mechanisms, and not rely solely on a gross comparison between epigenetics and genetics. More specifically, we explore how further investigation of the ambiguous notions of epigenetic normality and epigenetic plasticity should play a role in shaping this emerging debate.

Enacting the molecular imperative: How gene-environment interaction research links bodies and environments in the post-genomic age

Despite a proclaimed shift from 'nature versus nurture' to 'genes and environment' paradigms within biomedical and genomic science, capturing the environment and identifying gene-environment interactions (GEIs) has remained a challenge. What does 'the environment' mean in the post-genomic age? In this paper, we present qualitative data from a study of 33 principal investigators funded by the U.S. National Institutes of Health to conduct etiological research on three complex diseases (cancer, cardiovascular disease and diabetes). We examine their research practices and perspectives on the environment through the concept of molecularization: the social processes and transformations through which phenomena (diseases, identities, pollution, food, racial/ethnic classifications) are re-defined in terms of their molecular components and described in the language of molecular biology. We show how GEI researchers' expansive conceptualizations of the environment ultimately yield to the imperative to molecularize and personalize the environment. They seek to 'go into the body' and re-work the boundaries between bodies and environments. In the process, they create epistemic hinges to facilitate a turn from efforts to understand social and environmental exposures outside the body, to quantifying their effects inside the body. GEI researchers respond to these emergent imperatives with a mixture of excitement, ambivalence and frustration. We reflect on how GEI researchers struggle to make meaning of molecules in their work, and how they grapple with molecularization as a methodological and rhetorical imperative as well as a process transforming biomedical research practices.

From boundary-work to boundary object: how biology left and re-entered the social sciences

In an archaeological spirit this paper comes back to a founding event in the construction of the twentieth-century episteme, the moment at which the life- and the social sciences parted ways and intense boundary-work was carried out on the biology/society border, with significant benefits for both sides. Galton and Weismann for biology, and Alfred Kroeber for anthropology delimit this founding moment and I argue, expanding on an existing body of historical scholarship, for an implicit convergence of their views. After this excavation, I look at recent developments in the life sciences, which I have named the 'social turn' in biology (Meloni, 2014), and in particular at epigenetics with its promise to destabilize the social/biological border. I claim here that today a different account of 'the biological' to that established during the Galton-Kroeber period is emerging. Rather than being used to support a form of boundary-work, biology has become a boundary object that crosses previously erected barriers, allowing different research communities to draw from it.

Epigenetics in the Neoliberal "Regime of Truth": A Biopolitical Perspective on Knowledge Translation

Recent findings in epigenetics have been attracting much attention from social scientists and bioethicists because they reveal the molecular mechanisms by which exposure to socioenvironmental factors, such as pollutants and social adversity, can influence the expression of genes throughout life. Most surprisingly, some epigenetic modifications may also be heritable via germ cells across generations. Epigenetics may be the missing molecular evidence of the importance of using preventive strategies at the policy level to reduce the incidence and prevalence of common diseases. But while this "policy translation" of epigenetics introduces new arguments in favor of public health strategies and policy-making, a more "clinical translation" of epigenetics is also emerging. It focuses on the biochemical mechanisms and epigenetic variants at the origin of disease, leading to novel biomedical means of assessing epigenetic susceptibility and reversing detrimental epigenetic variants. In this paper, we argue that the impetus to create new biomedical interventions to manipulate and reverse epigenetic variants is likely to garner more attention than effective social and public health interventions and therefore also to garner a greater share of limited public resources. This is likely to happen because of the current biopolitical context in which scientific findings are translated. This contemporary neoliberal "regime of truth," to use a term from Michel Foucault, greatly influences the ways in which knowledge is being interpreted and implemented. Building on sociologist Thomas Lemke's Foucauldian "analytics of biopolitics" and on literature from the field of science and technology studies, we present two sociological trends that may impede the policy translation of epigenetics: molecularization and biomedicalization. These trends, we argue, are likely to favor the clinical translation of epigenetics-in other words, the development of new clinical tools fostering what has been called "personalized" or "precision" medicine. In addition, we argue that an overemphasized clinical translation of epigenetics may further reinforce this biopolitical landscape through four processes closely related to neoliberal pathways of thinking: the internalization and isolation (aspects of liberal individualism) of socioenvironmental determinants of health and increased opportunities for commodification and technologicalization (aspects of economic liberalism) of health care interventions.

From wandering to wayfaring: Reconsidering movement in people with dementia in long-term care

The movement of people with dementia in long-term care continues to be an issue of concern among clinicians, caregivers and families. This article will examine the social construction "wandering" and its association with pathology, risk discourse and surveillance technologies. Further, the article will explore the recent shift from the term "wanderer" to the phrase "people who like to walk" in person-centred dementia care. Engaging with Ingold's concept of movement as wayfaring, an alternative becoming-centred understanding of movement and its significance for people with dementia will be presented and illustrated through a case study. The paper concludes that depathologizing movement opens the possibility to see movement in people with dementia as an intention to be alive and to grow, rather than as a product of disease and deterioration. Suggestions for future research and implications for care interventions are discussed.