The management of enthusiasm: motives and expectations in cardiovascular medicine

Coexisting cancer regimes: Transformations of breast and lung cancer in the United Kingdom

Using in-depth interviews with medical professionals working in the UK, I explore the coexistence of two different cancer regimes in which the different innovations for breast and lung cancer can be located. Breast cancer treatment has seen a protracted series of significant innovations in the context of an emphasis on screening that coexists with a segmentation in subtypes that has allowed targeted therapies for most patients. Lung cancer has also seen the introduction of targeted therapies; however, these can only be used for small groups of patients. Consequently, some interviewees working on lung cancer have expressed a stronger focus on increasing the number of patients undergoing surgery, as well as introducing screening also for lung cancer. As a result, a cancer regime based on the promises of targeted therapies coexists with a more traditional approach that focuses on diagnosing and treating cancers in their early stages.

The UK COVID-19 contact tracing app as both an emerging technology and public health intervention: The need to consider promissory discourses

The UK's National Health Service (NHS) COVID-19 contact tracing app was announced to the British public on 12th April 2020. The UK government endorsed the app as a public health intervention that would improve public health, protect the NHS and 'save lives'. On 5th May 2020 the technology was released for trial on the Isle of Wight. However, the trial was halted in June 2020, reportedly due to technological issues. The app was later remodelled and launched to the public in September 2020. The rapid development, trial and discontinuation of the app over a short period of a few months meant that the mobilisation and effect of the discourses associated with the app could be traced relatively easily. In this paper we aimed to explore how these discourses were constructed in the media, and their effect on actors - in particular, those who developed and those who trialled the app. Promissory discourses were prevalent, the trajectory of which aligned with theories developed in the sociology of expectations. We describe this trajectory, and then interpret its implications in terms of infectious disease public health practices and responsibilities.

Beyond the hype: 'acceptable futures' for AI and robotic technologies in healthcare

AI and robotic technologies attract much hype, including utopian and dystopian future visions of technologically driven provision in the health and care sectors. Based on 30 interviews with scientists, clinicians and other stakeholders in the UK, Europe, USA, Australia, and New Zealand, this paper interrogates how those engaged in developing and using AI and robotic applications in health and care characterize their future promise, potential and challenges. We explore the ways in which these professionals articulate and navigate a range of high and low expectations, and promissory and cautionary future visions, around AI and robotic technologies. We argue that, through these articulations and navigations, they construct their own perceptions of socially and ethically 'acceptable futures' framed by an 'ethics of expectations.' This imbues the envisioned futures with a normative character, articulated in relation to the present context. We build on existing work in the sociology of expectations, aiming to contribute towards better understanding of how technoscientific expectations are navigated and managed by professionals. This is particularly timely since the COVID-19 pandemic gave further momentum to these technologies.

Population health AI researchers' perceptions of the public portrayal of AI: A pilot study

This article reports how 18 UK and Canadian population health artificial intelligence researchers in Higher Education Institutions perceive the use of artificial intelligence systems in their research, and how this compares with their perceptions about the media portrayal of artificial intelligence systems. This is triangulated with a small scoping analysis of how UK and Canadian news articles portray artificial intelligence systems associated with health research and care. Interviewees had concerns about what they perceived as sensationalist reporting of artificial intelligence systems - a finding reflected in the media analysis. In line with Pickersgill's concept of 'epistemic modesty', they considered artificial intelligence systems better perceived as non-exceptionalist methodological tools that were uncertain and unexciting. Adopting 'epistemic modesty' was sometimes hindered by stakeholders to whom the research is disseminated, who may be less interested in hearing about the uncertainties of scientific practice, having implications on both research and policy.

Contested futures: envisioning "Personalized," "Stratified," and "Precision" medicine

In recent years, discourses around "personalized," "stratified," and "precision" medicine have proliferated. These concepts broadly refer to the translational potential carried by new data-intensive biomedical research modes. Each describes expectations about the future of medicine and healthcare that data-intensive innovation promises to bring forth. The definitions and uses of the concepts are, however, plural, contested and characterized by diverse ideas about the kinds of futures that are desired and desirable. In this paper, we unpack key disputes around the "personalized," "stratified," and "precision" terms, and map the epistemic, political and economic contexts that structure them as well as the different roles attributed to patients and citizens in competing future imaginaries. We show the ethical and value baggage embedded within the promises that are manufactured through terminological choices and argue that the context and future-oriented nature of these choices helps to understanding how data-intensive biomedical innovations are made socially meaningful.

Epistemic modesty, ostentatiousness and the uncertainties of epigenetics: on the knowledge machinery of (social) science

Epigenetic processes are garnering attention in the social sciences, where some scholars assert their importance for theorizing social life. I engage with such ideas here by drawing on interviews with leading bioscientists. To begin with, I underscore the (productive) uncertainties of those working in and around epigenetics; I describe these as a manifestation of ‘epistemic modesty’, and suggest that dissensus helps to propel biomedical innovation. Then, drawing on the concept of ‘alien science’, I detail some researchers’ ambivalences regarding the notion of ‘transgenerational inheritance’; their dissatisfaction with the (public) communication practices of other scientists (situated in what I term a regime of ‘epistemic ostentatiousness’); and the challenges faced when moderating societal discussion of epigenetics in ways that expand excitement whilst deflating (what researchers regard as) unrealistic expectations. The paper concludes with reflections on the knowledge machinery of the (social) sciences, and employs the study data to interrogate sociological engagements with epigenetics.

Artefacts of not-knowing: the medical record, the diagnosis and the production of uncertainty in Papua New Guinean biomedicine

Anthropological and STS scholars of biomedical work have traditionally explored contexts where inconsistencies and lacunas in diagnostic knowledge-production are problematic for medical practitioners, and such scholars have consequently focused on the social and political processes by which such epistemic uncertainties are resolved. This article draws on ethnographic material from a Papua New Guinean hospital where diagnostic uncertainty is not rendered problematic and where the open-endedness of the diagnostic process gives rise to new forms of medical expertise and practice. The paper focuses on the medical record as an artefact of not-knowing that both documents and performs uncertainty as a valuable resource. It shows that medical records can operate as either technologies of 'opening' that multiply opportunities for pragmatic action within a hospital space or as technologies of 'closure' that move people and documents between spaces. Practices of not-knowing and knowing are therefore shown to be interdependent and interchangeable 'moments' of bureaucratic-biomedical work.