The antinomies of sovereigntism, statism and liberalism in European democratic responses to the COVID-19 crisis: a comparison of Britain and France

This paper argues that the current COVID-19 pandemic reveals and in a sense crystallizes a series of long-standing tensions about sovereignty that have become increasingly salient in the advanced capitalist democracies of the European Union. The spread of the pandemic led first to the activation of a conflict between a ‘sovereigntist reflex’ privileging the expression of national capacities and national self-reliance and a more ‘perforated’ understanding of sovereignty stressing the interdependence of peoples and states, both geographically and institutionally. As the response to COVID itself became more politicized we see the emergence of a second tension, between a libertarian ‘reflex’ supporting a residual state protecting liberties and facilitating individual choice and a sovereign-statist ‘instinct’, calling for an empowered guardian of the public good capable of ensuring collective security. A third tension relates to the seemingly growing opposition between a conception of sovereignty founded (and contingent) upon the will of the people and one in which the sovereign is, simultaneously, the discerner, defender and ultimate guarantor of the public good. After having mapped out these interwoven tensions and their main fault lines in general terms, the paper proceeds comparatively, tracking and tracing their (differential and specific) presence in governmental responses in two advanced capitalist democracies, France and Britain.

The Social and Emotional World of Twentieth-Century Anglo-American Surgery: The James IV Association of Surgeons

Founded in 1957 by a group of elite British and American surgeons, the James IV Association of Surgeons is an international organization that "promotes communication among surgeons across the globe." Every year since 1961, the association has funded trips for several "surgical travellers" to encourage "exchange and camaraderie between surgical communities." This article uses the association's archive to explore the social lives, professional identities, and affective experiences of the men and women who populated the "surgical world" of Britain and North America in the mid-twentieth century. Integrating the social history of medicine with emotions history, I argue that the social lives of surgeons were crucial to the development and maintenance of their professional identities and communities by assisting in the definition of what it meant to be a surgeon. This definition was structured not just by surgical skill but by the forms of sociability available to potential participants.

From "Honeymoon Period" to "Stable Marriage": The Rise of Management Consultants in British Health Policymaking

Since the creation of the National Health Service in 1948, different groups of experts have competed to inform the development of British health policy. This article analyzes the long-term rise of one of these groups-management consultants. The scale and regularity of their engagement has increased considerably over time, strikingly in recent years, and the functions fulfilled by consultants have become ever more diverse. At important moments they were often seen by policymakers-particularly when there was understood to be a lack of internal expertise-as possessors and imparters of important knowledge. Firms and individuals worked consciously to integrate themselves into emerging health policy networks. But there has often been relatively little consideration of their real suitability for work in the health field. Many debates around the use of external consultants today-accountability, value for money, dependency-were foreshadowed during earlier periods, with implications for current policymakers.

Framing drug and alcohol use as a public health problem in Britain: past and present

Recent attempts to approach drug and alcohol problems as a public health issue in the UK and globally have begun to achieve some success. Yet, in historical terms, the idea that the use of psychoactive substances should be regarded as a public health problem is a relatively new one. In the UK, it was only in the latter half of the 20th century that what were termed “public health” approaches to alcohol and drugs began to gain purchase. Moreover, what was meant by a “public health” framing of psychoactive substance use changed over time and between substances. This article examines the development of public health approaches to drugs and alcohol in Britain since the 19th century. It suggests that a public health view of substance use existed alongside, and interacted with, other approaches to drug and alcohol use. To understand the meaning of a “public health” framing of drugs and alcohol we need to locate this in historical and geographical context.

From One Medicine to Two: The Evolving Relationship between Human and Veterinary Medicine in England, 1791-1835

This article offers a novel perspective on the evolving identities and relationships of human medicine and veterinary medicine in England during the decades that followed the 1791 foundation of the London Veterinary College. Contrary to the impressions conveyed by both medical and veterinary historians, it reveals that veterinary medicine, as initially defined, taught and studied at the college, was not a domain apart from human medicine but rather was continuous with it. It then shows how this social, cultural, and epistemological continuity fractured over the period 1815 to 1835. Under the impetus of a movement for medical reform, veterinarians began to advance an alternative vision of their field as an autonomous, independent domain. They developed their own societies and journals and a uniquely veterinary epistemology that was rooted in the experiences of veterinary practice. In this way, "one medicine" became "two," and the professions began to assume their modern forms and relations.

The foundations of autism: the law concerning psychotic, schizophrenic, and autistic children in 1950s and 1960s britain

While the origins of child psychiatry in Britain can be traced to the interwar period, contemporary concepts and methodological approaches to pathological mental development in children were not created until the 1950s and 1960s. It was at this time that one of the most salient and lasting diagnoses in child psychiatry, autism, was established through a network of intellectual, institutional, and legal changes in Britain. This article argues that the work of child psychiatrists at the Maudsley Hospital was central in driving these changes and uses archival sources from this hospital, along with other legal and intellectual sources, to explore attempts to conceptualize pathological thought in infants in the 1950s and 1960s. When the first epidemiological study of autism was published in 1966, this finally established the autistic child as a scientific, demographic, and social reality in Britain.

Hearing science in mid-eighteenth-century Britain and France

Benjamin Martin, the English natural philosopher, and Claude-Nicolas Le Cat, the French surgeon, both published important work on auditory physiology and function in the mid-eighteenth century. Despite their different backgrounds, there was consensus between the two scholars on key principles of hearing research, most notably the importance of the inner ear in relation to auditory perception. Martin's work (1755 [1763?]) drew directly on the surgical work of Le Cat (1741) to demonstrate the importance of the auditory mechanism in listening processes. Le Cat's interest in the ear, however, came in turn from his interest in surgical anatomy. Martin used Le Cat's elegant designs as a tool for the vivid communication of auditory function to a popular, fee-paying audience. The meeting of two very different minds through intellectual agreement and material transfer demonstrates the way in which principles of hearing science were established in the Enlightenment period.

As depressing as it was predictable? Lung cancer, clinical trials, and the Medical Research Council in postwar Britain

In recent years lung cancer specialists have complained that due to stigma resulting from the association of the disease with smoking, theirs is a neglected field. This paper demonstrates that in the 1950s and 1960s, when the British Medical Research Council (MRC) started to organize clinical trials for various forms of cancer, this was not the case. Rather, the organizers of these trials saw lung cancer as a particularly promising object of research, for much was known about the disease. The cancer trials were part of a strategy to use the Randomized Controlled Trial (RCT) technology to cement the role of the MRC as the dominant body overseeing medical research in Britain. The organization of the trials, however, turned out to be very difficult, due to ethical problems and the dominance of one form of therapy, surgery. The trial results were deeply disappointing. I argue that these frustrating results contributed to the notion of hopelessness that has come to surround lung cancer, and to the shift of focus from cure to prevention that was triggered by epidemiologic studies identifying tobacco smoke as the main cause of the disease. The paper deals with an important episode in the history of clinical cancer research in postwar Britain, illustrating the ethical and practical problems faced by the organizers.

Tobacco control policy: the European dimension

The Royal College of Physicians has long played an important role in the struggle against tobacco. As tobacco is a legally traded substance, its regulation increasingly takes place at a European level, where governments seek to balance concerns about public health and free trade. Consequently, it is essential that those seeking to reduce the toll of tobacco-related disease understand the nature of the debate at a European level, in particular the strategies being pursued by the tobacco industry to undermine efforts to promote public health. After describing the European legislative process, this paper explores the current European debates on advertising restrictions, warning labels and cigarette composition, bans on public smoking, taxation, alleged industry involvement in smuggling, and subsidies for tobacco producers. It concludes by examining areas where the College might take action.