Comment two on the July issue of Science, Technology, & Human Values (July is volume 37, number 4).
Recently, I claimed that STHV had produced what I thought was one of the best issues in a while.
I will, in a series of posts over the next month or so, comment on each paper in the special edition on context with comments, criticisms, and occasional tangents.
Second paper is “Health Care Standards and the Politics of Singularities: Shifting In and Out of Context” by Moreira.
Context is a pivotal concept for social scientists in their attempt to weave singularities or universals to moral codes and political orders. However, in this, social scientists might be neglecting the ways in which individuals or groups who are excluded from the collective production of knowledge want to politicize their concerns also by claiming their uniqueness and singularity. In this article, drawing on the public controversy about access to dementia drugs on the U.K. National Health Service (NHS) and on the work of pioneering sociologist Helen McGill Hughes on “human interest stories,” the author argues that the “politics of singularities” can be articulated in two related ways within technical controversies. First, it expresses the unraveling of sociotechnical ties caused by institutional failure to take concerns into account. Second, it expresses the concrete uniqueness of persons caught by standardized, “universal” and impersonal implements and/or policies. Both these effects are underpinned by resourcing to allegorical expression, a literary form that while fostering political imagination in technological democracies might weaken Science and Technology Studies’ (STS) ambitions to influence decision making.
Reaction and Commentary:
This is an exceptional paper, but the abstract is a bit misleading, as much of it makes the clearest sense only after you’ve already read the article in its entirity. I’ll help to decode a bit. The real key to appreciating this paper is that it does not have as much to do with context or the irreductionist approach to context so much so as it is a case-in-point about how the “politics of singularity” operates (and, it might be argued, within the broader context of Big Science, in particular, in the pharmaceutical industry and, in this case, access to experimental dementia drugs in the UK).
The “politics of singularity” works like this. Big Science decontextualizes knowledge from its origins, which is a common story that some of us know from experience: considerable effort is made on the part of scientists to disentangle “data” from their messy origins so that they appear clean and universally applicable later on (or elsewhere). The goal, then, is to uncover where and how decontextualization attempts occur. In a Garfinkelian move, the author shows how decontexutalizaiton fails to decontextualize. So, what happens, then, when this model is challenged by outsiders (i.e., non-scientists), what do they use to challenge it, and why might it work? All three of the answers blend “singularities” with “politics”.
What do non-scientists use to challenge scientists conducting large-scale clinical trials? The author draws-up (and shows excellent evidence for this) a model wherein we come to see clinical trials as charateristically “generalizing” and “conclusive” (which are two things, of course, that map onto basic tenants of science quite well). When clinical trials are challenged, citizen non-scientists tend to emphasize just the opposite, their “pleas” (or “human interest stories” RE: Helen McGill Hughes) are “individuating” and “emergent”. Consider their contents, respectively. Scientific accounts of dimentia record verified tests of cognitive scores or memory evaluations, which when combined from many patients over time aids in creating generalized and conclusive knowledge about an intervention for dimentia. In contrast, personal accounts (pleas or “human interest stories”) operate according to an alternative dynamic. They emphasize dimentia as a lived experience at home where loved ones report whether or not the family member (RE: patient) is doing well and is feeling comfortable, which is drawn-up against backdrop of the home where “all this is really happening right now” with the implicit message that some sort of intervention could/should be taken.
Why might it work? According Moreira, individuating pleas have a curious political consequence. While we may assume, and plenty of sociological research about social movements suggests precisely this, that it is through large numbers of people banding together that we should expect politically-based change to, in this case, transform scientific trials. However, we do not see that in the UK dimentia controversy. Instead, the controversy is populated by “human interest stories” (RE: Helen McGill Hughes and the Chicago School analysis of “news”). These highly-individualistic portrayals of human life have a surprisingly hidden-in-plain-sight consequence: we related to them, despite their specificity, and this is a result of their un-fixity (or the quality that they are happening right now and it is not too late to do something about them).
What happens when this model is challenged by outsiders? Moriera encapsulates the answer winningly:
… the politics of singularities works in a dynamic relationship with the politics of generalization. Persons or groups locked out of the collective production of evidence capture the public imagination by shifting the frame of reference. The political imagination of the case is the delicate effect of the displacement that gathers in tension “the most extensive generalization” and “the most precise individuality.” (p.324-5).
The key being to bring the general and singular in tension, and the author means this not only hypothetically, but also in terms of a recipe for citizens that want to challenge “larger issues”. This notion of “bringing into tension” or (more actively) “gathering tension” seems like a fruitful technique for citizens and sensitizing process for scholars to keep in their analytical tool belts.