There is a paradox in clinical uncertainty management. While contemporary medical education and training dismisses prognosis in favor of diagnostic and treatment skills, prognosis is ever present in daily medical life. In fact, physicians arguably engage in more prognostic behavior than most other professionals because, bound by their duty to heal, they are routinely called upon to concurrently navigate short-term and long-term care goals. With new accumulating evidence establishing prospection (i.e., the mental simulation of possible futures) as a central organizing principle of cognition and behavior, and with more clinicians warning about the central role of prognosis in clinical decision making, concerns about the relative neglect of prognostic training are becoming louder. Yet, although there is much writing and some fairly robust guidelines about how physicians should do prognosis, very little is currently known about what the process of medical prognosis actually looks like on the ground. I begin to fill this gap in my forthcoming book How Doctors Make Decisions, based on a three-year ethnographic study of hospital cardiology.
Fascinating discussion about what infrastructure is and how the concept may have subtly changed over time (for example, the material and conceptual, the blueprint and the waste, etc.). Quality work from the British Academy.
Over the past decade, infrastructures have emerged as compelling sites for qualitative social research. This occurs in a general situation where the race for infrastructural investment has become quite frenzied, as world superpowers compete for the most effective means to circulate energy, goods and money. At the same time, millions of people disenfranchised by trade corridors, securitized production sites, and privatized service provision seek to establish their own possibilities that intersect, disrupt or otherwise engage the high level investments that now routinely re-configure their worlds. The projects of the powerful and the engagements of the poor are thus thoroughly entangled in this contemporary drive to “leverage the future.”
There is a growing connection between a small research area in the business school literature called “futures studies” (wherein forecasting, scenario planning, etc.) and STS. Early thinkers in (what is now) this area are folks like Toffler; you might remember his books Future Shock or the Third Wave. In the link to STS, foundational thinkers that readers might recall are folks like Cynthia Selin (who I wrote about back in 2011).
Well, inspired by this, I started writing with a colleague at Roskilde University (Denmark) named Matthew Spaniol. Our first paper linked STS and futures studies through the notion of multiplicity in “The Future Multiple.” Our new paper, which is nearly out now, deepens this linkage, drawing upon some STS insights to address issues voiced from within futures studies about scenario planning, a process that unfolds, in the standard account, through a series of stages, phases, and steps. We offer a much more tentative understand of that process in “Social Foundations of Scenario Planning.”