10.6092/issn.2038-3460/16864
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2038-3460
16864
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Stefano Crabu
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Tecnoscienza – Italian Journal of Science & Technology Studies
Adele E. Clarke, Laura Mamo, Jennifer Ruth Fosket, Jennifer R. Fishman and Janet K. Shim (eds.), Biomedicalization. Technoscience, Health, and Illness in the U.S, Duke University Press, 2010
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Book Reviews
2011-12-29
2023-04-28
2011-12-29
2023-07-06
119-123
TS
Stefano Crabu
2011/12/29
10.6092/issn.2038-3460/16864
119
Università di Padova
2038-3460
2
en
123
Adele E. Clarke, Laura Mamo, Jennifer Ruth Fosket, Jennifer R. Fishman and Janet K. Shim (eds.), Biomedicalization. Technoscience, Health, and Illness in the U.S, Duke University Press, 2010
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                                                         TECNOSCIENZA – 2 (2)       119




hopeful note: “Indeed, perhaps            several case studies, the tendencies
science has only just begun” (p. 178)     assumed by biomedicine in the
– a powerful reminder of the              postmodern society. In the last
importance of keeping an open mind        decades, indeed, the technological
even when the achievements of             innovation in the health care field has
science seem to give us final answers.    laid the groundwork for a consistent
Castel and Sismondo’s discussion          development of the biomedical
will certainly please all philosophers,   knowledge, considerably moving the
sociologists and historians with an       medical intervention limit on the
interest in scientific practice, while    human body, till to interweave life’s
the broad range of case studies and       and human experience’s aspects that
illustrations in each chapter will take   otherwise would be considered
students and general readers on a         "natural" (Kaufman and Morgan,
wonderful journey of discovery.           2005). In particular, the emergence
                                          of new substantive areas of the life
                                          sciences such as genomics, molecular
                                          biology, genetic medicine and
                 ***                      pharmacogenetics, accompanied by
                                          complex diagnostic and information
                                          technologies, provides just some
                                          examples of the changes that have
Adele E. Clarke, Laura Mamo, Jennifer     affected the modality of production
Ruth Fosket, Jennifer R. Fishman, Janet   and circulation of the medical
            K. Shim (eds)                 knowledge. For this reason the Social
  Biomedicalization. Technosci-           Sciences, and in particular way the
  ence, Health, and Illness in the        Science and Technology Studies
               U.S.                       (STS), in the last years have devoted
                                          a constantly increasing attention to
 2010, Duke University Press, 498 pp.     the intersection between biology,
                                          medicine and life sciences in general,
                                          focusing the analysis on the emergent
             Stefano Crabu
                                          biomedical technologies (Hogle
         (Università di Padova)           2008).
                                              The works composing the
                                          anthology proposed by Adele Clarke
    The anthology edited by Clarke,       and her colleagues present, on the
Mamo, Fosket, Fishman and Shim,           whole, the most innovative STS
called "the gang of five" by Virginia     features. In doing so, treating the
Olesen because of their constant          relation between medicine and
“shoulder to shoulder” academic           society, the editors introduce an
work, proposes to face, within an         approach to social studies that is
innovative theoretical perspective        different from the classical one
accompanied by the discussion of          constituted by the medicalization
120   BOOK REVIEWS




      paradigm. The volume has its              science. At the same time, the most
      theoretical foundations in a seminal      traditional medical sociology and the
      article written in 2003 by the editors    studies on the medical institutions
      of the book themselves (Clark et al.),    are strongly permeated by the studies
      and selected as the opening chapter       on science and technology. Without
      for the anthology (ch. 1). Such           doubt, this virtuous contamination
      contribution, which has already had       between perspectives has been
      not only an important relevance in        encouraged by the increasing
      the US debate, but also among             complexity of the biomedicine and
      European scholars, characterizes          its practices, which has brought new
      itself for researching a lively and       topics to the attention of the Social
      fruitful convergence between socio-       Sciences.
      logical perspectives that traditionally       From an analytical point of view,
      have looked at the same phenol-           the essays in this collection, since its
      menon − i.e. the relation between         introduction, provide the reader with
      medicine and society – from different     a complex and articulated mapping
      perspectives. Specifically, the clas-     of the prevailing phenomena that
      sical Sociology of Health and Illness     characterize contemporary biomedi-
      has dedicated considerable space to       cine such as, for instance, the
      the subjective experience of the          creation and commodification of new
      illness, however omitting the increa-     preventive medicines (preventive
      sing importance assumed by the            chemotherapies) or body enhance-
      technologies as production devices of     ment      products     (Viagra),     the
      the medical knowledge. Besides the        definition of new epidemiological
      modalities through which the              and biomedical models of the risk
      biomedical knowledge is produced          and prevention of the risk, the
      and      shared    have   not     been    commodification of the biological
      documented with enough attention.         material (tissues, stem-cells, sperm
      Likewise the STS, to which this book      and so on) till the constitution of new
      is mainly oriented, have a solid          identities of patients and new
      tradition in studying the "harder"        expressions of biological citizenship
      sciences, and only in recent years a      constituted inside the biomedical
      strong interest has emerged towards       networks. In order to describe and to
      constructing the medical and              interpret this wide range of
      biological knowledge, and towards         phenomena, the editors propose the
      the technoscientific practices inside     umbrella concept of "biomedical-
      the biomedical field (Bruni, 2008).       lization", focusing the analysis on the
      As it clearly emerges from the            processes and the social practices
      extensive review of the literature        coming from the convergence
      presented in the introductory chapter     between biological knowledge and
      to the text (pp. 1-44), the STS are       medical knowledge. On this line, the
      currently characterized by a vivacious    classical concept of medicalization
      interest in biology and medical           turns out to be as unsuitable as
                                                          TECNOSCIENZA – 2 (2)         121




essentialist in individualizing the        tred on the clinical gaze – which took
contemporary biomedicine features          place at the patient’s sickbed – to a
and its emergent dimensions. The           biomedicine characterized by a
term "biomedicalization", in fact, is      "molecular gaze" (p. 23), in which
used by the editors from the very first    the mediation of biological techno-
pages of the book to indicate "the         logies appears decisive for the bodies
increasingly complex, multisided,          scrutiny and for the biomedical
multidirectional        process       of   knowledge production.
medicalization that today is being             The work, on the whole, is
both extended and reconstituted            articulated through a clear tripartite
through the emergent social forms          structure. The first part (chs. 1-4) is
and practices of a highly and              oriented to analyse in depth the
increasingly technoscientific biome-       thorniest      and     most     complex
dicine" (p. 47). The suffix "bio" − in     theoretical matters, or rather the shift
the concept of medicalization –            from the medicalization thesis, which
denotes the increasing importance          has dominated the sociological
assumed by biological sciences in the      debate on the connection between
medical discursive regime. In              medicine and society for almost thir-
particular, the birth of modern            ty years, to the biomedicalization
medicine, in a scientific perspective,     thesis. To understand not only the
establishes itself on the so-called        theoretical importance of the
"clinical gaze" (Foucault, 1963) in        biomedicalization thesis, but also its
which the human eye was under-             epistemological one, the editors
stood as a generating element and at       express themselves in the following
the same time as the depositary of         terms: "medicalization was co-
knowledge. In the last decades,            constitutive of modernity, while
however, the clinical practice has         biomedicalization is also co-con-
increasingly relied on technological       stitutive of postmodernity" (p. 52).
devices supporting the diagnostic              In this first part of the text, what
activities previously entrusted to the     turns out to be particularly important
"handicraft" abilities of the physic-      for the STS is ch. 4, edited by
cian. This innovation of biomedicine       Elianne Risk, which proposes an
and its practices is interpreted, in the   interesting critical reading of the shift
text (chs. 2-3), in terms of a slow and    from the medicalization thesis to the
constant transformation of the             biomedicalization one through the
clinical gaze on the patient body, in      gender lens. The author thoroughly
which the technological devices have       shows how the theoretical shift from
played a decisive role. The text,          the medicalization to the biome-
therefore, guides the reader through       dicalization has involved a new
an articulated path that is first theo-    critical reading of the body and its
retical, then substantive. The purpo-      materiality in the light of the new
se is describing and interpreting the      biomedical practices, deconstructing
decisive shift from a medicine cen-        the man-woman and nature-culture
122   BOOK REVIEWS




      dichotomy that has deeply charac-           molecular epidemiology and its
      terized the debate on the medi-             consequences in classifying the
      calization of society.                      populations in the face of the risk.
          The second and the third part of        The section devoted to the
      the volume are devoted to present           "difference" dimension is closed with
      the case studies, which offer a             the case study introduced by
      theoretically deepened analysis of the      Jonathan Kahn (ch. 9), which, along
      biomedicalization processes. The            the lines of Shim’s reflection,
      essays gathered in the second part          investigates the "racial" dimension of
      (chs. 5-9) mainly focus on the              the biomedicalization processes,
      "difference" dimension, highlighting        retracing the history of the BiDil, the
      the modalities through which the            first medicine introduced to the
      processes of biomedicalization and          market to treat the cardiac
      its practices are articulated, redefined    insufficiency among the Afro-Ame-
      and contextually re-elaborated. This        rican population.
      section is opened by Laura Mamo’s               The last part of the volume (chs.
      empirical work (ch. 5) on the               10-13) focuses on the biomedical
      experience of the lesbians who turn         technologies of “enhancement” of
      to the services of the sperm bank for       the body, retracing the liminal
      getting pregnant. Analyzing inter-          boundaries between health and
      views with lesbian consumers of             illness and the medical criterions of
      sperm bank services, the author             intervention on the body. This
      shows how the conceptive practices,         section faces the emblematic case of
      neoliberal ideology and health care         the erectile dysfunction and the
      policies are mutually productive,           Viagra as a procedure of biomedical-
      critically discussing what she defines      lization of man’s sexual health
      "Fertility, Inc.". The second case          (Jennifer Fishman, ch. 10), the
      study, introduced by Kelly Joice (ch.       bariatric surgical weight loss (Natalie
      6), focuses on the relation between         Boero, ch. 11) and the "chemopre-
      the new technologies and the                ventive" treatment of those women
      measurement        and     classification   "at risk" of breast cancer (Jennifer
      regimes of the bodies, exploring a          Ruth Fosket, ch. 12). The last section
      biomedicalization key dimension: the        of the anthology is concluded with
      use of new imaging technology as            the remarks by Jackie Orr on the
      devices for re-elaborating and              transformation of the biological
      redefining the individual and collec-       psychiatry following the introduction
      tive technoscientific identities. Janet     of "brain imaging" technologies.
      Shim, in the third case study (ch. 7),          The anthology edited by the
      faces in a dialectical way the liaison      "gang of five" offers, from my point
      between ethnic and class inequalities       of view, a fundamental contribution
      and cardiac illnesses. The case study       and an innovative theoretical frame-
      discussed by Sarah Shostak (ch. 8)          work for understanding not only the
      focalizes on the emergence of               relation between medicine and
                                                                   TECNOSCIENZA – 2 (2)         123




society, but also the study of the                     Tomás Sánchez Criado (ed)
technoscientific practices tout court.               Tecnogénesis: la construcción
Nevertheless, since the theoretical                técnica de las ecologías humanas
contribution     in   the    volume’s                           (2 Vols.)
opening, an excessive emphasis is
                                                   (Technogenesis: the technical construction
given to the American national
                                                            of human ecologies)
context, to such a point that, in the
work, the specific features of the                  2008, Editorial AIBR - Antropólogos
American health care system are                    Iberoamericanos en Red, 300 pp. vol. 1,
taken for granted. However, this
territorial connotation is slightly                             244 pp. vol. 2
mitigated by the conclusive chapter
(Adele E. Clarke), which constitutes
the volume’s epilogue and offers an                           Celia Dìaz Catalan
interesting as innovative transnation-                            (IESA-CSIC)
al study of the biomedicallization
processes.                                                Postmodernism is an interesting
                                                     symptom of transition, let’s accept it
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