Stabilizing Instabilities: The Role of the Laboratory in the United Kingdom Cervical Screening Programme

Singleton, Vicky

doi:10.1515/9780822399179-006

Cited by 6 publications

(10 citation statements)

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“…One important insight this ethnographic account of laboratory work provides comes from the analysis of infrastructural instability as inherently political, relational, and institutional; it is not merely a material and logistical issue, as commonly suggested by health systems literature (e.g., Sayed et al 2018). This research article also adds to the growing body of anthropological literature on improvisation and stability in laboratory medicine (Mika 2020;Singleton 1998) by focusing on the creative ways in which laboratory technicians integrate new equipment into their work even without the usual accompanying social and technological assemblages. Departing from Mika (2020) and Singleton (1998), I have pointed to the limitations of improvisation as a means of improving the clinical value of Connaught's laboratory.…”

Section: Discussionmentioning

confidence: 88%

“…This research article also adds to the growing body of anthropological literature on improvisation and stability in laboratory medicine (Mika 2020;Singleton 1998) by focusing on the creative ways in which laboratory technicians integrate new equipment into their work even without the usual accompanying social and technological assemblages. Departing from Mika (2020) and Singleton (1998), I have pointed to the limitations of improvisation as a means of improving the clinical value of Connaught's laboratory.…”

Section: Discussionmentioning

confidence: 99%

“…This section makes clear that, in a similar manner as described in Singleton's (1998) study of the UK screening programme's laboratory, Connaught's lab staff's improvisations were able to (temporarily) stabilise the use of diagnostic tests and equipment by incorporating the instability of other institutions (e.g., the government's procurement unit and the hospital administration). However, different from Singleton's argument, the ability of Connaught's lab workers to incorporate infrastructural instability did not provide durable stability.…”

Section: The Social and Economic Value Of Laboratory Workmentioning

confidence: 92%

“…1 In STS analyses and particularly actor-network theory (ANT) studies (e.g., Callon 1986;Latour 1987;Law 1992), the focus has been on understanding how human actors (laboratory technicians, research scientists) and non-human elements (microbes, texts, laboratory instruments) are connected, coordinated, and stabilised in a network of associations; an actor-network (Mol and Law 1994). The focus on the stabilisation of knowledge practices in research laboratories was later extended to analyse the (in)stability of laboratory work in hospital settings, where the production of knowledge is geared to inform diagnosis and clinical decision making (Singleton 1998;Mol 2002). In her ethnographic study on the role of the laboratory in a wellestablished UK cervical screening program, Vicky Singleton (1998) challenged the actor-network theory, which posits that a network is maintained by the stability of its socio-material elements.…”

Section: Introductionmentioning

confidence: 99%

“…The focus on the stabilisation of knowledge practices in research laboratories was later extended to analyse the (in)stability of laboratory work in hospital settings, where the production of knowledge is geared to inform diagnosis and clinical decision making (Singleton 1998;Mol 2002). In her ethnographic study on the role of the laboratory in a wellestablished UK cervical screening program, Vicky Singleton (1998) challenged the actor-network theory, which posits that a network is maintained by the stability of its socio-material elements. Rather, she argued that the ability of laboratory staff to deal with instabilities, such as ambivalences in screening or sample-taking procedures, contributed to the long-term stability of the screening programme.…”

Section: Introductionmentioning

confidence: 99%

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Infrastructural Instability, Value, and Laboratory Work in a Public Hospital in Sierra Leone

Vernooij¹

2021

MAT

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This research article examines the relationship between infrastructural instability and laboratory work in a public referral hospital in Sierra Leone. Drawing on ethnographic fieldwork conducted inside the hospital’s wards and clinical laboratory, I show how attending to infrastructure and materiality (i.e., laboratory spaces, diagnostic equipment, and supply chains) provides insight into the different kinds of value that laboratory work holds for laboratory technicians, clinicians, hospital administrators, and international donors. Through the case study of a newly arrived non-functioning diagnostic instrument, I reveal the institutional undervaluing of both the laboratory and the improvisation work performed by lab technicians to stabilise unstable equipment. Infrastructural instability in the laboratory enables the generation of new kinds of value, including economic and social value for laboratory technicians themselves, but undermines the clinical value of laboratory tests for clinicians and patients. By discussing the everyday practices, challenges, and meanings of laboratory work in a context of infrastructural instability, I aim to draw attention to the clinical laboratory space as a field site worthy of (more) anthropological inquiry and health systems research and contribute new insights about improvisation, instability, and diagnostic value creation in under-resourced settings.

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Section: Discussionmentioning

confidence: 88%

Section: Discussionmentioning

confidence: 99%

Section: The Social and Economic Value Of Laboratory Workmentioning

confidence: 92%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Infrastructural Instability, Value, and Laboratory Work in a Public Hospital in Sierra Leone

Vernooij¹

2021

MAT

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Competing realities, uncertain diagnoses of infectious disease: Mass self‐testing for COVID‐19 and liminal bio‐citizenship

Petersen

Pienaar

2023

Sociology Health & Illness

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Diagnoses of infectious diseases are being transformed as mass self‐testing using rapid antigen tests (RATs) is increasingly integrated into public health. Widely used during the COVID‐19 pandemic, RATs are claimed to have many advantages over ‘gold‐standard’ polymerase chain reaction tests, especially their ease of use and production of quick results. Yet, while laboratory studies indicate the value of RATs in detecting the SARS‐CoV‐2 virus antigen, uncertainty surrounds their deployment and ultimate effectiveness in stemming infections. This article applies the analytic lens of biological citizenship (or bio‐citizenship) to explore Australia’s experience of implementing a RAT‐based mass self‐testing strategy to manage COVID‐19. Drawing on Annemarie Mol’s (1999, The Sociological Review, 47(1), 74–89) concept of ontological politics and analysing government statements, scientific articles and news media reporting published during a critical juncture of the strategy’s implementation, we explore the kind of bio‐citizenship implied by this strategy. Our analysis suggests the emergence of what we call liminal bio‐citizenship, whereby citizens are made responsible for self‐managing infection risk without the diagnostic certitude this demands. We discuss how the different realities of mass self‐testing interact to reinforce this liminal citizenship and consider the implications for the sociology of diagnosis.

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When craft kicks back: Embryo culture as knowledge production in the context of the transnational fertility industry

Helosvuori

Homanen

2022

Soc Stud Sci

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The multibillion-dollar fertility industry promotes standardization in in vitro fertilization laboratories. Transnational pharmaceutical and biotechnological giants distribute a wide range of fertility products, from embryo culture mediums and incubator technologies to add-ons such as time-lapse embryo monitoring. These technologies are designed to standardize and automate knowledge production regarding embryonic viability. More effective knowledge production enables the more effective selection of embryos for transfer, which in turn leads to more future babies and enables economic scaling-up. Drawing on two multi-sited ethnographic studies at eight fertility clinics in Finland during 2013–2020, this article discusses how knowledge about embryos is produced in the processes and practices of embryo culture. We argue that automation and standardization in clinical practice are not always perceived as economically desirable. Sometimes standard technologies do not replace hands-on knowledge production, although they may transform it. The technologies are also perceived as modifying the object of knowledge itself in undesired or unnecessary ways. In such cases, concerns are raised regarding the best interests of patients, embryos and future babies, who might be better served by masterful laboratory craftwork. We conclude that embryo culture is not only a site of knowledge production – one that aims to make babies and parents through standard and craftwork knowledge practices – but also a site of multiple bio-economies of assisted reproduction, some of which resist automation and standardization.

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Stabilizing Instabilities: The Role of the Laboratory in the United Kingdom Cervical Screening Programme

Cited by 6 publications

References 0 publications

Infrastructural Instability, Value, and Laboratory Work in a Public Hospital in Sierra Leone

Infrastructural Instability, Value, and Laboratory Work in a Public Hospital in Sierra Leone

Competing realities, uncertain diagnoses of infectious disease: Mass self‐testing for COVID‐19 and liminal bio‐citizenship

When craft kicks back: Embryo culture as knowledge production in the context of the transnational fertility industry

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