Gareth+memo+10+-+Literature+Review


 * __INCOMPLETE___**


 * Memo 10: Three Literatures, Thirty Citations**

Four conceptual keywords form a central core in the following fields of study: **Place/Location**- which I mobilize to examine the relationship between local culture/situation and transportable/universal Biomedicine; **Choice-** referring to the expanding influence of neoliberalism, especially the constituent concept of individuality and choice, as it plays out in the discourse of “transparency” and “flexibility”; **Health-** The different ideas of “health”, concepts and rights to health. In STS the focus on the way systems of material technologies and expert knowledge contribute to the experience and constitution of each, in Transnationalism studies, the extension of institutions and the negotiation that forms in expanding liminal zones, and in comparative health systems/policy studies the way that structuring of institutions and policies respond to and influence access and quality of care in response to different mechanisms and ideas of health and choice.

Some notes and quotes i haven't integrated...


 * Science and Technology Studies**

The multiple definitions of Place, Choice and Health are conceived in any situation in an intrinsic linked to their framing in terms of expertise and authority, Science and technology studies represents a vital ongoing dialogue about the construction of expertise and the role of authority and uneven distribution of power between various knowledge and expert systems (Woodhouse and Nieusma 1997; Collins & Evans 2002). One avenue in which this negotiation of meaning has been examined is the formation of shared scientific “imaginaries”, systems of meaning based around a cohesive vision of the world (Appadurai 1996; Deblonde 2008; Fortun 2005; Marcus 1995). This model is of particular interest to me because it allows an examination of the value of the mental comparison in participants predictions of outcome, and the way values contribute to the formation of acceptance of expertise. These imaginaries may allow communication between groups that conceive of the same real world space distinctly. At the same time, as these systems interact they demand boundary work, the negotiation between expertise and external that maintains authority (Epstein 1996; Galison and Stump 1996; Gieryn 1999) and allows participants to construct their credibility in relation to differing sociocultural contexts (Latour 1986; Latour 1988; Knorr-Cetina 1999; Shapin 1999). This conflict in interaction between local cultures has been described in the globalization literature as part of the process of “glocalization” and to it sociologist George Ritzer (2003) counterpoints “globalization” which suggests local cultures include national and institutional interests that are maintained in these liminal points constituting part of the “glocal” interaction. This construction of expertise, and ongoing system of practice that enables experts to be authoritative often is communicated in the form of standards, a key tool in the universalization of scientific knowledge and authority. Standards ( Bowker 2000; Demortain 2008; Lampland 2009; Subramanian 2007) and standardized uses, forms and perception of bodies, both human (Scheper-Hughes and Wacquant 2003; Sharp 2006; Inhorn 2003a; Landecker 2007a, 2007b; Rader 2004) Kohler 1994) act to allow universal science, and to create a very special space in science for communication between local cultures. These bridging devices are not solely scientific, technology studies also forms a vital literature on the ethical and practical complexity of transporting technologies between national contexts (Dijck 2005; Escobar 1994; Helmreich 2000; Inhorn 2003b; Lansing 1991). In examining this role of technology and its impact across domains I draw on Andrew Pickering’s observation of science as “ a realm of instruments, devices, machine, and substances that act, perform, and do things in the material worlds”(Pickering 1995). That these objects along with the material world in which they work form a “mangle,” shaping the production and application of scientific knowledge in an extended dialectic of “resistance and accommodation” between our idealized and transportable medical knowledge and the messier (Turnbull 2000) world of practice and materiality Thus by particular focus on what Peter Galison (1997) terms “material culture” and what Hans Jorg Rheinberger calls the “technical conditions of the production of science”(Rheinberger 1997) we can find the points at which negotiation between the universalizable and idealized ‘medical knowledge’ that is in practice shifts in relation to its local position.


 * Transnationalism/Globalization Studies (Neoliberalism)**

Examining science and technology in the practice of biomedicine between nations and local contexts is of particular valence in the way that it performs as a Trans-national conversation (Levitt 2007; Levitt and Khagram 2008) While differences in medical practice based on locality is a topic in medical anthropology and STS (i.e. Lock 2001, in medical anthropology, and Mol et al. 1998, in STS) I use the framework of transnationalism to emphasize that medical tourism is anchored in and simultaneously transcends the boundaries of one or more nation-states (Kearney 1986; Kearney 1995) and thus offers a social space that both is best analyzed in that space between and that offers insight into the formation of those local cultures that it participates in. Moving away from traditional state-centric models of international relations (i.e. Wallerstein 2004) we can see a move towards the recognition of complex inter-national connection that is subject of an extensive literature (Harvey 2007; Lash 2001, 2007; Ong 1998a). These differ from theorists focusing on ‘modernity’ (i.e. Giddens 1991; Habermas 1998; Jameson 1991; Lyotard 1984) in which the local impact is the central figure. The idiom of transnationalism is used to participate in a discussion about the liminal constructions between nations, as well as the emerging/ rearranging of flows and Frictions/ tensions that these new global assemblages The formation of transnational organizations emerged as the subject of a growing body of literature regarding the formation of social movement and buissiness sector formation across and in spite of international borders. Of particular interest is that despite decentralized formation these assemblages act in concerted organization (McIntyre-Mills 2000; Morales-Gómez and International Development Research Centre (Canada) 1999; Della Porta 2004). In the context of healthcare transnational formations extend and differ from traditional healthcare activism by their participation in scientific expertise, particularly because it allows an a-local authority (Doyal 1979; Kroll-Smith and Floyd 2000; Turshen 2007; Epstein 1996) .Similar discussions of the increasing importance of transnational formations and their bridging effect across traditional national boundaries look at the challenge these institutions pose to forms of governance

Theories of transnationalism are part of an ongoing effort to understand new forms of life activities as they evolve. Recent discussions of the way these changes effects different institutions, such as citizenship (Ong 1998a), cultural imaginaries and ethnicity (Appadurai 1996), economic structures (Harvey 2007), the organ trade (Lock 2001) and others, have not yet focused on the nature of international and transnational healthcare delivery.

A contemporary key theme in this literature is the growth and consequences of dispersal of ‘neoliberalism’. Neoliberalism is a presumed governmentality/ governing mentality (Dean 1999; Foucault 1995, 1984; Campbell 2007) in which market forces are idealized and in a shift away from the welfare state/entitlement model, states are moving industries, including health care delivery to corporate models (Ong 2006; Harvey 2007). The effects of this privatization appear as a key point of overlap in the subject of theory of transnationalism and study of healthcare systems and policy (Dodier 2005; Barbara Prainsack and Ursula Naue 2006; Goldstein 1992; Petersen and Lupton 1997; Altenstetter 1991). This discussion of Neoliberalism overlaps with the discussion in STS of the function of Discourses of development (Escobar 1994) and the emphasis on the individual (Latour 2004; Barbara Prainsack and Ursula Naue 2006). The central importance of the individual in American discourse and policy (Altenstetter 1991; Lowy 2007) and in the specific formation of scientific knowledge and policy (Jasanoff 2007a, 2007b) has been connected to discussions of the value of “Flexibility”(Beck, Giddens, and Lash 1994; Martin 1995; Ong 1998b) and the rise of the concept of “choice”.


 * BACKGROUND MATERIALS??**


 * Comparative Health Systems/ Health Policy (Healthcare)**

Central to the subject of Comparative Health Systems (CHS) and many Current studies in Health Policy (HPS) is a shift of governance of healthcare provision that effects access. While the boundary work and antagonism around availability and industry form in healthcare represents a key historical theme in the US context (Stevens, Rosenberg and Burns 2006; Murray 2007; Hoffman 2001; Starr 1987), the strength of national health systems, and their prominence arising in colonial governmentalities has only recently been threatened by the export of neoliberalism. As population mobilization, migration and privatization have had greater effect the sort of active debate on industry form that has existed in the US has extended to the International and comparative frame.


 * Studies of Tourism/ Anthropology of tourism**

of global networks and the “mobile nature of the whole touristic venture” (Nash 2005, pp 263), and critiques of the very nature of local authenticity and focusing on deterritorialization (Rojek and Urry 1997; Sheller and Urry 2004).

Comparative case example to a stronger literature on Sex Tourism (Kempadoo …) that shares some keywords including the body, intimacy, and authenticity, and the specific differential formation of tourism as parts of different national economies and cultures. Recent work on the relation between poverty and cultural traditions of hospitality, among other factors contribute to national reliance on tourism, Indian accelerated development

Lynn Stephen’s (2005) work on the reproduction of “sameness” as part of the framing process in social movements potentially leading to essentiallization can be connected to Smith’s concern about responses to contact and power difference in exchange, as tourists demand the same experience they were implicitly promised before arrival. At the same time, as these systems interact they demand boundary work (Epstein 1996) as participants construct their credibility in relation to differing socio-cultural contexts. In tourism studies McCannell (1976), describes the transfer, and notional portability of artifacts as a key characteristic of modernity and the formation of the notion of tourism, as fundamentally based in power relations, and in response the demand for the local to match the expectation of the visiting tourist, he suggests that the roles and terms of tourism became natural, as opposed to starting off that way. Medical tourism as a new form of healthcare provides new insights into the extension of scale that is characteristic of late-modernity (Tsing 2000). Tourism studies has looked at these changes and responded in a theoretical shift away from neat divisions of visitors and locals, to a more complex interplay of global networks and the “mobile nature of the whole touristic venture” (Nash 2005). This has been part of a controversy over the very nature of local authenticity focused on deterritorialization (Sheller and Urry 2004) regarding the development of new systems and discussion of basic changes in the nature of societies and institutions in the contemporary world. The study of tourism in sociology (Smith 1977;McCannell 1973; Pearce 1982) and anthropology (Graeburn 1989; Stronza 2001) has been characterized by their focus on descriptions of the tourist as a product of leisure, and accounts often focus on the roles, performances and positions of the actors as opposed to the negotiation or interaction between them (Cohen 1984). The flexibility of identity presents a potential problem as one can see medical tourism as a reform movement, or an extension of preexisting hegemonic business practices in neoliberalism (extended from Harvey 2005). Depending on whether, as Marc Edelman (2005) points out, the benefits are part of a projected false identity or “shell” which use a claim of popular support to gain false credibility. This conception of a false understanding, and negotiation of identity (of states and individuals) parallels the conception of “culturally intimate” knowledge as opposed to open public knowledge (Herzfeld 2005) and suggests one danger of the acceptance of cultural phenomena as natural in the contemporary setting.


 * Area Studies / South Asian Studies (Philippines, India, and Thailand)**

Largely defined by the site of work, Area Studies forms based on recognition that the cultural and social worlds in geographic regions share distinct histories and cultural familiarity benefits social scientific evaluation. In preparing for comparative study in South Asia I intend to develop some familiarity with the extensive literature on the culturally specific world of South Asia. While traditional Area Studies focuses more narrowly, the shared aspects of colonialism and development in the whole region offer a vital lense for comparison. I focus on literatures about the local conceptions of body, health, and medicine in this region, and the variation between nations.

Philippines

India

Thailand

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