1.
Pasquini, Mirko, 1991
(författare)
The Negotiation of Urgency: Economies of Attention in an Italian Emergency Room
2021
Doktorsavhandling (övrigt vetenskapligt/konstnärligt) abstract
Urgency in a hospital Emergency Room (ER) is not a self-evident state. Urgency is made, by establishing priorities, distributing attention and material resources, and deciding who and what needs to be attended to first – and, simultaneously, who and what has to wait. The process of determining urgency is known as “triage” (from the French verb, trier, “to choose”). This thesis is about the vicissitudes of triage in an Italian ER. Based on one year of ethnographic fieldwork, the thesis explores what happens when urgency is at stake; when it is contested and caught up between different, and frequently conflicting, perspectives. It explores how urgency is determined in practice, and shows how triage always is a vulnerable process of negotiation guided by economies of attention. How is urgency actually shaped in interactions between patients, their families and friends, and the ER staff? The different chapters explore how time in the ER is created through shifting registers of attention, and how attention in the ER is affected by widespread economic and social precarity, and neoliberal national policies of governance. It discusses how triage increasingly is structured by attitudes of mistrust; and also by potential or real outbreaks of violence. Addressing the particular positioning of the ER as a thick space of conjunction between neoliberal state politics and people's increasing need for care and recognition, the thesis aims to contribute to medical anthropology literature by analyzing triage not as a neutral medical way of sorting, but as a practice that actively creates difference. It explores both the limits of triage, and how those limits can spark improvisation and creative reinvention.
2.
Petersson, Jesper, 1974
(författare)
Geographies of eHealth: Studies of Healthcare at a Distance
2014
Doktorsavhandling (övrigt vetenskapligt/konstnärligt) abstract
This thesis examines the proliferation of healthcare services using information and communication technology to overcome spatial and temporal obstacles. These services are given such names as telemedicine and telecare, which are sometimes grouped together as telehealthcare under the umbrella term eHealth. My main argument is that a prevalent and overoptimistic rhetoric of how the possibilities of digitalization are expected to produce a homogenous and ubiquitous healthcare space conceals many of the spatiotemporal complexities involved in introducing telehealthcare and in the overall organizing of healthcare. To counteract such simplifications, I contend that we need a relational understanding of the technical and the geographical as always nested in the social and vice versa. With such an approach, it is arguably possible to begin to tease apart the many spatiotemporal entanglements of these innovations and to trace their political ramifications. This position is developed by integrating perspectives from science and technology studies with insights from human geography. The four constituent papers of this thesis pursue this argument in qualitatively grounded case studies of telehealthcare and its geographies. Paper I looks at various initiatives for fetal tele-ultrasonography, demonstrating that this practice cannot be reduced to a mere transparent relay for the speedy transmission of digital information across space and time. The paper investigates how its introduction could affect medical knowledge production, power hierarchies, and subject positions, for example, the status attributed to the fetal figure. Paper II traces Swedish transformations of telehealthcare. The use of telemedicine to reach those outside medicine’s range has arguably been accompanied by efforts to achieve intra-organizational streamlining via telemedicine. This process has continued with the emergence of telecare for personal use directed toward the overlapping groups of the elderly people and patients with chronic conditions. I contend that this shift can be understood through a geographical lens as attempts to save space and time by keeping as many patients as possible out of costly hospitalization and preventing them from engaging scarce specialist resources. Paper III compares four telemedicine projects in Sweden. In detailing how the purpose of practicing telemedicine differed between these projects in relation to, for example, the specifics of distance, care availability, and treated medical conditions, the paper demonstrates the existence of many versions of telemedicine. Whereas this fluidity could further the spread of telemedicine, it could also cause problems. To various actors wanting to use telemedicine in a homogenous and fixed way for national streamlining purposes, this diversity has generated confusion when they wished to align telemedicine in a preferred direction. The paper concludes that technology travels best when it can contain both fluid and fixed relationships. Paper IV argues that, whatever is claimed about creating a space- and time-independent healthcare by means of telehealthcare, the use of telecare to connect the standardized spaces of healthcare with the fluid everyday lives of elderly people and patients with chronic conditions actually works by unfolding new spaces of visibilities and establishing new temporalities as well. By investigating these spatiotemporalities, I demonstrate how these applications draw together discourses on individual freedom with medically derived algorithms and concerns about how to make best use of scarce healthcare resources.
3.
Lutz, Peter A.
(författare)
Tinkering Care Moves : Senior Home Care in Practice
2016
Doktorsavhandling (övrigt vetenskapligt/konstnärligt) abstract
This dissertation builds on the current anthropological studies of care relations in practice. It draws inspiration from science and technology studies (STS) and postfeminist technoscience. A qualitative ethnographic approach grounds the empirical data collection and analysis. This entails ethnographic fieldwork with senior home care in the United States and Sweden during 2007–2008 and 2011–2012. Analytical attention centers on how movements situate various tensions of senior home care in practice. Four interrelated published works comprise the main thematic chapters. Each article exemplifies how human and nonhuman relations move and mediate care. They develop several heuristic terms that advance ideas about how older people, aging bodies, technologies, spaces, and times that tinker each other through movements of care in practice. The comprehensive summary frames these articles with an overview of the primary thematic orientations and methodological concerns. A discussion of the main contributions and implications of the dissertation concludes the work.
4.
Holm, Marie-Louise
(författare)
Fleshing out the self : Reimagining intersexed and trans embodied lives through (auto)biographical accounts of the past
2017
Doktorsavhandling (övrigt vetenskapligt/konstnärligt) abstract
This thesis explores how current ways of imagining possibilities for intersexed and trans embodied lives within medical contexts might be informed by and reimagined through the historical lived experiences of intersexed and trans individuals as they have been articulated in autobiographical accounts.Postmodern, queer, intersex, and trans researchers and activists have criticised existing standards of intersex and trans healthcare for limiting the possibilities for diverse embodied lives by articulating certain forms of embodiment and selfhood as more likely to enable a liveable life than others. This has often been done in a medico-legal context by referring to experiences in the past of the unliveability of corporealities and gendersexed situations that differ from privileged positions. With a point of departure in these critiques, this thesis reopens questions about how intersexed and trans people may be embodied and have relations with others by reflecting upon the period of the first three-quarters of the 20th century, when the present standards of care and diagnostic categories were emerging, but had not yet become established.Drawing upon a unique set of historical source material from the archives of the Danish Ministry of Justice and the Medico-Legal Council, intersexed and trans persons’ life stories are rearticulated from their own and medico-legal experts’ accounts written in relation to applications for change of legal gendersex status and medical transition. In this way, the process is traced through which these life stories have been repeatedly rearticulated in order to become a usable basis for diagnosis and decision-making. At the same time, the stories are unfolded once more in a rearticulation focusing on their complexity and diversity.
