Paper long abstract:

Since the end of the 1990s the WHO and the EU have proposed active ageing as the solution to the challenge of ageing populations. Active ageing rearticulates the possibilities of old age, by positioning the ageing process as malleable and proposing longer work lives and healthier lifestyles as key for an economically sustainable organisation of society.

As I have argued together with Tiago Moreira, active ageing is a multiple knowledge-driven policy that attempts to unmake old age through an operationalisation of a variety of forms and standards based on different epistemes (Lassen & Moreira 2014, http://dx.doi.org/10.1016/j.jaging.2014.03.004).

In this paper I elaborate on the 'investments in form' (Thevenot 1984) of active ageing policies. Models such as population pyramids and dependency ratios are epistemic forms that the EU active ageing policies invest in. I argue that the investments in epistemic forms are supplemented with investments in problems of everyday practises, such as dependence and passivity. As such, I propose everyday practices to be a co-constituent of knowledge-driven policies and demonstrate how epistemic forms, everyday practices and governing are entangled. This paper demonstrates the way this entanglement produce specific ideals of the good late life in active ageing policies.

Paper long abstract:

Over the past couple of decades several countries have issued guidelines for the use of palliative sedation in end of live care. The logic of the guidelines can be summarised in five points. 1) Palliative sedation shall only be used as a last resort, in cases with short expected lifetime and intractable suffering that cannot be relieved in any other way. 2) This requires access to medical and psychological expertise in multiple areas, which among others evaluates the patient's psychological condition and competence to consent. 3) The proportionality principle applies. To ask of a physician to collaborate in the long term or permanent reduction of a patient's consciousness, and therewith life experience, is of such significance that this can only be requested in cases where the patient's suffering is of equal magnitude. 4) Nothing the physician does or does not do shall shorten the patient's life. 5) Everything has to be done to ensure that, in the end, the underlying incurable disease is the cause of death.

Authored by dedicated task forces or standing medical ethical committees, authorized by the respective boards of professional medical associations, and supported of health authorities, the proclaimed value objective of the guidelines is to protect the patient's autonomy - the prime Medical Ethical Principle - and life experience in the face of death. The guidelines are epistemic hybrids, amalgams associating different modes of knowing true from false, right from wrong and legal from illegal.

Paper long abstract:

The rationale which permeates the political field of governing health in Denmark is that evidence based policies are considered the means to improve public health.

'Health Promotion Package against Overweight' is a new policy guideline from the Danish Health and Medicine Authority, which aims to advice Danish municipalities in preventing overweight. This 'package' is topical in municipalities' current work and especially interesting as it is not evidence based despite the political focus on evidence. I investigate how this politically promoted overweight prevention guideline is negotiated and practiced. Which role do (lack of) 'evidence' play? How is this influential in the unfolding of the guideline in practice?

Articulated a 'package', the guideline is framed as an enriching object that is transferred directly between a sender and receiver. Contrarily, considering the guideline as an actor, the guideline gets agency, interact with and is translated in relation with actors at different levels (state, regional, municipal and citizen). Taking an explorative approach, I travel with the policy by combining retrospective insights in the conduction of the policy with a practice-based analysis of the actual unfolding. Preliminary findings suggest that 'lack of evidence' is not essential for the municipal decision makers, indicating a mere negligible role of evidence in the play of governance. Furthermore, the guideline is not only enacted to a different degree among the municipalities, but also translated in different ways according to the context it unfolds in; ranging from a legitimizing tool used with a persuasive aim to pure normative prescriptions.

Paper long abstract:

Coherent knowledge is a prerequisite for evidence-based policy-making. A substantial part of policy processes can therefore be devoted to collecting and synthesizing knowledge claims. Experts who are recruited to fulfil this task frequently represent different knowledge paradigms. Studies demonstrate that such situations can lead to futile discussions among experts concerning what is the general "truth". It has therefore been argued that experts involved in policy processes should be pragmatic and willing to compromise in order to find temporary "workable truths". This paper continues this discussion.

The paper is based on an ethnographic study of the Weight Project, a policy project run in a Swedish county council. The aim was to produce a knowledge-based action plan for reducing the population's overweight. A variety of experts were recruited and tasked with synthesizing knowledge on prevention and treatment of overweight. The paper investigates, analyses and elaborates on why the experts failed this task. It is argued that a key explanation is that although the experts represented different epistemological (and ontological) knowledge paradigms, they were quite willing to listen to other experts critique of their knowledge claims. The effect was that the experts as a group gradually came to question the validity for the Weight Project of almost all potentially relevant knowledge, including evidence-based guidelines produced by well established institutes.

Paper long abstract:

Considering their ubiquity in almost all fields of welfare policy, guidelines seem to play a vital role in the efforts to govern practitioners in the frontline of the welfare state through the supply of scientific knowledge. This paper interrogates the seemingly successful guideline genre. The argument builds on an ethnographical study of the production of a science-based governmental guideline aiming at governing teachers in Norwegian schools towards more efficient prevention of alcohol and drugs related problems. As the authorship progressed, an ongoing shrinking pattern emerged in terms of textual volume, imperative language and scientific content. For each new draft the document became less of the governing tool as it was commissioned. Yet, for reasons other than its science-shipping and governing capacities, the guideline was finalized and published after more than four years of production. This paper suggests that explanations to the Guideline's successful genesis must be sought beyond the part it is set to play within the field of prevention of alcohol and drugs related problems. The disarming shrinking pattern was also a productive transformation that afforded for the guideline's casting in the staged play of governance. Notwithstanding its lenient script and unostentatious launching, it became a policy document reinforcing a hierarchy of expertise conducive to its own genesis. It was a governing tool protected by and simultaneously protecting the envelope of science-based practice as a recursive, self-reproducing structure.

Paper long abstract:

The panacea in governing social work these days seems to be technologies such as case management systems (CMS). They are used to introduce governmental guidelines in social workers' practice. Besides being considered a way to higher efficiency CMS's are also believed to provide better assessments of the clients, heightening accountability and provide better performance - and management information. All of which impose registration tasks on the case worker. The use of the management or performance information has drawn little attention (Moynihan 2008) and a more or less ignored issue is the actual production of it. Even though scholars have discussed measuring problems the details of the actual collecting and working up data have largely been ignored. This paper focus on production of management information in relation to introduction of governmental guidelines.

The RQ is: How do case work registrations become management information?

The study is designed as a cross time study in the disability offices in 11 Danish municipalities. Interviews were conducted with caseworkers, administrative staff and managers in each municipality. Drawing on the concept oligoptikon (Latour 2005) and the perception of the information structures (Star 1999) the analysis addresses the discrepancy of perception of reliability of the management information between the administrative staff, who is producing it, and the managers using it. The administrative staff points to uncertainties in regards to the reports, since the calculations are 'handmade', whereas the managers have high confidence in their management information and don't mind making decision on grounds of them.

Paper long abstract:

The paper addresses contemporary reform in postgraduate medical residency training that aims to standardize residency training practice. The reform is guided by public policy interventions to increase quality of care, objectify residents' performances, and to prepare residents for changing health care needs. The reform takes in a shift from traditional apprenticeship-based training models of "learning-by-doing" and role modeling, to formalized training programs based on the educational insights of competency-based training and standardized performance assessment. In the paper we perceive medical education as a new epistemic culture alongside the traditional professional authority-based system of training residents. Drawing on ethnographic research on residency training in the Netherlands, the paper examines how medical educational knowledge has been incorporated in medical training programs and how this has affected the training of residents.

The paper elucidates how medical education has manifested itself in medical training practice by bringing in new ways of evaluating and teaching residents. The paper shows how attending physicians enact a kind of epistemic pragmatism by embracing the newly offered instruments to objectify resident evaluation on the one hand, and re-linking them with clinical work on the other. As such, contemporary reforms have enlarged the teaching repertoires of clinical teachers.

Paper long abstract:

This paper is part of a research project investigating whether, where and how more integrated forms of assessment of emerging science and technology could make a positive difference in European decision-making. The paper presents an in-depth case study focusing on the process of knowledge use by the European Commission's (EC) DG Connect in its production of a cloud computing strategy. The case study describes the development of an international field of assessments and how this field was drawn upon and influenced by the EC strategy formulation process. The paper critically discusses this process based on assumptions from the literature on integrated forms of assessment and with a view to the quality criteria for knowledge use set out in the EC's internal guidelines. On the basis of this discussion, the paper attempts to identify specific needs for more integrated assessment forms in the EC's processes of knowledge use.

Paper long abstract:

Quasi-governmental guidelines have gained functional importance for the regulation of nanotechnology. Regulators face the problem that, currently, generalizable scientific statements describing the handling of nanoparticles for the safety of employees, consumers and the environment are not possible. Laws regulating the production and consumption of nanoparticles would need to be based on the precautionary principle. Then, on a broad scale, regulatory measurements would need to intervene in economy and science implying profound consequences for investments and growth. In contrast, quasi-governmental guidelines offer an alternative allowing more flexible and less intruding rules.

In the societal nano-debate, commissions having issued guidelines share the commonality to be oriented towards participation. Depending on the policy-level, some or all relevant actors join a dialogue on the handling of nanoparticles. In interviews actors claim that the status of knowledge constructed in these commissions is comparable to scientific knowledge and consequently is eligible to inform regulations. Being based on the perspectives of actors from science, economy, politics and civil society, the knowledge of the commissions is seen as the best available one. A comparison of three commissions (German NanoKommission, ISO-Committee and OECD-Working-Party) reveals several reasons for the influential status of the commissions' guidelines and their knowledge: e.g. the reputation of a guideline through repetition in various situations, the relation of the guidelines to existing law, the commissions' institutional authority, the societal context etc. The analysis shows that the epistemic validity of the commissions' knowledge is strongly interweaved with social mechanisms which are set within the play of governance.

Paper long abstract:

In its 2012 proposal for a General Data Protection Regulation (confirmed in the European Parliament and Council Proposals), the European Commission introduced the obligation for data controllers to perform so-called data protection impact assessments. These in turn, introduce the novel notion of "risk to a right": they should be triggered where "processing operations present specific risks to the rights and freedoms of data subjects".

This paper reflects critically upon the "risk to a right" notion. Granted that they belong within different spheres of knowledge, what kind of relation is instituted? The contribution explores different possible relations (risks or rights, rights as risks, risks within rights), and on this basis, speculates on possible meaning(s) of a risk to a right; keeping in mind that merging the two concepts entails that their respective initial meaning are changed into something that could hardly be predicted in advance. In devising such possible meaning(s), lessons could be learnt from the field of environmental governance, which has now long dealt with the governance of new and emerging technologies. Specifically, it could provide insights to the following questions. What kind of knowledge should be mobilised, who can be involved, and according to which methodologies and principles? The shape and outcome of impact assessments will differ depending on who is allowed to define and answer such questions, which in turn will determine whether the introduction of this methodology in its current form might itself pose a risk to the rights of privacy and data protection.

Paper long abstract:

Non- and misuses of professional bibliometric indicators has become a matter of concern for scientometrics in recent times, with the growing perceptions of widespread uses of alternative, ready-to-hand products in formal research evaluation contexts and academic life more generally (Buela-Casel & Zich, 2012, Derrick & Gillespie, 2013). As well as a growing source of competition, some in the community see the widespread presence of 'amateur' bibliometrics as a threat to the credibility of quantitative performance measures per se (Wouters et al, 2014). To date one key mediating strategy of professional scientometricians has been articulating standards for using advanced bibliometrics in research evaluation, through producing and circulating initiatives like best practice guidelines. This paper is about problems in 'implementing' such standards (Zuiderent-Jerak, 2007). Specifically we follow ongoing struggles to transport standards from 'knowledge infrastructures' into 'evaluation infrastructures' (Wouters, 2014) in Dutch University Medical Centers (UMCs).

First we draw on fieldwork carried-out among six research groups in UMCs and two evaluation panels charged with formally evaluating the performance of a single UMC, along with interviews with UMC administrators. We report on key moments of 'data friction' and 'infrastructural inversion' (Edwards, 2010) vis-à-vis situating professional standards and measures. Through document analysis we then argue 'distancing work' inscribed in scientometic 'meta-data' (ibid) are generally inhibiting successful extensions of professional knowledge infrastructures into evaluation practices. We conclude that shifts towards 'located' (Suchman, 2002) and 'situated' (Engel & Zeiss, 2013) accountability practices would constitute a more promising strategy for 'implementing' standards within the research evaluation contexts.

Paper long abstract:

If a child is related to a criminal case, he/she might be interviewed as a witness in court. Different actors relate to this interview in various ways, at different times and places. It may even shape the outcome of a court case. Interviewing child witnesses and documenting these interviews, however, are processes that seem to be standardized only at the first sight. A closer look reveals the epistemic claims and some creativity involved documenting interviews with child witnesses.

In order to present these epistemic claims, this paper investigates the process of documenting the interview, particularly the transformation of spoken into written words. The paper presents how the documented interview serves organizational requirements, that it addresses a selected audience and is written in a specific form. In the documentation of the interview certain elements of the child's reality were singularized, generalized and mobilized. When the orally conducted interview becomes a written document, a lot of this transformative work is no longer visible. Then, the newly enacted document renders statements of the interview as facts.

Documenting child witnesses not only enacts knowledge about the specific court case. Instead, in the process of blackboxing the process of documenting, various claims are attached to the document, among them an objectivity of the statements and care for children.

This paper draws from interviews conducted with judges, attorneys and a psychologist, which provide a Statement Validity Assessment report after a child was interviewed.