Paper long abstract:

'Solidarity' is widely considered a founding principles for collective arrangements for the delivery of medical care in Europe. Yet the centrality of solidarity is often of a rhetorical nature, used to defend arguments in favor of and against both increased privatization and managerial approaches to health care, and the emergence of personalized medicine. Very few analysts seriously address the question what 'solidarity' means in practice; how it is situated in infrastructures and practices for health care delivery and gets configured through the distribution of concrete medical interventions.

In this paper, I link questions of 'solidarity in practice' to the conceptual framework of bio-constitutionalism. This framework seeks to understand the joint configuration of understandings of what life is and prescriptions for how to live it - individually and collectively. In the particular context of European health care delivery, it opens avenues for seeing how situated notions of solidarity, institutional mechanisms for health care delivery and genetic diagnostic categories in medicine are jointly defined. 'Solidarities', then, are culturally pre- and reconfigured practices that shape how the delivery of medical innovations ought to contribute to the collective good.

I develop this argument through a comparative study of the distribution of genetic technologies in three European countries. With specific examples, I argue that different applications and understandings of genetics in medicine as well as different institutional mechanisms for delivery of care co-produce distinct formations of solidarity in the Germany, the Netherlands, and the United Kingdom.