Paper short abstract

This paper explores how molecular markers of biological difference can ‘solidify’ and acquire new meaning when translated into administrative classifications that delineate access to costly precision technologies and pose challenges to solidary healthcare financing

Paper long abstract

Long celebrated as a scientific frontier, precision medicine now gives rise to complex negotiations of limit-setting in healthcare. This paper explores a particular aspect of these negotiations: the co-production of disease classification and economic concerns. Since the 1980s, molecular markers of disease have reconfigured diagnostic criteria, and generated novel markets for diagnostic assays and targeted therapies. Driven by future imaginaries (Fujimura 2003) of reduced overtreatment (and overspending), these precision technologies come, however, with high costs for already constrained healthcare systems. Drawing on collaborative ethnographic research on the introduction of precision medicine in Denmark since 2017, we trace negotiations about how to delineate the use of costly precision technologies across the fields of inherited eye disease, spinal muscular atrophy, lung- and blood cancer, and diabetes care. In particular, we attend to the interplay of clinical and administrative meaning-making in the delineation of treatment eligible populations and the issues of in- and exclusion it raises in a publicly funded healthcare system founded on principles of universalism and equal access. Drawing upon classical STS-debates on boundary-work (Gieryn 1983, 2007) and the reification of facts (Latour & Woolgar 1979), we demonstrate how cell counts, genetic tests, and cut-off points, used as fluid markers in laboratory and clinical settings, tend to ‘harden’ when translated into administrative classifications. In this process of ‘solidification’, molecular markers acquire new meaning as they come to demarcate limits to publicly funded healthcare and pose challenges to solidarity.

Boundary-work; Denmark; Healthcare; Limit-setting; Precision medicine; Rationing; Solidarity; Solidification

Paper short abstract

This proposal seeks to explore how the limits between health practices and political practices are being (re)made in local Prevention and Promotion of Health agencies in Madrid, giving careful consideration to the specific biopolitical rationality that these practices enact in everyday life.

Paper long abstract

This ethnographic research has been conducted in Madrid Salud, a local community-oriented health agency located in Madrid, Spain. This public agency drives prevention and promotion of health systems, seeking to reduce health inequalities within and between city districts. In Madrid Salud, health and social professionals work in collaboration with a complex set of entities: vaccines, district municipal boards, frindisk tests, and others, trespassing and redefining what it means to be a patient and a healthcare professional. This collaboration between human and non-human entities generates particular and intricate definitions of health and healthcare that are supported, negotiated, and resisted by regional and state health agencies and other community-oriented organizations in the city.

The goal of this research is to shed some light on the multiple ways that these practices shape new ways of understanding medical and health practices and to explore the opportunities and limitations of community-oriented health agencies in societies that are trying to deal with the presence of chronic illnesses, by bringing forward the intersections between bodies and political decisions and re-imagining the limits between health and disease in livable futures.

This research has been conducted as part of the Spanish National Research Agency I+D+I project CIMES (Cartographies, Itineraries and Mechanisms of Health Exclusion and Expulsion).

Keywords: Community-oriented health, Prevention and Promotion of health, Care practices.

Paper short abstract

This paper examines how local care actors in two Dutch neighborhoods learn to navigate tensions between institutional and community logics. Drawing on action research, it shows how relational learning processes help sustain and reshape neighborhood care infrastructures.

Paper long abstract

In high-income countries such as the Netherlands, health systems rooted in biomedical models are increasingly reaching their limits as they struggle to address broader social determinants shaping population well-being. At the neighborhood level, local actors with both formal and informal care roles often address these social determinants while navigating tensions with institutions organized around different logics of care and accountability. In doing so, they are continuously learning from and adapting to the local context, their collective practices both sustaining and transforming local care infrastructures. Drawing on action research conducted in two Dutch neighborhoods, including ethnographic methods, interviews, and living labs, this paper examines these continuous learning processes.

Specifically, the study shows how local care actors enact learning processes to navigate tensions between institutional and community logics surrounding roles, time, and space. We show that tensions are experienced between formal mandates and context-responsive, often unpaid roles; between institutional time structured by budgets, timelines and accountability frameworks and the relational rhythms of care; and between administrative boundaries of what a neighborhood is and the fluid understandings of community. In response, actors identify, balance and question these tensions, coordinate across them through dialogue and translation practices, reflect individually and collectively to make implicit assumptions explicit, and at times actively transform relationships, roles, and care practices. These learning processes are relational and occur both during planned learning activities and everyday interactions. Their capacity to influence local care infrastructures depends on the forms of legitimacy that actors can mobilize within both formal and informal contexts.

Paper short abstract

Aggressive behavior forms a limit condition within institutional care arrangements. I analyze the “escalating situation” as a temporal device transforming care practices by enacting specific relations between past, present and future.

Paper long abstract

Aggressive behavior and physical violence form a limit condition for staff in health and welfare services, transgressing institutional mandates and professional skill sets. At the same time, it can index ways in which institutional care provision is limited and limiting. In this contribution I draw on ethnographic engagement with de-escalation trainings and practices in German health and welfare services. A professional approach to instances of aggression, these efforts center the “escalating situation” as an object of caring and securitizing intervention. My contribution examines how the escalating situation becomes productive as a frame, and more specifically, a temporal device. Working with escalating situations, I show, sets them apart as a circumscribed space of intervention, while also crafting connections between past, present and future care practices. As a scenario, the escalating situation enables temporal logics of security, which can work to change care practices in the now in anticipation of a potential future risk. But care practioners also create epistemic links between escalating situations, to open them up as experimental space and learn from past situations for future situations. Working as container device, meanwhile, the escalating situation can enact temporal logics of crisis, setting an urgent now apart from the routine everyday life and institutional constraints within which it emerges. By examining these temporal dynamics, I show the various ways in which escalating situations come to be limiting to care, a frontier of care practices, or a limit of care.

Paper short abstract

Based on interviews with patients and doctors in Germany, we examine how lifestyle devices reshape medical authority through patient-generated data (PGD). We demonstrate how caring for epistemic limits unfolds across conflicting temporalities of continuous monitoring and temporary consultations.

Paper long abstract

Lifestyle devices and health apps have introduced new forms of patient-generated data (PGD) into medical consultations. Drawing on 35 interviews with patients and physicians in Germany, we explore how medical authority is negotiated when such data circulate between continuous personal self-tracking and temporary professional care. PGD create specific temporal tensions: continuous monitoring produces a sense of immediacy and anticipation for patients, while physicians rely on episodic consultations and validated timeframes of diagnosis. From a medical perspective, lifestyle devices and health apps produce masses of messy data that cannot be accounted for in the limited timeframes of consultations. These polychronic temporal regimes shape how limits are recognised and cared for, what counts as relevant evidence, whose time matters, and when knowledge becomes actionable. Patients experience illness by learning to “listen” to their bodies through devices yet emphasise the need for professional interpretation; doctors value engagement but question reliability based on their expertise, often reframing PGD as supplementary rather than authoritative. Caring for limits thus becomes a joint practice: maintaining trust by acknowledging experience without dissolving boundaries of expertise. We argue that continuous digital self-tracking does not erode medical authority but reconfigures it temporally – through rhythms of measurement, waiting, validation and response that sustain the fragile balance between empowerment and dependence in everyday healthcare.

Paper short abstract

Drawing upon ethnographic research, this presentation explores the various limits encountered in the making of the artificial placenta; and how these limits enable the enactments of futures rooted in the specific everyday work of biotechnological development.

Paper long abstract

The artificial placenta, one of the technologies that falls within the ambit of the Artificial Amniotic Sac and Placenta Technologies, is currently under pre-clinical development. Through an enforced continuation of the physiological foetal state, these technologies seek to increase the chances of survival for extremely premature babies. Driven by a range of disciplinary expertise, including different kinds of engineering, biomedicine, as well as caregiver involvement, this work regularly encounters techno-biological, organizational, as well as epistemic limits. This includes limits around working with/against non-Newtonian natured blood, constrained project timelines, and disciplinary differences between collaborators. The enactments of these limits, moreover, are contingent upon the diverse spatio-temporal realities that the work of biotechnological development is located within.

Drawing upon ethnographic research done with a group of European scientists working on developing the artificial placenta, I will present findings that point to the negotiations, contestations, and coordination around these limits, which emerge in the course of this work. I will bring forth the role played by tools, objects, and entities that enable the materialization and navigation of certain limits. At the same time, I will explore how, faced with these limits, distinct epistemic realities perform temporality in different ways. In so doing, I will highlight how the limits of developing an artificial placenta enable the enactments of futures rooted in quite specific presents, which in turn draw upon past ideas of futurity by reaching into both science fiction and biotechnological worlds.

Keywords: Artificial placenta, techno-biological limits, epistemic realities, pasts-presents-futures

Paper short abstract

Better diagnosis and treatment have lengthened the lives of people with rare diseases, who are now experiencing the transition from pediatric to adult care. This paper attends to transition as a boundary object and asks who and what cares for this frontier, which is in constant flux.

Paper long abstract

In recent years, transition has become a buzzword in the rare disease community. Better and faster diagnosis and the development of treatment modalities have prolonged the lives of many people with rare diseases, conditions that affect 1 in less than 2000 individuals in Europe. Yet, commonly understood in biomedicine as the transition from pediatric to adult care and often demarcated by the legal age of 18, transition is neither stable nor well entrenched in healthcare systems in many countries.

This paper draws from ethnographic interviews with different stakeholders and a preliminary survey on transition experiences of adults with rare metabolic disorders and their caregivers in Poland. Engaging with the concept of “boundary objects” (Star and Griesemer 1989; Bowker and Star 2010) and care studies in STS (Lindén and Lydahl 2021; Mol and Hardon 2021), I attend to transition as a boundary object and a frontier, which is in constant flux. The mere possibility of transition for these patients highlights their extended life span. Nonetheless, in countries such as Poland, transition also reveals care limits in rare genetic diseases. Patients and caregivers feel abandoned by the healthcare system, standards and guidelines are lacking, not to mention ethical and legal entanglements, which affect people with rare diseases and intellectual disabilities. I ask who and what facilitates or inhibits care in transition and how transition, as a new time-space frontier in rare diseases, emerges as a boundary object.

Paper short abstract

This paper explores the temporal work of trauma in making certain pasts, presents and futures possible. Drawing on interviews from a study of trauma and drug use, I identify the binary logics on which the trauma concept relies, arguing that it installs limits on experience and subjectivity.

Paper long abstract

Recent decades have seen a turn to ‘trauma-informed’ approaches in healthcare. In this presentation, I apply insights from feminist research and STS to consider the temporal performativity of trauma in making certain pasts, presents and futures possible. Drawing on interviews from an Australian study of trauma and drug use, I argue that trauma renders suffering and distress legible within a socio-medical frame. As our participants accounts show, it offers a heuristic for designating frontiers, e.g. between the everyday and the exceptional, normality and pathology, memory and amnesia, and present and past. In this sense, trauma functions as a powerful conceptual frame that installs temporal and ontological limits on experience and subjectivity. These limits constitute trauma as a transformative event: an exceptional rupture of ordinary experience. However, as Lauren Berlant argues, even the worst events which may attract the label ‘trauma’ are in fact ‘embedded in life’ and ‘twist continuity rather than shattering it’ (2018: 117). In tracing the temporal regimes of trauma and the limits they enact, I illuminate the founding assumptions and binary logics on which the trauma concept relies, and reflect on its effects in healthcare. I suggest that while trauma-informed therapies are a welcome move in acknowledging the social context of suffering, they do not sidestep the pathologising effects of locating dysfunction in the individual, and thus may serve neoliberal therapeutic agendas. In making this argument, I consider the sociopolitical implications of the turn to trauma, including its possibilities and limits for addressing structural violence and suffering.

Paper short abstract

Dementia care forms a site of relational tensions between stakeholders, due to differences in values, beliefs, needs and tempo's. This paper unpacks temporal tensions, discusses how stakeholders navigate tensions through relational attunement, and examines where attunement reaches its limits.

Paper long abstract

Dementia care at home involves close collaboration between people living with dementia, informal caregivers, and health and social care professionals. Such ‘care triads’ form sites of relational tensions, due to differences in participants’ values, beliefs, needs and tempo’s. Drawing on two empirical studies (Yaron et al., 2024; the ongoing CONTACT study), this paper focuses on temporal tensions as an understudied dimension of dementia care. In addition, it explores how triad participants navigate all four tensions through relational attunement—and where attunement reaches its limits.

Temporal tensions in care triads amount to three asymmetries. The first is caused by differences between the person with dementia’s past and present self (previous versus new preferences and roles). The second asymmetry originates in variations in triad participants’ subjective temporal horizon (e.g. accepting the diagnosis, adjusting to changes). The third asymmetry is tied up with distinct temporalities of the care system (rosters, allocated hours) versus the lifeworld (organic rhythms of everyday life).

Triad participants use various strategies to navigate relational tensions. Their efforts to attune can be seen as a type of affective labor that ultimately aims to retain voluntary connection amid difference and dependency. Such relational attunement is an inherently temporal phenomenon: it takes time and unfolds over time. Yet attunement has limits. Triad participants may find themselves unable or unwilling to attune—through exhaustion, severe distress, or when facing unsafe situations. We discuss what attending to these limits means for how we understand the conditions under which good care in dementia triads remains possible.

Paper short abstract

In Western countries, demographic ageing is seen as pushing social protection systems to their limits. This paper focuses on how the boundaries between a phenomenon (demographic ageing) and its consequences (costs) are blurred, leading to the representation of population ageing as a limit.

Paper long abstract

In Western countries, demographic ageing is seen as pushing social protection and health systems to their limits. Rather than examining the contours of these limits, for example in terms of pension funding or healthcare needs in the next decades, this paper focuses on how the boundaries between a phenomenon (demographic ageing) and its consequences (health needs, housing needs, pension funding, etc.) are blurred by political, scientific, economic and media narratives, leading to the representation of population ageing as a limit.

We will examine four types of rationales at work in these narratives:

- Escaping the limit (debate on the “right to die” and assisted dying)

- Pushing back the limit (policies promoting “ageing at home” and supporting “autonomous” ageing)

- Blowing up the limit (anti-ageing medicine, rejuvenation research)

- Reversing the limit (techno-solutionism, the limit as a technological and economic opportunity).

We will then examine a fifth rationale, which would be that of avowing and caring for the limit, in dialogue with the call by Dominguez Rubio et al. (2025, p.7) for "a radical avowal of fragility".

Paper short abstract

Chemsex users in their efforts to access healthcare negotiate the definition of health with healthcare personnel, highlighting a controversy: how to understand health in practices involving the sexualised use of drugs, where boundaries define the concept itself

Paper long abstract

Healthcare for chemsex users is structured around different boundaries and limits that arise from the relationships that develop between objects, chemsex users, healthcare personnel, and public institutions. Formally, there is an epistemic differentiation between chemsex users and healthcare personnel. However, based on research involving the tracking of objects and personal interviews, these formal boundaries lose their rigidity and we find hybrid entities, such as healthcare personnel who practise chemsex and use healthcare services.

These boundaries become more apparent when we consider how stigma manifests itself in the lives of chemsex users in a healthcare system weakened by the neoliberal offensive of recent decades. PrEP and antiretroviral treatment are presented as guarantors of the health of chemsex users because of the benefits they obtain by adhering to them. This formal equality, which is based on the affirmation of health as a universal right, is called into question when migrants try to access these treatments without a health card. They are faced with expensive bills and healthcare that is far from this universal formulation of health as a right.

This research seeks to unravel how these boundaries and limits are reified or contradicted by following objects such as mephedrone, PrEP, or antiretroviral treatments. In addition, we must recognise the intimate entanglements that enable the agency of pivotal health professionals, who are health workers committed to care of the communities that are excluded form healthcare system, and chemsex users and their capacity to produce scientific knowledge in an impure way with health workers.

Paper short abstract

How is a form of ‘hospital consciousness’ being imagined and integrated into the Spanish public hospital through antimicrobial optimisation programmes? At the edge of intervention, where the limits of antimicrobial treatments are witnessed, collectivity offers professionals a shared medical project.

Paper long abstract

With the development of antimicrobial resistance (AMR) continuing to unsettle the foundations of medicine, antibiotic treatments may not fully respond, limiting the outcomes of otherwise routine hospital medicine. Healthcare professionals must find ways to adapt. They are not only innovating in drug treatment regimes and diagnostic processes. They are also actively rethinking how responsibility and hospital care are collectively understood. In this paper I argue that a form of ‘hospital consciousness’ is being imagined and integrated into the Spanish public hospital. At the edge of intervention, where the limits of antimicrobial governance are felt and witnessed, professionals experiment with doing the hospital otherwise. Based on a multi-sited ethnography, the story follows the everyday practices of interdisciplinary teams running Spain’s medical programmes dedicated to optimising antimicrobial drug treatments in public healthcare. I show how the Programas para la Optimización del Uso de Antimicrobianos (shortened to ‘PROA’) are less a technical solution to AMR, and more a social infrastructure through which clinicians, microbiologists, and pharmacists, among others, see themselves as belonging to a shared moral economy and a common epistemic project. Through an exploration of the affects and politics involved in building PROA interventions, and the historical dimensions of antimicrobial governance, this work problematises the hospital’s collective character. The case of PROA interventions demonstrates how collective work on a collective problem unfolds in a medical system otherwise organised around the individual—the individual patient, doctor, medical specialty, room, ward—; in turn producing crucial forms of professional belonging, ethical deliberation, and affective commitments.

Paper short abstract

This paper examines how communities living near cement plants in Pakistan experience health impacts from long-term dust exposure. Using ethnographic research and expert triangulation, it explores the limits of environmental governance and care.

Paper long abstract

Industrial development is frequently framed as a pathway to economic growth and resilient futures. Yet for communities living near heavy industry, resilience often reveals the limits of environmental care and health protection. This paper draws on a comparative ethnographic study conducted in six communities near cement plants across three provinces of Pakistan. Through in-depth interviews, community workshops, and expert consultations, it examines how residents experience and interpret the health consequences of prolonged exposure to industrial dust emissions. Participants described respiratory illnesses, persistent dust accumulation inside homes, contamination of water sources, and declining agricultural productivity. These accounts were triangulated with expert assessments and available monitoring data to explore how pollution risks are recognized, measured, and governed. The analysis reveals tensions between lived experience and formal regulatory systems, particularly in air quality monitoring, complaint mechanisms, and enforcement practices. Concerns about unequal employment access and limited institutional responsiveness further expose the uneven distribution of industrial benefits and burdens. By foregrounding everyday experiences of exposure, the paper argues that prevailing models of industrial resilience obscure structural inequalities and the practical limits of regulatory care. It calls for environmental accountability frameworks that integrate community knowledge and prioritize health equity within industrial governance.

Paper short abstract

This presentation explores how limitations to care and well-being result from the gradual deterioration of urban infrastructure. Drawing from ethnographic research in Chile, it demonstrates how families work to maintain care and create sustainable, livable moments despite declining urban conditions.

Paper long abstract

Urban environments increasingly shape the conditions that enable care and health. In cities struggling with infrastructural inequality, environmental neglect, and fragmented public services, caring practices often operate on the margins of what urban life permits. But these limits are not only spatial or institutional—they are also temporal. Urban infrastructure ages, deteriorates, and falls into disrepair; public spaces become unsafe or unusable; and systems that once circulated care gradually lose their capacity to support daily life.

Based on ethnographic research with children and caregivers in Chilean cities, we examine how limits to urban well-being develop through the temporal dynamics of urban environments. Using walking interviews, workshops, and creative activities with children, the research shows how deteriorating infrastructure, unsafe public spaces, pollution, and overcrowded transportation create low-level stress and strain that shape children’s everyday emotional experiences.

Instead of viewing these conditions merely as failures of care, the analysis explores how families and communities develop localized practices to live with and around these limits. I describe these delicate arrangements as greenhouses of care: small, carefully maintained spaces—material, relational, and temporal—where care can temporarily flourish despite hostile surroundings. These spaces do not eliminate urban limits; instead, they slow the deterioration of livable environments and sustain existing ways of life as uncertain futures unfold.

By highlighting the temporal boundaries of infrastructures and care practices, the paper contributes to STS debates on health, care, and temporality. It suggests that caring for limits may involve maintaining livable moments within gradually declining urban environments.