Paper short abstract:

Bariatric professionals direct patients to morally recuperate through “moral laboratories,” which invite moments of experimentation with moral change in everyday life. This moral project is understood through new relationships within various registers of patients’ subjectivity.

Paper long abstract:

While overweight bodies have been radically medicalized in modern Western discourse, they are also culturally conceived as a moral project. In clinical settings aimed at transforming the impaired body, the encounters between bariatric professionals and patients reveal nuanced moral deliberations. I suggest that bariatric surgery becomes a site of a “moral breakdown,” where professionals direct patients to morally recuperate not only through technologies of the self, such as intensive bodywork and diets, but through “moral laboratories,” which invite moments of experimentation with moral change in everyday life. Drawing on ethnographic inquiry in a bariatric clinic that deploys a multidisciplinary treatment, I argue that this moral project is understood through new relationships within various registers of patients’ subjectivity. First, patients are instructed to “listen to their bodies” and to reconnect to their embodied sensations. They are further guided to cognitively imitate an effortless “thin state of mind.” And finally, they are instructed to “put themselves first” by reorganize their interactions with significant others. Professional guidance encourages dialogue and reflexivity within the patient that are consonant with neoliberal understandings of the self-disciplined subject, yet they expand, and at times undermine these neoliberal notions by attending to other body ethics, and contesting elements of fat stigma.

Paper short abstract:

The aim with this paper is to analyze how medical knowledge production can be challenged by people in social media movements. I examine testimonies of Swedish health care encounters, shared by patients on social media, using the method of digital ethnography and the concept epistemic injustice.

Paper long abstract:

The aim with this paper is to analyze how medical knowledge production in the context of Swedish health care encounters can be challenged by people participating in social media movements. The data consists of observations on the social media platform Instagram, focused on a number of Swedish so called hashtags #. Through the method of digital ethnography and framework of networked sociality, I examine testimonies of health care encounters, shared from a patient perspective via these hashtags. Two examples are #alltserfintut (“everything looks fine”) in the context of postpartum injuries, and #minabiverkningar (“my side effects” of hormonal contraceptives). Through these #, Swedish women share experiences of their testimonies of pain and complications not being taken seriously by health care practitioners and a lack of knowledge about their conditions.

From an ethnological perspective, health care encounters can be understood as cultural processes, in which medical assessments are affected by social and cultural perceptions of what is “biologically natural”; by which bodies are norm within medical practice and research; and by normative views of pain among different groups. In the analysis I use an intersectional perspective, and the concept of epistemic injustice – how some patients’ testimonies are deemed more credible than others’ due to prejudices, and some conditions, bodies and experiences are more researched and better understood. With these analytical tools I analyze accounts of health care encounters shared on social media, and how their content, along with the community formed by shared experiences, can challenge epistemic injustice within health care.

Paper short abstract:

Since the 1970s, pharmaceuticals based on immunosuppression have been produced, distributed, and consumed worldwide. By focusing on the reception of immunosuppressants in Brazil, I discuss how multiple actors in a Global South setting have problematized their contemporary as self-evident.

Paper long abstract:

Since the 1970s, pharmaceuticals based on immunosuppression and made in the Global North have been produced, distributed, and consumed worldwide. As such, immunosuppressants have become the hegemonic biomedical model to treat autoimmunity. Comprising drugs as diverse as cyclosporine, monoclonal antibodies, and corticosteroids, they are used to palliatively treat conditions like arthritis and lupus, which are considered incurable and consequently categorised as chronic. Through an anthropological analysis of the reception of immunosuppressants in Brazil, I seek to understand in this paper how multiple actors in a Global South setting have problematized the contemporary use of immunosuppressants as self-evident.

Enthusiastically adopted and widely prescribed in Brazil, immunosuppressants tend to be formally approved by local medico-legal authorities without constraint. Found at every pharmacy in the country, even chronic patients with modest incomes can acquire them through state subsidies and lawsuits. Yet, despite the naturalization of immunosuppressants’ use in Brazil, a significant number of local actors question the efficacy and logic of immunosuppression-based treatments. Many among them call attention to their numerous side effects, whilst simultaneously others informally adopt marginalized biomedical therapies based on the opposite principle of immunostimulation.

Combining literature review, archive research and participant observation, I highlight how aspects of immunosuppression as a hegemonic therapeutic model are being substantially contested. For it, I focus on disputes about immunosuppressant and immunostimulants, carried out by their respective stakeholders and networks, and issues concerning the innovativeness of immunosuppressants’ last generation as biopolitical artefacts.