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Disciplining reproduction: modernity, American life sciences, and “the problems of sex”

Authors:
Book
Reviews
trials,
as
I
have
long
felt
them
to
be
a
rationing
device
beloved
of
regulators
who
need
reassurance.)
On
another
note,
I
felt
that
many
of
the
contributors
may
not
have
appreciated
the
impact
that
mescaline
and
LSD
induced
states
had
had
on
the
psychiatric
"psyche"
leading
to
the
"shift
in
the
paradigm"
facilitating
the
discovery
of
psychotropic
drugs.
The
wide
spread
of
the
nationalities
of
the
members
of
the
Collegium
is
impressive,
and
their
accounts
show
how
universal
are
science
and
clinical
practice.
Many
of
those
whose
names
come
up
in
the
book
are
well-
known
researchers
and
authors,
and
their
personal
histories
brought
to
life
for
me
the
intense
excitement
of
the
time
when
we
started
to
use
modern
drugs.
David
Marjot,
Sunbury-on-Thames
Adele
E
Clarke,
Disciplining
reproduction:
modernity,
American
life
sciences,
and
"the
problems
of
sex",
Berkeley
and
London,
University
of
California
Press,
1998,
pp.
xvii,
421,
£35.00,
$45.00
(0-520-20720-3)
From
the
mid-nineteenth
century,
sexuality
and
reproduction
have
become
biomedical
subjects.
In
her
long-awaited,
comprehensive
monograph
on
the
emergence
and
evolution
of
scientific
approaches
to
human
reproduction
in
America
from
the
early
twentieth
century
to
the
1960s,
Adele
Clarke
analyses
important
sections
of
this history.
Central
to
Clarke's
analysis
is
the
argument
that
the
loosely
defined
group
of
reproductive
sciences
have
always
had
to
struggle
with
low
and
marginal
status
in
the
scientific
hierarchy-
a
position
that
Clarke,
not
very
satisfactorily,
denotes
in
shorthand
as
"illegitimacy"-and
their
pervasive
influence
has
been
obscured
by
their
apparent
marginality
within
the
scientific
world.
"My
focus",
says
Clarke,
"is
on
how
certain
scientists
in
specific
locales
came
to
envision
a
set
of
problems
of
reproductive
research,
how
they
organized
themselves
to
work
on
those
problems,
and
how
they
interacted
among
themselves
and
with
their
audiences,
sponsors,
and
consumers
to
sustain
this
research
and
develop
it
into
a
recognized
discipline"
(p.
27).
The
so-called
reproductive
sciences,
she
shows,
were
constituted
during
a
formative
period
in
American
life
sciences
by
the
amalgamation
of
forces
stemming
from
the
worlds
of
biology,
medicine,
and
agriculture,
greatly
aided
by
the
contemporaneous
expansion
of
American
universities
and
research
institutions.
These
forces,
in
turn,
existed
in
an
often
creative
state
of
tension
with
the
rather
different
worlds
of
birth
control
activists
and
eugenicists.
Initially,
scientists
interested
in
reproduction
steered
clear
of
socially
sensitive
issues
such
as
birth
control,
focusing
exclusively
on
basic
physiological
research.
The
elucidation
of
the
menstrual
cycles
of
laboratory
animals,
for
instance,
was
considered
a
truly
scientific
subject
while
the
development
of
a
simple
contraceptive
device
was
not.
Similarly,
the
study
of
human
sexual
behaviour
and
its
supposed
aberrations
was
also
left
strictly
alone.
In
all
this,
the
emerging
science
of
the
endocrine
secretions
provided
the
paradigm,
which
was
influenced
significantly
by
the
well-established
embryological
orientation
of
American
biology.
Although,
as
Clarke
documents,
the
reputation
of
endocrinology
itself
was
rather
dubious
in
the
earlier
years
of
this
century
because
of
its
associations
with
matters
such
as
biological
rejuvenation,
it
was
still
a
dazzling
new
science
and
eminently
suited
to
provide
a
scientific
foundation
for
reproductive
biology.
The
establishment
of
the
reproductive
sciences
in
America
was
not,
however,
an
exclusively
intellectual
matter:
as
Clarke
shows,
the
reproductive
sciences,
despite
their
apparent
marginality,
were
remarkably
successful
in
attracting
generous
funding
from
sources
such
as
the
Rockefeller
Foundation
and
from
the
134
Book
Reviews
pharmaceutical
industry.
Part
of
the
reason
why
foundations
supported
reproductive
research,
Clarke
suggests,
was
because
they
felt
it
was
the
ultimate
way
to
achieve
biological
control
over
populations,
an
aim
dear
to
their
hearts
at
this
time.
Even
more
striking
was
the
gradual
rapprochement
between
the
reproductive
scientists
and
the
once-suspect
world
of
birth
control
activists,
which
led
to
reproductive
scientists
becoming
"integral
parts
of
family
planning,
population
control
and
infertility
research
worlds,
where
they
remain
today"
(p.
28).
This
exhaustively
researched,
thoroughly
documented
and
well-organized
study
of
a
crucial
but
virtually
unexplored
area
of
American
science
should
become
essential
reading
for
historians
of
the
life
sciences.
Like
any
worthwhile
work
of
scholarship,
it
does
not
simply
tell
an
interesting
story
and
offer
analytical
insights
but
raises
interesting
research
questions
for
future
work.
Why,
for
instance,
did
American
reproductive
scientists
eschew
questions
of
human
sexual
orientation
and
behaviour
while
continental
European
biologists
did
not
feel
too
many
qualms
about
addressing
them?
Clarke
is
to
be
thanked
for
compelling
us
to
think
about
such
issues
and
her
admirable
study
will
provide
a
point
of
departure
for
those
wishing
to
explore
other
dimensions
of
this
complex
and
fascinating
subject.
Chandak
Sengoopta,
Wellcome
Institute
for
the
History
of
Medicine
Milton
Lewis,
The
thorns
on
the
rose:
the
history
of
sexually
transmitted
diseases
in
Australia
in
international
perspective,
Canberra,
Australian
Government
Publishing
Service,
1998,
pp.
xxii,
574,
Austral.
$69.95
(0-644-36085-2).
The
thorns
on
the
rose
is
a
wide-ranging
study
which
aims
to
locate
the
Australian
experience
of
sexually
transmitted
diseases
(STDs)
within
both
an
historical
and
a
comparative
perspective.
Throughout
the
book,
Lewis
is
concerned
to
establish
the
links
between
European
and
Australian
discourses
surrounding
STDs,
and
the
early
chapters
are
devoted
to
contextualizing
the
development
of
epidemiology
and
control
policies
in
nineteenth-century
Australia,
with
particular
emphasis
on
the
ideology
and
outcome
of
contagious
disease
legislation
and
the
efforts
of
Western
societies
to
regulate
prostitution.
There
follows
an
exhaustive
survey,
at
both
the
federal
and
state
levels,
of
the
impact
of
new
chemotherapies
and
diagnostic
techniques
on
treatment
regimes
and
public
health
policies
in
the
early
1900s,
along
with
an
assessment
of
the
role
of
other
factors
such
as
the
social
purity
movement,
eugenics,
and
the
exigencies
of
war.
Lewis's
treatment
of
inter-war
developments
adheres
to
a
similar
format
with
a
review
of
Australian
initiatives
juxtaposed
to
a
survey
of
developments
in
Western
Europe
and
the
USA
and
international
co-operation
on
issues
of
social
hygiene.
Particular
attention
is
paid
to
the
impulses
and
constraints
shaping
health
education
programmes
and
to
the
ongoing
debate
over
the
relative
merits
of
compulsory
and
voluntary
control
strategies.
Two
further
chapters
are
devoted
to
the
impact
of
penicillin
and
the
"permissive
society"
on
the
treatment
and
control
of
classic
venereal
diseases
as
well
as
of
the
second
and
third
generation
of
STDs
during
the
period
1945-80.
Shifts
in
the
incidence
and
epidemiology
of
STDs
are
related
to
the
vicissitudes
in
the
status
and
resourcing
of
venereology
as
a
speciality,
to
the
application
of
less
coercive
methods
of
STD
controls
such
as
contact
tracing,
and
to
broader
societal
shifts
in
sexual
mores.
A
much-needed
and
highly
illuminating
chapter
is
devoted
to
the
impact
of
STDs
on
Aboriginal
society
in
Australia
from
the
nineteenth
century
to
the
present
day.
Lewis
addresses
wide-ranging
issues
relating
to
the
incidence
and
epidemiology
of
STDs
among
135
... The ''we's'' articulating these visions are related to, but not entirely reducible to, professional identity. They represent distinctive ''communities of practice and discourse''(Clarke, 1998) that are constructed in relation to both institutionalized professional roles, and interactions with the genetic technologies (both tests and counselling) themselves (Clarke, 1998; Wailoo , 1997). Questions about who will control genetic technologies are not simply turf battles between the professions: they are also inescapably questions about what the genetic technologies should and will accomplish clinically. ...
... In accordance with case study methods, we analyzed the data for its fit with a set of theoretical propositions, and searched actively for contrary interpretations. The theoretical propositions that drove our analysis derive from social worlds/arenas theory and related theories in the history of medicine, namely, that ''communities of practice and discourse'' form and reform through efforts of collective meaning-making in arenas of concern and action (Clarke, 1998), and that technoscientific products are ''implicated actors'' in these collective efforts, influencing and being influenced by these encounters (Clarke & Montini, 1993; Wailoo, 1997). From grounded theory we adopted the iterative and constant comparative analytic method (Charmaz, 2000), but with a more reflexive, hermeneutic approach to data interpretation (Addison, 1999). ...
... In articulating a ' ' genetic vision of care ' ' and an ' ' onco - logic vision of care , ' ' respondents identify two different and locally - produced ' ' communities of discourse and prac - tice ' ' ( Clarke , 1998 ) . These communities are , in the first in - stance , a function of practical issues : of disciplinary and professional identity ( e . ...
Article
Growth in genetic medicine has provoked debate about how new and emerging genetic services should be provided, and specifically, what roles non-genetic clinicians should assume. We address this question through a qualitative interview based case study of the program in genetic testing for the hereditary cancer syndromes (breast/ovarian and colorectal) in Ontario, Canada. We argue that two communities offer parallel visions of cancer genetic care: one "genetic," the other "oncologic." Both communities argue from precedent that cancer genetics is a natural extension of their work: it is "what we do." Both communities also highlight the importance of their own expertise in providing core elements of cancer genetic care: it requires "what we know." Further, both communities perceive the need for leadership by their own (or a related) community as genetic medicine expands to include a broader array of more common and complex diseases: it is expanding "where we're leading." Yet, the "we's" articulating these visions are not reducible to professional identity; rather, both represent distinctive "communities of practice and discourse" that are constructed in relation to institutionalized professional roles, and interactions with the genetic technologies (both tests and counselling) themselves. Available literature on the role of diverse health care professionals in the provision of genetic health care presumes a fixed identity and set of approaches for each professional group that might play a role. Further, existing models tend to assume that genetic technologies are given as tools, and that service organization concerns primarily questions of who will have access to these tools and their powers, as well as the consequent professional and ethical responsibilities. Yet questions about who will control genetic technologies are not simply turf battles between the professions: they are also inescapably questions about what the genetic technologies should and will accomplish clinically.
... The Aschheim–Zondek reaction is generally regarded as the first modern test for the pregnancy hormone, today known as 'human chorionic gonadotrophin' or hCG. Though not the first laboratory pregnancy test, it was the first to be used on a large scale. 1 Invented by Selmar Aschheim and Bernhard Zondek in Berlin in the late 1920s (Bröer, 2004; Finkelstein & Zondek, 1966; Hinz, Ebert, & Goetze, 1994; Rudloff & Ludwig, 2005; Schneck, 1997), by the mid 1930s a diagnostic service in Edinburgh was performing thousands of tests every year for clinicians and hospitals around Britain (Clarke, 1998, p. 320; Gurdon & Hopwood, 2000, pp. 45–46; Hanson, 2004, p. 136; McLaren, 2012, pp. ...
... I will show how the Aschheim– Zondek test was made, less into a yes-or-no test for normal pregnancy , and more into a versatile tool for differential diagnosis, calibrated to monitor placental tumours and hormonal deficiencies believed to cause miscarriage. 4 I do not doubt that pregnancy tests were, as Adele Clarke put it, 'early and important technoscientific products of the reproductive sciences' (Clarke, 1998, p. 149), but innovation is not the whole story. A case study in use-based history of medical technology, my account will focus less on the novelties of scientific research than on the establishment and maintenance of routine practices. ...
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Full-text available
The Aschheim–Zondek reaction is generally regarded as the first reliable hormone test for pregnancy and as a major product of the ‘heroic age’ of reproductive endocrinology. Invented in Berlin in the late 1920s, by the mid 1930s a diagnostic laboratory in Edinburgh was performing thousands of tests every year for doctors around Britain. In her classic history of antenatal care, sociologist Ann Oakley claimed that the Aschheim–Zondek test launched a ‘modern era’ of obstetric knowledge, which asserted its superiority over that of pregnant women. This article reconsiders Oakley’s claim by examining how pregnancy testing worked in practice. It explains the British adoption of the test in terms less of the medicalisation of pregnancy than of clinicians’ increasing general reliance on laboratory services for differential diagnosis. Crucially, the Aschheim–Zondek reaction was a test not directly for the fetus, but for placental tissue. It was used, less as a yes-or-no test for ordinary pregnancy, than as a versatile diagnostic tool for the early detection of malignant tumours and hormonal deficiencies believed to cause miscarriage. This test was as much a product of oncology and the little-explored world of laboratory services as of reproductive medicine.
... We explore these issues through looking at Adele Clarke's historical sociology of the American 'disciplines of reproduction' in the 20 th century (Clarke, 1998). This study, as Clarke states, comes out of just the combination of intellectual curiosity and political interest, which tend to lead to the worries about politics idenfitied by Brown. ...
... In the hands of later users, this article provided argumentative resources for those Clarke views as progressive feminists, no less than for those she identifies as conservative Christian fundamentalists. Clarke therefore characterizes her own project as more than the staple 'chronicle of transformations' (Clarke, 1998: xii). Although she believes that 'good scholarship informs social change' she is also aware that this scholarship is not by itself capable of controlling the shapes such change will take. ...
... Let us look at a recent use of grounded theory and speculate on how it might have differed from another analysis of the same subject not benefiting from grounded theory. Clarke, an ex-student of Strauss (Clarke, 1998), undertakes an excellent analysis of the American reproductive sciences which, she reports, emerges out of grounded theory analysis. She notes, in a general description of grounded theory, that " the data are coded, and codes are densified and ultimately integrated into an analysis " (p. ...
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Grounded theory's popularity persists after three decades of broad‐ranging critique. In this article three problematic notions are discussed—‘theory,’ ‘ground’ and ‘discovery’—which linger in the continuing use and development of grounded theory procedures. It is argued that far from providing the epistemic security promised by grounded theory, these notions—embodied in continuing reinventions of grounded theory—constrain and distort qualitative inquiry, and that what is contrived is not in fact theory in any meaningful sense, that ‘ground’ is a misnomer when talking about interpretation and that what ultimately materializes following grounded theory procedures is less like discovery and more akin to invention. The procedures admittedly provide signposts for qualitative inquirers, but educational researchers should be wary, for the significance of interpretation, narrative and reflection can be undermined in the procedures of grounded theory.
... In spite of the campaigns of birth control activists, their advocacy of the idea that fertility should be 'planned' through the use of precoital contraception did not become accepted as a mainstream part of medical practice until the 1960se70s (McLaren, 1990). McLaren suggests that the availability of a more high-status and 'scientific' (Clarke, 1998) method of contraception in the form of the Pill was critical in the profession's change of heart concerning the goals of the birth control movement. Another important event was that, during the late 1960s, health professionals in much of the UK suddenly became faced with responsibility for the provision of abortion (Aitken-Swann, 1977; Davis & Davidson, 2005; Hawkes, 1996; McLaren, 1990; Thomas, 1985). ...
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