ABSTRACT
'Biopolitics' is a much-used concept in recent academic literature. One of its main fields of application is in the analysis of public health projects. This article analyses the national Explicit Health Guarantees project in Chile from that perspective. However, we criticize the standard invocation of 'biopolitics' by observing that such public health projects require technoscientific operations that establish truths and regimes of obligation for the groups involved -understanding regime both as a set of imposed orders and a set of regulated processes. Specifically, the Explicit Health Guarantees project defines what we call 'speculative objects'. These have two characteristics: (a) They relate highly diverse entities into integrated wholes that are and involve objects of knowledge and uncertainty, and (b) this integration creates regimes of obligation considered as scientific truths on many different groups. We conclude by proposing new questions about the notion of biopolitics and its relationship with uncertainty and speculation.
Subject(s)
Public Health , ChileABSTRACT
Resumen En este trabajo, analizamos la producción de certidumbre en una política en salud configurada desde el esquema epistémico de la medicina basada en la evidencia: el régimen de Garantías Explícitas en Salud en Chile. Con base en los estudios de ciencia y tecnología, el análisis de material producido mediante etnografías focalizadas en escenarios ministeriales, y considerando entrevistas a expertos y profesionales, exponemos cómo en estos escenarios los objetos vinculados con la evidencia llegan a servir para tres propósitos: reducir la complejidad de procesos globales, conectar lo local con lo global y, fundamentalmente, generar un nuevo continuo que vincula la verdad con la incertidumbre. Caracterizamos a estas entidades como "objetos especulativos", destacando su importante papel en la articulación de retóricas que permiten la configuración local de la biopolítica.
Abstract This article analyzes the production of certainty in a health policy shaped by the epistemic scheme of evidence-based medicine: the Regime of Explicit Health Guarantees in Chile. Based on studies on science and technology, the analysis of material produced through focused ethnographies in ministry settings, and interviews with experts and professionals, this study exposes how objects linked to the evidence serve for three purposes in these scenarios: to reduce the complexity of global processes, to connect the local with the global, and to generate a new continuum that links truth with uncertainty. These objects are characterized here as "speculative objects," highlighting their important role in the articulation of rhetoric that allows the local configuration of biopolitics.
Subject(s)
Humans , Male , Female , Public Health , Decision Making , Science, Technology and Society , Health PolicyABSTRACT
Disasters affect sociospatial links in a dynamic and unstable meshwork of aspects that are reconfigured. In this sense, accounting for this complexity is central to analyze the transformation of the sociospatial linkage of the affected people and communities. Addressing from community environmental psychology, we propose the concept of assemblage to guide a situated reading of subjective, material, and community aspects present in a reconstruction process after a disaster. Following a qualitative methodology, using spatially referenced narrative interviews (n = 16) and thematic analysis, it is described how these links are presented in a community that lived the mega-fire of a part of the city of Valparaíso in Chile. The results describe that the experience of being a community is a variable flow within a process defined by an ever-emerging configuration of spatial, technological, personal, social, and sensory characteristics. We conclude by pointing out the qualities of the communities when considered from an assemblage perspective.
Subject(s)
Disasters , Chile , Cities , HumansABSTRACT
Los documentos han formado parte importante de los procesos de formalización y transforma-ción organizacional. Esto ha sido particularmente evidente en el campo de la medicina. En este trabajo analizamos las acciones que promueven documentos como las guías de práctica clínica. Realizamos etnografías focalizadas, entrevistas y análisis documental en espacios de diseño, así como también en centros de atención. Para el análisis, adoptamos la perspectiva de la teoría del actor-red. Esta aproximación nos ha permitido señalar cómo las guías inscriben relaciones que son interpretadas localmente, entablan vínculos de co-afección en tanto modifican y son modificadas por los escenarios clínicos, y participan de arreglos pragmáticos para formular de-terminados efectos. Finalmente, y adoptando elementos de la filosofía procesual de Whi-tehead, consideramos que estas pueden ser concebidas como objetos proposicionales. Estos ob-jetos recogen las potencialidades normativas de un escenario, ofrecen ocasiones para ser in-troducidos en relaciones y, asimismo, orientar su curso. (AU)
Documents have been an important part of organisational formalization and transformation. This has been particularly evident in the medical field. In this work we analyze the actions promoted by documents such as clinical practice guidelines. We carried out focused ethnogra-phies, interviews, and documentary analysis in design spaces, as well as in care centres. For the analysis, we adopted actor-network theory perspective. This approach has allowed us to point out how the guides inscribe relationships that are interpreted locally, establish co-affection links as they modify and are modified by the clinical scenarios, and participate in pragmatic arrangements to formulate clinical effects. Finally, and adopting elements of Whitehead's process philosophy, we consider that these can be conceived as propositional ob-jects. These objects collect the normative potential of a scenario, offer opportunities to be introduced into relationships and, likewise, guide its course. (AU)
Subject(s)
Humans , Official Letters , Structure of Services , Organizations/history , Organizations/organization & administration , Organizations/standards , Practice Guidelines as TopicABSTRACT
La biosocialidad hace referencia a modos de identificación personal y colectiva que se definen a partir de un rasgo biológico. Diversas investigaciones, que han abordado formaciones sociales de este tipo, han exaltado cómo en los procesos de interacción con entidades socio-técnicas la identidad de los actores involucrados se ve redefinida. En este trabajo se analiza las implicancias de la participación en colectivos biosociales para los humanos involucrados, desde la teoría del actor-red. En tal sentido, se describe cómo la identidad en estos espacios se comporta como una composición que implica la asociación de elementos heterogéneos, que articulan un humano a una serie de entidades que permiten transformar la definición de sí mismo. De esta manera, se adquieren significados que amplifican el espectro de acciones posibles al enfrentar la incertidumbre de la enfermedad. Empleando el término de equipamiento, descrito por Foucault y rescatado por Rabinow, se considera que la participación en entramados biosociales incide en la adquisición de nuevas capacidades para enfrentar escenarios de incertidumbre. Un equipamiento consiste en un continuo de acciones orientadas a un fin práctico que implica la preparación para hacer frente a contextos diversos, a partir de la asociación a entidades heterogéneas...
Biosociality refers to modes of personal and collective identification that are defined from a biological trait. Diverse investigations that have addressed social formations of this type, have exalted how through interaction processes with socio-technical entities, the identity of involved actors is redefined. In this paper are analysed the implications of participation in biosocial collectives to the humans involved, from the actor-network theory. In that sense, it is described how in these spaces the identity behaves as a composition, involving the association of heterogeneous elements which articulate a human to a number of entities that can transform the definition of the self. Also, are acquired meanings that amplify the spectrum of possible actions to face the uncertainty of the disease itself. By using the term of equipment, described by Foucault and rescued by Rabinow, it is considered that participation in biosocial weaves affects the acquisition of new skills to deal with scenarios of uncertainty. An equipment consists in a continuum of actions aimed to a practical purpose involving the preparation to deal with different contexts, from the association to heterogeneous entities...
