Complicity: Methodologies of power, politics and the ethics of knowledge production.

In this collection we develop the concept of "complicity" as a means to understand how medical sociologists might be allied in unexpected or uncomfortable ways with dominant structures of power. After giving examples of complicity from our own research, we introduce existing scholarship on complicity, describing it as a concept that comes coupled with a sense of responsibility and that is related to, yet distinct from, a range of other terms including reflexivity, collusion, guilt, and shame. We also discuss how complicity has been described to occur at the level of the institution, within theoretical frameworks, and during mundane moments that we face on a day-to-day basis. Building on this review, we hypothesise that medical sociology - where access to fieldsites is often hard won, where "researching up" in medical and scientific institutions is common, and where our own work frequently concerns matters central to medical institutions themselves - is a discipline wherein mundane complicity is likely. Following this gathering exercise, we introduce the interventions that comprise this collection: interventions from a diversity of sociologists of health and illness who, perhaps for the first time in written form, account for how complicities of various kinds came to shape their work and how, with varying levels of success, they have sought redress. We close by offering some insight into the process of developing this collection, celebrating its successes while also acknowledging that many gaps and complicities remain.

Consider the woodpecker: The contested more-than-human ethics of biomimetic technology and traumatic brain injury.

Chronic Traumatic Encephalopathy, or CTE, is a neurodegenerative disease caused by traumatic brain injury and most frequently associated with contact sports such as American Football. Perhaps surprisingly, the woodpecker - an animal apparently immune to the effects of head impacts - has increasingly figured into debates surrounding CTE. On the one hand, the woodpecker is described as being contra-human and used to underscore the radical inappropriateness of humans playing football. On the other, there have been attempts to mitigate against the risk of CTE through the creation of biomimetic technologies inspired by woodpeckers. In this article I examine the highly politicized encounters between humans and woodpeckers and discuss how the politics of re-/dis-/en-tanglement during these interspecies relations is rendered meaningful. I show here, first, that those who seek to keep the human and the woodpecker apart envisage social overhaul while biomimetic technologies are put to work for the status quo. Second, I stress that different forms of entanglement have diverse sociopolitical consequences. I conclude by suggesting that the case of the woodpecker troubles a strand of contemporary scholarship in Science and Technology Studies that argues that biotechnologies are inherently transformatory and that foregrounding entanglement and interspecies relations is ethically generative. Instead, a discursive separation of nature and culture may be innovative.

"Learning to Listen to Them and Ask the Right Questions." Bennet Omalu, Scientific Objectivities, and the Witnessing of a Concussion Crisis.

The death of American Football player Mike Webster has become foundational to narratives of sport's twenty-first century concussion crisis. Bennet Omalu, the neuropathologist who conducted Webster's autopsy and subsequently diagnosed Webster with Chronic Traumatic Encephalopathy (CTE), has, likewise, become a central figure in the concussion crisis. Indeed, it is frequently argued that there is something about Omalu in particular that made it possible for him to "witness" CTE when the disease entity had hitherto remained invisible to a great many medics and scientists. In this article, and drawing upon auto/biographies, I consider Omalu's self-described mode of scientific witnessing which purportedly allowed him to (re)discover CTE. I find Omalu's described objectivity to be shaped by three factors: First, the importance of "trained judgment" within which Omalu's scientific training is emphasized. Second, the infusion of religiosity within scientific practice. Third, a self-described position as an "outsider" to both football and American culture. Throughout this analysis, I pay attention not only to the ways in which Omalu's narratives depart from conventional depictions of scientific objectivity; I also note the similarities with particular bodies of social scientific work, most notably within a feminist "turn to care" in Science and Technology Studies (STS) and related standpoint epistemologies. Following these analyses, I argue that, first, Omalu's writing affords the dead a "response-ability" that is often absent within analyses of the concussion crisis and, second, that a focus upon diverse forms of objectivity, such as those described in Omalu's work, complements existing work into concussion science that has foregrounded scientific conflict of interest.

Autism Scientists' Reflections on the Opportunities and Challenges of Public Engagement: A Qualitative Analysis.

This article draws upon qualitative interviews in order to examine how UK based research psychologists understand public engagement activities and interactions with autistic advocates. Researchers describe public engagement as difficult and understand these difficulties as stemming from autistic impairments. In particular, it is reported that a heterogeneity of autism impairments means there is little agreement on the form research should take, while socio-communicative impairments make interactions difficult. Conversely, researchers describe autistic individuals as having the capacity to positively influence research. In this paper we discuss the nature of these claims and stress the need for autism-specific modes of engagement to be developed.

The categorisation of resistance: interpreting failure to follow a proposed line of action in the diagnosis of autism amongst young adults.

Many characteristics typical of autism, a neurodevelopmental condition characterised by socio-communicative impairments, are most evident during social interaction. Accordingly, procedures such as the Autism Diagnosis Observation Schedule (ADOS) are interactive and intended to elicit interactional impairments: a diagnosis of autism is given if interactional difficulties are attributed as a persistent quality of the individual undergoing diagnosis. This task is difficult, first, because behaviours can be interpreted in various ways and, second, because conversation breakdown may indicate a disengagement with, or resistance to, a line of conversation. Drawing upon conversation analysis, we examine seven ADOS diagnosis sessions and ask how diagnosticians distinguish between interactional resistance as, on the one hand, a diagnostic indicator and, on the other, as a reasonable choice from a range of possible responses. We find evidence of various forms of resistance during ADOS sessions, but it is a resistance to a line of conversational action that is often determined to be indicative of autism. However, and as we show, this attribution of resistance can be ambiguous. We conclude by arguing for reflexive practice during any diagnosis where talk is the problem, and for a commitment to acknowledge the potential impact of diagnostic procedures themselves upon results.

(Dis)entangling Barad: Materialisms and ethics.

In the wake of the widespread uptake of and debate surrounding the work of Karen Barad, this article revisits her core conceptual contributions. We offer descriptions, elaborations, problematizations and provocations for those intrigued by or invested in this body of work. We examine Barad's use of quantum physics, which underpins her conception of the material world. We discuss the political strengths of this position but also note tensions associated with applying quantum physics to phenomena at macro-scales. We identify both frictions and unacknowledged affinities with science and technology studies in Barad's critique of reflexivity and her concept of diffraction. We flesh out Barad's overarching position of 'agential realism', which contains a revised understanding of scientific apparatuses. Building upon these discussions, we argue that inherent in agential realism is both an ethics of inclusion and an ethics of exclusion. Existing research has, however, frequently emphasized entanglement and inclusion to the detriment of foreclosure and exclusion. Nonetheless, we contend that it is in the potential for an ethics of exclusion that Barad's work could be of greatest utility within science and technology studies and beyond.

Autistic Heterogeneity: Linking Uncertainties and Indeterminacies.

Autism is a highly uncertain entity and little is said about it with any degree of certainty. Scientists must, and do, work through these uncertainties in the course of their work. Scientists explain uncertainty in autism research through discussion of epistemological uncertainties which suggest that diverse methods and techniques make results hard to reconcile, ontological uncertainties which suggest doubt over taxonomic coherence, but also through reference to autism's indeterminacy which suggests that the condition is inherently heterogeneous. Indeed, indeterminacy takes two forms-an inter-personal form which suggests that there are fundamental differences between individuals with autism and an intra-personal form which suggests that no one factor is able to explain all features of autism within a given individual. What is apparent in the case of autism is that scientists put uncertainty and indeterminacy into discussion with one another and, rather than a well-policed epistemic-ontic boundary, there is a movement between, and an entwinement of, the two. Understanding scientists' dialogue concerning uncertainty and indeterminacy is of importance for understanding autism and autistic heterogeneity but also for understanding uncertainty and 'uncertainty work' within science more generally.

Failing, hacking, passing: Autism, entanglement, and the ethics of transformation.

One of the most notable recent changes in autism science is the belief that autism is a heterogeneous condition with no singular essence. I argue that this notion of 'autistic heterogeneity' can be conceived as an 'agential cut' and traced to uncertainty work conducted by cognitive psychologists during the early 1990s. Researchers at this time overcame uncertainty in scientific theory by locating it within autism itself: epistemological uncertainty was interwoven with ontological indeterminacy and autism became heterogeneous and chance like, a condition determined by indeterminacy. This paper considers not only the conceptual significance of this move but also the impact upon forms of subjectivity. This analysis is undertaken by integrating the agential realism of Karen Barad with the historical ontology of Michel Foucault. I argue that these two approaches are, firstly, concerned with ontologies of emergence and, secondly, foreground the inherently ethical nature of change. As such these theories can be used to articulate an 'ethics of transformation'. I argue that the agential cut which brought about autistic heterogeneity is potentially problematic within an ethics of transformation, limiting the possibility of future change in subjectivity by imagining difference and resistance as properties of autism rather than the individual.

Charisma and the clinic.

Here we argue that 'charisma', a concept widely taken up within geography and the environmental humanities, is of utility to the social studies of medicine. Charisma, we suggest, draws attention to the affective dimensions of medical work, the ways in which these affective relations are structured, and the manner in which they are intimately tied to particular material-discursive contexts. The paper differentiates this notion of charisma from Weber's analyses of the 'charismatic leader' before detailing three forms of charisma - ecological (which relates to the affordances an entity has), corporeal (related to bodily interaction) and aesthetic (pertaining to an entity's initial visual and emotional impact). Drawing on interview data, we then show how this framework can be used to understand the manner in which psychologists and neuroscientists have come to see and act on autism. We conclude the article by suggesting that examining charisma within healthcare settings furthers the concept, in particular by drawing attention to the discursive features of ecologies and the 'non-innocence' of charisma.

Infancy, autism, and the emergence of a socially disordered body.

Twenty academic psychologists and neuroscientists, with an interest in autism and based within the United Kingdom, were interviewed between 2012 and 2013 on a variety of topics related to the condition. Within these qualitative interviews researchers often argued that there had been a 'turn to infancy' since the beginning of the 21st century with focus moving away from the high functioning adolescent and towards the pre-diagnostic infant deemed to be 'at risk' of autism. The archetypal research of this type is the 'infant sibs' study whereby infants with an elder sibling already diagnosed with autism are subjected to a range of tests, the results of which are examined only once it becomes apparent whether that infant has autism. It is claimed in this paper that the turn to infancy has been facilitated by two phenomena; the autism epidemic of the 1990s and the emergence of various methodological techniques, largely although not exclusively based within neuroscience, which seek to examine social disorder in the absence of comprehension or engagement on the part of the participant: these are experiments done to participants rather than with them. Interviewees claimed that these novel methods allowed researchers to see a 'real' autism that lay 'behind' methodology. That claim is disputed here and instead it is argued that these emerging methodologies other various phenomena, reorienting the social abnormality believed typical of autism away from language and meaning and towards the body. The paper concludes by suggesting that an attempt to draw comparisons between the symptoms of autism in infant populations and adults with the condition inevitably leads to a somaticisation of autism.

Cold pressor pain reduces phobic fear but fear does not reduce pain.

UNLABELLED: Negative emotion has a variable effect on pain perception. This variability has been explained by the motivational priming hypothesis (MPH) which predicts that emotional stimuli generating low levels of arousal will facilitate pain, while stimuli generating high levels of arousal will inhibit pain. However, a study by Sneddon et al with rainbow trout discovers a relationship not found in the human literature, that fear-related behavior decreased in the presence of a nociceptive stimulus. The current experiment examined this possibility in humans. In Experiment 1, 30 healthy, female subjects with "at least a mild aversion to spiders" participated in 3 trials: 1 in which a Brazilian salmon pink tarantula was present; a second with the right hand immersed in a cold pressor; and a third with both the tarantula and the cold pressor present. Experiment 2 added distance as an extra variable to this methodology. In both experiments it was found that spider presence had no impact upon pain perception but spider fear was reduced by the cold pressor. There was no interaction between trial and either time or distance. These findings are novel in human subjects and not well accounted for by the MPH. We suggest that an explicitly evolutionary framework should be adopted, and that spider fear was reduced to facilitate escape from the more threatening cold-pressor experience. PERSPECTIVE: This study examined the relationship between pain and fear. Subjects with an aversion to spiders sat next to a tarantula with their right hand in iced water. Subjects reported reduced fear but no change in pain. Consequently, the authors reevaluate the Motivational Priming Hypothesis and emphasize evolutionarily determined threat values.