Technologies of the Clinic: Tools, Tests and Explanatory Strategies

Abstract

The constituting and transformatory role of technology in the development of different clinical and medical specialties has been central to science studies (Casper and Koenig 1996; Mol and Berg 1998). This perspective stands in contrast to what has been a somewhat more reluctant approach within anthropology to examine the material practices of bio-medicine itself (Lock and Lindenbaum 1993). Drawing on recent work situated across these disciplinary divides, which have begun to produce new kinds of inquiry at the intersection between technology, patienthood and a variety of health care specialisms or practices, this chapter examines the routines of the cancer genetic clinic. In attending to how genetic knowledge is communicated at the interface between patients and practitioners, it explores how certain clinical narratives along with both old and new material or visual technologies are important tools for predictive practices. Like other ‘boundary objects’ (Star and Griesemar 1989), these devices are reproduced and sustained in part through the ‘co-production’ of patients and practitioners. In this sense they are not ‘shot through with power’ (Rapp 1999) in a simple or direct way and do more than just, or always successfully, service medical knowledge or professional expertise. This chapter explores how the power, mutability and ultimately also the inherent instability of tools and technologies must be understood in relation to the collective, conjoined, yet differently situated investments that meet at the juncture of this clinical domain.