During the 1990s and early years of the 2000s, the tree commonly known as neem became a powerful symbol of traditional knowledge, which was contrasted with “biopiracy,” a term coined by activists to describe the appropriation of natural resources and associated knowledge from the Global South. This resulted from high-profile campaigns to rescind two patents held by an American chemical company, W. R. Grace, on neem derivatives for use in biopesticides. Activists and the media highlighted neem’s uses in India, representing Grace’s patents as the corporate plunder of traditional knowledge. This article historicizes the controversy and considers how plant histories relate to intellectual property (IP) debates. The neem case popularized the concept of “biopiracy,” but claims about neem were used in different and even conflicting ways. While activists critiqued the expansion of IP rights to include patents on living things, the case was used by some in India to justify neem-related patents and to extend state jurisdiction over traditional knowledge. The activism of the 1990s also influenced historical work, inspiring studies of colonial appropriations of natural knowledge. Many such works focus on cinchona, the source of quinine. Neem and cinchona have intertwined histories with different endpoints. As cinchona became “modern” and “global,” neem was increasingly viewed as “local” and “traditional,” even while spreading across warmer parts of the world and becoming the object of scientific study. While cinchona is often used to epitomize colonial appropriations of indigenous knowledge, neem represents a different story in which appropriation was partial and the tree was reclaimed as “traditional” in new contexts.
在20世纪90年代和21世纪初，通常被称为“楝树”的树成为传统知识的有力象征，与“生物剽窃”形成鲜明对比。“生物剽窃”是活动人士创造的一个术语，用来描述从全球南方国家窃取自然资源和相关知识的行为。这源于撤销美国化学公司w·r·格雷斯(W. R. Grace)持有的两项用于生物农药的印楝衍生物专利的高调运动。活动人士和媒体强调了楝树在印度的用途，称格蕾丝的专利是企业对传统知识的掠夺。本文将这一争议历史化，并考虑植物历史与知识产权(IP)辩论的关系。印楝树案普及了“生物剽窃”的概念，但有关印楝树的说法却以不同甚至相互矛盾的方式被使用。尽管活动人士批评将知识产权扩大到包括生物专利的做法，但印度的一些人却利用此案来证明与neei相关的专利是正当的，并将国家管辖权扩大到传统知识。20世纪90年代的激进主义也影响了历史工作，激发了对殖民挪用自然知识的研究。许多这样的作品集中在金鸡纳，奎宁的来源。印楝和金鸡纳有着不同终点的交织历史。随着金鸡纳变得“现代”和“全球化”，印度楝树越来越被视为“本地的”和“传统的”，尽管它正在世界上较温暖的地区传播，并成为科学研究的对象。金鸡纳通常被用来代表殖民地对土著知识的挪用，而印度楝树则代表了一个不同的故事，在这个故事中，挪用是部分的，这种树在新的背景下被回收为“传统”。
{"title":"Becoming “Traditional”","authors":"A. Winterbottom","doi":"10.1086/713897","DOIUrl":"https://doi.org/10.1086/713897","url":null,"abstract":"During the 1990s and early years of the 2000s, the tree commonly known as neem became a powerful symbol of traditional knowledge, which was contrasted with “biopiracy,” a term coined by activists to describe the appropriation of natural resources and associated knowledge from the Global South. This resulted from high-profile campaigns to rescind two patents held by an American chemical company, W. R. Grace, on neem derivatives for use in biopesticides. Activists and the media highlighted neem’s uses in India, representing Grace’s patents as the corporate plunder of traditional knowledge. This article historicizes the controversy and considers how plant histories relate to intellectual property (IP) debates. The neem case popularized the concept of “biopiracy,” but claims about neem were used in different and even conflicting ways. While activists critiqued the expansion of IP rights to include patents on living things, the case was used by some in India to justify neem-related patents and to extend state jurisdiction over traditional knowledge. The activism of the 1990s also influenced historical work, inspiring studies of colonial appropriations of natural knowledge. Many such works focus on cinchona, the source of quinine. Neem and cinchona have intertwined histories with different endpoints. As cinchona became “modern” and “global,” neem was increasingly viewed as “local” and “traditional,” even while spreading across warmer parts of the world and becoming the object of scientific study. While cinchona is often used to epitomize colonial appropriations of indigenous knowledge, neem represents a different story in which appropriation was partial and the tree was reclaimed as “traditional” in new contexts.","PeriodicalId":54659,"journal":{"name":"Osiris","volume":"36 1","pages":"262 - 283"},"PeriodicalIF":0.5,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1086/713897","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43219603","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"哲学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
This chapter examines the impact of colonialism on the “invention” of Vietnamese medicine (VM) in the first half of the twentieth century. It focuses more specifically on the legal framework dealing with VM in the interwar period, when Vietnamese nationalism was on the rise and French colonial authorities were assessing the “successes” and “failures” of the Assistance Médicale Indigène (AMI), the colonial health care system established in 1905. I argue that this invention was at the same time pragmatic, programmatic, and ideological; it aimed at “naturalizing” the AMI to adapt it to local medical needs within the imperial framework and French budgetary constraints. Bridging political, institutional, professional, and therapeutic spaces, this article brings into focus the process whereby VM was not only domesticated, but legally defined for the first time and given specific roles within the colonial health care system. Analysing the discourses framing VM as a “traditional,” “complementary,” and “natural” medicine, I explore the different meanings of science, toxicity, and tradition in this context, as well as the issue of accessibility to essential care. I emphasize the participation of the Vietnamese population, especially Vietnamese doctors and healers, in this process. In so doing, this article helps to reconsider the historiography of traditional medicine worldwide and underlines the importance of a postcolonial approach to a much-needed history of so-called complementary and alternative medicine (CAM). Last but not least, it highlights the impact of colonialism on the framing of a “national medicine” that would play a crucial role in post-1954 Vietnam medicalization and nation building.
{"title":"The Reinvention of an Appropriate Tradition or the Colonial Birth of Vietnamese Medicine","authors":"L. Monnais","doi":"10.1086/713423","DOIUrl":"https://doi.org/10.1086/713423","url":null,"abstract":"This chapter examines the impact of colonialism on the “invention” of Vietnamese medicine (VM) in the first half of the twentieth century. It focuses more specifically on the legal framework dealing with VM in the interwar period, when Vietnamese nationalism was on the rise and French colonial authorities were assessing the “successes” and “failures” of the Assistance Médicale Indigène (AMI), the colonial health care system established in 1905. I argue that this invention was at the same time pragmatic, programmatic, and ideological; it aimed at “naturalizing” the AMI to adapt it to local medical needs within the imperial framework and French budgetary constraints. Bridging political, institutional, professional, and therapeutic spaces, this article brings into focus the process whereby VM was not only domesticated, but legally defined for the first time and given specific roles within the colonial health care system. Analysing the discourses framing VM as a “traditional,” “complementary,” and “natural” medicine, I explore the different meanings of science, toxicity, and tradition in this context, as well as the issue of accessibility to essential care. I emphasize the participation of the Vietnamese population, especially Vietnamese doctors and healers, in this process. In so doing, this article helps to reconsider the historiography of traditional medicine worldwide and underlines the importance of a postcolonial approach to a much-needed history of so-called complementary and alternative medicine (CAM). Last but not least, it highlights the impact of colonialism on the framing of a “national medicine” that would play a crucial role in post-1954 Vietnam medicalization and nation building.","PeriodicalId":54659,"journal":{"name":"Osiris","volume":"36 1","pages":"113 - 131"},"PeriodicalIF":0.5,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46573670","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"哲学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
This article examines the trial of a subaltern surgeon named Sukaroo Kobiraj from 1886 to 1887 in British Bengal. The presiding judges explicitly accepted the right of more scholarly “traditional” medical practitioners, such as Ayurvedic practitioners, to engage in their profession, even while criminalizing Sukaroo’s surgical practice. The decision therefore illustrates the need to distinguish subaltern therapeutics from the larger domain of traditional medicines. It also demonstrates that, though legislative intervention into medicine was limited in nineteenth-century Bengal, colonial law did in fact intervene and shape the medical landscape. All this becomes more significant because the Sukaroo case appeared in legal reports of the time, and then was rapidly and widely incorporated into legal textbooks and even annotated versions of the Indian Penal Code, thereby becoming an important legal precedent. It has continued to feature in postcolonial legal textbooks in South Asia and beyond. This long legal shadow cast by the case highlights the ways in which colonial case law has shaped the modern lives of traditional medicines in South Asia. In particular, it demonstrates the long history of tacit assumptions denigrating subaltern therapeutics that have structured the institutionalized medical pluralism operating in contemporary India.
{"title":"Subaltern Surgeries","authors":"P. Mukharji","doi":"10.1086/714222","DOIUrl":"https://doi.org/10.1086/714222","url":null,"abstract":"This article examines the trial of a subaltern surgeon named Sukaroo Kobiraj from 1886 to 1887 in British Bengal. The presiding judges explicitly accepted the right of more scholarly “traditional” medical practitioners, such as Ayurvedic practitioners, to engage in their profession, even while criminalizing Sukaroo’s surgical practice. The decision therefore illustrates the need to distinguish subaltern therapeutics from the larger domain of traditional medicines. It also demonstrates that, though legislative intervention into medicine was limited in nineteenth-century Bengal, colonial law did in fact intervene and shape the medical landscape. All this becomes more significant because the Sukaroo case appeared in legal reports of the time, and then was rapidly and widely incorporated into legal textbooks and even annotated versions of the Indian Penal Code, thereby becoming an important legal precedent. It has continued to feature in postcolonial legal textbooks in South Asia and beyond. This long legal shadow cast by the case highlights the ways in which colonial case law has shaped the modern lives of traditional medicines in South Asia. In particular, it demonstrates the long history of tacit assumptions denigrating subaltern therapeutics that have structured the institutionalized medical pluralism operating in contemporary India.","PeriodicalId":54659,"journal":{"name":"Osiris","volume":"36 1","pages":"89 - 112"},"PeriodicalIF":0.5,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1086/714222","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41376433","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"哲学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Emilie Cloatre, Nayeli Urquiza-Haas, Michael Ashworth
The practice of healing by anyone other than qualified doctors or pharmacists has been allegedly illegal in France since the nineteenth century. In this judicial order, the state delegated the power to oversee the boundaries of medicine to doctors and pharmacists, allowing them, with support from criminal courts, to determine which therapeutic techniques should remain their exclusive right. In practice, this apparently neat legal system was never clear-cut; therapists without medical qualifications continued to infringe upon spaces that doctors and pharmacists saw as their preserve, often carving out zones of juridical tolerance. In the 1980s and 1990s, negotiations over the legality or illegality of different kinds of healing intensified. Alternative therapies, such as acupuncture and herbalism, had gained in popularity and their practitioners were keen to negotiate a legal position that would make their work licit. While some succeeded, others got entangled in a new governmental framework that characterized alternative medicines as gateways to "sects." This article examines these developments and explains how new juridical techniques to govern certaintherapies arose in the 1990s. These operated through decentralized surveillance systems that enrolled new actors. These included agencies dedicated to monitoring sects; associations of victims; and individuals such as users, their families, or health professionals. Together, they aimed to "prevent" deviant behavior, thereby fostering what is today one of the most peculiar features of the way the French state regulates alternative healing, which it considers potentially "cult-like."
{"title":"Legalities of Healing: Handling Alterities at the Edge of Medicine in France, 1980s-2010s.","authors":"Emilie Cloatre, Nayeli Urquiza-Haas, Michael Ashworth","doi":"10.1086/713659","DOIUrl":"https://doi.org/10.1086/713659","url":null,"abstract":"<p><p>The practice of healing by anyone other than qualified doctors or pharmacists has been allegedly illegal in France since the nineteenth century. In this judicial order, the state delegated the power to oversee the boundaries of medicine to doctors and pharmacists, allowing them, with support from criminal courts, to determine which therapeutic techniques should remain their exclusive right. In practice, this apparently neat legal system was never clear-cut; therapists without medical qualifications continued to infringe upon spaces that doctors and pharmacists saw as their preserve, often carving out zones of juridical tolerance. In the 1980s and 1990s, negotiations over the legality or illegality of different kinds of healing intensified. Alternative therapies, such as acupuncture and herbalism, had gained in popularity and their practitioners were keen to negotiate a legal position that would make their work licit. While some succeeded, others got entangled in a new governmental framework that characterized alternative medicines as gateways to \"sects.\" This article examines these developments and explains how new juridical techniques to govern certaintherapies arose in the 1990s. These operated through decentralized surveillance systems that enrolled new actors. These included agencies dedicated to monitoring sects; associations of victims; and individuals such as users, their families, or health professionals. Together, they aimed to \"prevent\" deviant behavior, thereby fostering what is today one of the most peculiar features of the way the French state regulates alternative healing, which it considers potentially \"cult-like.\"</p>","PeriodicalId":54659,"journal":{"name":"Osiris","volume":"36 ","pages":"328-348"},"PeriodicalIF":0.5,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1086/713659","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9474754","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"哲学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Toward the end of the eighteenth century, African-derived spiritual practices glossed as “obeah” came to be intensely associated with pathologies of the imagination, first by British Caribbean slaveholders, and then much more widely by others. This article focuses on how early writings about, and legal regimes against, African Caribbean spirit work were shaped by theories of mind-body interaction during the final decades of British Caribbean slavery. Medical ideas about the powers of the imagination had played a key part in the decriminalization of “witchcraft” across Western Europe in the late seventeenth and early eighteenth centuries. This study examines how, conversely, medical theories of the imagination influenced the criminalization of obeah as a capital offense in British Caribbean colonies in the context of rising abolitionism and slave rebellion. I argue that the colonial association of obeah with imaginative pathology was used by slavery defenders to explain away high rates of slave mortality and to portray severe measures of social control as paternalistic. Reciprocally, the chapter points to how early writings about, and laws against, obeah informed theories of mental influence on bodily health during this period and thereafter.
{"title":"Powers of Imagination and Legal Regimes against “Obeah” in the Late Eighteenth- and Early Nineteenth-Century British Caribbean","authors":"K. Ramsey","doi":"10.1086/713926","DOIUrl":"https://doi.org/10.1086/713926","url":null,"abstract":"Toward the end of the eighteenth century, African-derived spiritual practices glossed as “obeah” came to be intensely associated with pathologies of the imagination, first by British Caribbean slaveholders, and then much more widely by others. This article focuses on how early writings about, and legal regimes against, African Caribbean spirit work were shaped by theories of mind-body interaction during the final decades of British Caribbean slavery. Medical ideas about the powers of the imagination had played a key part in the decriminalization of “witchcraft” across Western Europe in the late seventeenth and early eighteenth centuries. This study examines how, conversely, medical theories of the imagination influenced the criminalization of obeah as a capital offense in British Caribbean colonies in the context of rising abolitionism and slave rebellion. I argue that the colonial association of obeah with imaginative pathology was used by slavery defenders to explain away high rates of slave mortality and to portray severe measures of social control as paternalistic. Reciprocally, the chapter points to how early writings about, and laws against, obeah informed theories of mental influence on bodily health during this period and thereafter.","PeriodicalId":54659,"journal":{"name":"Osiris","volume":"36 1","pages":"46 - 63"},"PeriodicalIF":0.5,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1086/713926","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46085684","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"哲学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
In Costa Rica today, where the use of contraceptives is widespread, the most popular method is female sterilization. Notably, Costa Rica’s high rates of this surgery were attained in the context of a very restrictive legal framework for the provision of sterilization. Until 1999, when a presidential decree explicitly regulated and permitted sterilization for contraceptive purposes, only therapeutic sterilization was legally allowed (i.e., to prevent a woman who had a serious health condition from becoming pregnant). Between 1970 and 1999, successive governments and state judicial bodies were unwilling to resolve the legal status of voluntary contraceptive sterilization. Government bureaucracies and different judicial branches repeatedly bounced the legal problem back to physicians to resolve. In the uncomfortable position of having to respond to an increasing demand for the surgery, specialist physicians responsible for sterilization, and their professional association, created a regulatory legal framework that ostensibly restricted the practice while actually enabling it. The provisions established by the professional association dictated access to sterilization in the country for over two decades, and were acknowledged not only by the population but also by state institutions, including those charged with surveying and protecting legality. A kind of judicial surrogacy was created in Costa Rica, though this surrogate role was not one Costa Rican physicians ever wanted, or felt comfortable playing.
{"title":"Enabling Restrictions","authors":"M. Maxera","doi":"10.1086/713762","DOIUrl":"https://doi.org/10.1086/713762","url":null,"abstract":"In Costa Rica today, where the use of contraceptives is widespread, the most popular method is female sterilization. Notably, Costa Rica’s high rates of this surgery were attained in the context of a very restrictive legal framework for the provision of sterilization. Until 1999, when a presidential decree explicitly regulated and permitted sterilization for contraceptive purposes, only therapeutic sterilization was legally allowed (i.e., to prevent a woman who had a serious health condition from becoming pregnant). Between 1970 and 1999, successive governments and state judicial bodies were unwilling to resolve the legal status of voluntary contraceptive sterilization. Government bureaucracies and different judicial branches repeatedly bounced the legal problem back to physicians to resolve. In the uncomfortable position of having to respond to an increasing demand for the surgery, specialist physicians responsible for sterilization, and their professional association, created a regulatory legal framework that ostensibly restricted the practice while actually enabling it. The provisions established by the professional association dictated access to sterilization in the country for over two decades, and were acknowledged not only by the population but also by state institutions, including those charged with surveying and protecting legality. A kind of judicial surrogacy was created in Costa Rica, though this surrogate role was not one Costa Rican physicians ever wanted, or felt comfortable playing.","PeriodicalId":54659,"journal":{"name":"Osiris","volume":"36 1","pages":"181 - 199"},"PeriodicalIF":0.5,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1086/713762","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44506374","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"哲学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Focusing on colonial Algeria ca. 1890 to 1940, this article explores what Muslim intellectuals and ordinary people learned about microbes and how they responded to bacteriological medicine. Many Algerians feared invisible spirits (jinn) and sought the healing powers of saints and exorcists. Was it then permitted for Muslims to use French treatments and follow Pasteurian rules of hygiene? Specialists in Islamic law, other intellectuals, and unlettered villagers showed a persistent concern with these and other questions in the wake of colonial conquest and violence in Algeria, as novel techniques, therapeutics, and forms of epistemic authority were introduced, and new visions of religious orthodoxy and national revival were formulated. Examining writings across a range of genres and formats—including a treatise of independent juristic reasoning (ijtihad), questions and answers prepared by a mufti, popular petitions, newspaper articles, advertisements, poetry, and a cartoon—this article argues that Islamic tradition and law were integral to the emerging science and culture of microbes in early twentieth-century Algeria. While Islamic reformists sought to displace jinn theories of illness, other Algerian intellectuals and colonial officials found it convenient to explain germs in terms of jinn. Both French and Muslim elite men sought to combine religious law with hygienic advice to advance competing hegemonic projects targeted at the Muslim family, thereby attempting to displace women’s jinn-based practices.
{"title":"Of Jinn Theories and Germ Theories","authors":"Hannah-Louise Clark","doi":"10.1086/713657","DOIUrl":"https://doi.org/10.1086/713657","url":null,"abstract":"Focusing on colonial Algeria ca. 1890 to 1940, this article explores what Muslim intellectuals and ordinary people learned about microbes and how they responded to bacteriological medicine. Many Algerians feared invisible spirits (jinn) and sought the healing powers of saints and exorcists. Was it then permitted for Muslims to use French treatments and follow Pasteurian rules of hygiene? Specialists in Islamic law, other intellectuals, and unlettered villagers showed a persistent concern with these and other questions in the wake of colonial conquest and violence in Algeria, as novel techniques, therapeutics, and forms of epistemic authority were introduced, and new visions of religious orthodoxy and national revival were formulated. Examining writings across a range of genres and formats—including a treatise of independent juristic reasoning (ijtihad), questions and answers prepared by a mufti, popular petitions, newspaper articles, advertisements, poetry, and a cartoon—this article argues that Islamic tradition and law were integral to the emerging science and culture of microbes in early twentieth-century Algeria. While Islamic reformists sought to displace jinn theories of illness, other Algerian intellectuals and colonial officials found it convenient to explain germs in terms of jinn. Both French and Muslim elite men sought to combine religious law with hygienic advice to advance competing hegemonic projects targeted at the Muslim family, thereby attempting to displace women’s jinn-based practices.","PeriodicalId":54659,"journal":{"name":"Osiris","volume":"36 1","pages":"64 - 85"},"PeriodicalIF":0.5,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1086/713657","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45166160","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"哲学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
A major player in the political economy of pharmaceuticals in the Global South, and boasting a universal health care system, Brazil offers fertile ground for exploring the unanticipated ways people have mobilized for treatment access in contexts of stark inequality. In this article, I place the ever-evolving twin phenomena of the pharmaceuticalization and judicialization of health in a multilayered historical context: the post–World War II push for states to embrace the idea that their citizenry had a right to health, and Brazil’s particular embrace of a constitutional right to health in 1988; the turn of the World Health Organization (WHO) to essential medicines in the 1970s, and the responses of both governments and pharmaceutical companies in the ensuing decades; the advent of neoliberal forces as they swept the globe, landing in Brazil in the early 1990s; and the HIV/AIDS pandemic in Brazil with the government’s precedent-setting provision of lifesaving antiretroviral therapies in the late 1990s. This dynamic context sheds light on a bottom-up ethnographic inquiry of the ways the poor in Brazil have turned in increasing numbers over the last two decades to the courts to litigate access to medicines. Through their collective trust in the judiciary and their willingness to be a frontline force against the ill effects of neoliberalism, citizen-litigants are instantiating a kind of magical legalism, opening up new possibilities for the state to live up to its human rights and medical commitments. People’s quests for accountability reveal an ambitious vision of justice at a local scale and a distinct sense of politics in-the-making, even alongside a resurgent authoritarianism.
{"title":"The Pharmaceuticalization and Judicialization of Health","authors":"J. Biehl","doi":"10.1086/713426","DOIUrl":"https://doi.org/10.1086/713426","url":null,"abstract":"A major player in the political economy of pharmaceuticals in the Global South, and boasting a universal health care system, Brazil offers fertile ground for exploring the unanticipated ways people have mobilized for treatment access in contexts of stark inequality. In this article, I place the ever-evolving twin phenomena of the pharmaceuticalization and judicialization of health in a multilayered historical context: the post–World War II push for states to embrace the idea that their citizenry had a right to health, and Brazil’s particular embrace of a constitutional right to health in 1988; the turn of the World Health Organization (WHO) to essential medicines in the 1970s, and the responses of both governments and pharmaceutical companies in the ensuing decades; the advent of neoliberal forces as they swept the globe, landing in Brazil in the early 1990s; and the HIV/AIDS pandemic in Brazil with the government’s precedent-setting provision of lifesaving antiretroviral therapies in the late 1990s. This dynamic context sheds light on a bottom-up ethnographic inquiry of the ways the poor in Brazil have turned in increasing numbers over the last two decades to the courts to litigate access to medicines. Through their collective trust in the judiciary and their willingness to be a frontline force against the ill effects of neoliberalism, citizen-litigants are instantiating a kind of magical legalism, opening up new possibilities for the state to live up to its human rights and medical commitments. People’s quests for accountability reveal an ambitious vision of justice at a local scale and a distinct sense of politics in-the-making, even alongside a resurgent authoritarianism.","PeriodicalId":54659,"journal":{"name":"Osiris","volume":"36 1","pages":"309 - 327"},"PeriodicalIF":0.5,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1086/713426","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45193003","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"哲学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
The histories of patent law and medical practice in the United States have intersected in various ways over the past 150 years, beginning with the professional campaign against “patent medicines” in the late nineteenth century, and culminating, for now, in attempts to patent the diagnostic procedures discussed in this article. The patenting of diagnostic procedures provokes a set of fundamental questions about the episteme of patent law. These questions are not new. They emerged at the very origins of patent jurisprudence, centered on the question of what distinguished an invention from a law of nature, and this question of patentability has persistently reemerged over the past century in the contexts of plant breeding, biotechnology, and now diagnostic medicine. So far, the question has been addressed in terms that imagine the invention as a machine, understood in the figurative sense of a transformative organization of forces and elements. But diagnostic procedures, because they address the body informationally, as a system based on the recursive patterning of signals rather than a linear transformation of inputs into outputs, stretch the figure of the machine to the point at which it ceases to be effective. How then should one define and delimit invention?
{"title":"Patenting Personalized Medicine","authors":"M. Biagioli, A. Pottage","doi":"10.1086/713991","DOIUrl":"https://doi.org/10.1086/713991","url":null,"abstract":"The histories of patent law and medical practice in the United States have intersected in various ways over the past 150 years, beginning with the professional campaign against “patent medicines” in the late nineteenth century, and culminating, for now, in attempts to patent the diagnostic procedures discussed in this article. The patenting of diagnostic procedures provokes a set of fundamental questions about the episteme of patent law. These questions are not new. They emerged at the very origins of patent jurisprudence, centered on the question of what distinguished an invention from a law of nature, and this question of patentability has persistently reemerged over the past century in the contexts of plant breeding, biotechnology, and now diagnostic medicine. So far, the question has been addressed in terms that imagine the invention as a machine, understood in the figurative sense of a transformative organization of forces and elements. But diagnostic procedures, because they address the body informationally, as a system based on the recursive patterning of signals rather than a linear transformation of inputs into outputs, stretch the figure of the machine to the point at which it ceases to be effective. How then should one define and delimit invention?","PeriodicalId":54659,"journal":{"name":"Osiris","volume":"36 1","pages":"221 - 240"},"PeriodicalIF":0.5,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1086/713991","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43692110","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"哲学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
This article contributes to historiographies of forensic medicine by examining late twentieth-century women’s rights activism for new clinical standards on medical forensic exams for sexual assault (commonly known as “rape kits”). I argue that three features of these exams distinguish new standards of care from older practices in forensic medicine: the addition of specialized medical care to evidence-collection routines; attention to psychological trauma; and the creation of specific protocols to standardize, professionalize, and guide routine administration of the exam. To illustrate this shift, I follow “rape kit” protocols that emerged within nursing in the United States beginning in the 1970s, to their uptake and codification in international guidelines, to more recent attempts to adapt them for use in conflict zones. New clinical guidelines transformed the “rape kit” into an assemblage of instruments, medical routines, and new ways of thinking about sexual assault. The rape kit assemblage simultaneously became a traveling technology of care and a technology of governance and law. In practice, however, as new standards were implemented more widely, tensions between medical care and evidence collection emerged. At the intersection of law and medicine, distinct logics and assumptions came together, positioning not only medical and legal professionals, but also patients, in the unenviable liminal zone in which care and justice met and produced friction. This comes across clearly from an analysis of their use in the eastern region of the Democratic Republic of Congo, where mass rape had taken place. In this context, political turmoil and war conditioned the delivery of health care and, by extension, the liminal zone between medicine and law that standards for post-rape care occupy. Investigations of mass rape threatened to contravene confidentiality of medical records and expose health workers and patients to retaliation from suspects, renewing controversies surrounding the feasibility of aligning the institutional logics of medicine and law in this way.
{"title":"The Geopolitics of “Rape Kit” Protocols","authors":"Jaimie Morse","doi":"10.1086/713425","DOIUrl":"https://doi.org/10.1086/713425","url":null,"abstract":"This article contributes to historiographies of forensic medicine by examining late twentieth-century women’s rights activism for new clinical standards on medical forensic exams for sexual assault (commonly known as “rape kits”). I argue that three features of these exams distinguish new standards of care from older practices in forensic medicine: the addition of specialized medical care to evidence-collection routines; attention to psychological trauma; and the creation of specific protocols to standardize, professionalize, and guide routine administration of the exam. To illustrate this shift, I follow “rape kit” protocols that emerged within nursing in the United States beginning in the 1970s, to their uptake and codification in international guidelines, to more recent attempts to adapt them for use in conflict zones. New clinical guidelines transformed the “rape kit” into an assemblage of instruments, medical routines, and new ways of thinking about sexual assault. The rape kit assemblage simultaneously became a traveling technology of care and a technology of governance and law. In practice, however, as new standards were implemented more widely, tensions between medical care and evidence collection emerged. At the intersection of law and medicine, distinct logics and assumptions came together, positioning not only medical and legal professionals, but also patients, in the unenviable liminal zone in which care and justice met and produced friction. This comes across clearly from an analysis of their use in the eastern region of the Democratic Republic of Congo, where mass rape had taken place. In this context, political turmoil and war conditioned the delivery of health care and, by extension, the liminal zone between medicine and law that standards for post-rape care occupy. Investigations of mass rape threatened to contravene confidentiality of medical records and expose health workers and patients to retaliation from suspects, renewing controversies surrounding the feasibility of aligning the institutional logics of medicine and law in this way.","PeriodicalId":54659,"journal":{"name":"Osiris","volume":"36 1","pages":"200 - 218"},"PeriodicalIF":0.5,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1086/713425","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45939621","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"哲学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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