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Alienation is among the most influential terms in Marxist theory, but also one of the most ambiguous and controversial. Unlike previous literature, which has tended to focus on Marx' early philosophical writings, this offers a novel reinterpretation of the theory of alienation found in Marx's later works. Rather than conceiving alienation as a subjective experience or an inherent feature of social organization, I contend that alienation in the Marxist sense can be understood as an objective process arising from the appropriation of the results of production and their transformation into capital. This interpretation resolves the main theoretical problems conventionally associated with alienation theory, for example the tendency towards essentialism and moral paternalism. In particular, a Marxist theory of alienation explains the paradox of social power and isolation that characterizes contemporary capitalist societies, in which feelings of powerlessness and loneliness are intensified despite objective increases in humanity's social power and interdependence.

AbstractMedical technologies of various kinds play an increasingly important role in medical treatment, but may also increase health inequalities if they are primarily used by high‐status patients. While many have problematised inequalities in the material access to medical technologies, differences in use and perception are also salient for explaining the relationship between medical technologies and health inequalities. This article attempts to theorise these inequalities by bringing health inequality research into dialogue with social constructivist perspectives on user‐technology relations. Based on qualitative interview data from a case study of the technological self‐management of type 1 diabetes, I construct three clusters of technological practices and perceptions corresponding to three broad user types. These user types are then discussed in the context of patient empowerment and the promotion of the active, autonomous and self‐reflective 'expert' patient in European health care systems. To the extent that they materialise and enforce institutional expectations which only the most resourceful patients will be able to live up to, medical technologies may serve to entrench and legitimate social inequalities in health and medical care. Research therefore needs not only to consider how medical technologies are distributed, but also their design and appropriation by users.

During the last decade, class analysis has been re-invigorated as a response to increasing economic inequality, social fragmentation and political unrest. Somewhat paradoxically, however, the perspective that has traditionally been most associated with class analysis – Marxism – has largely been absent from these debates. This article reconstructs Marxist class analysis by considering the previously unexplored relationship between social class and alienation. Incorporating insights from alienation theory, we argue, allows for an expanded conception of class that avoids economism while also retaining the distinctness of Marxist theory as compared to other approaches. Our central argument is that Marxist class analysis cannot be reduced to an explanation of economic inequality but must instead be seen as a struggle over the conditions of social development. We conclude by demonstrating the theoretical, empirical and political implications of our analysis and by arguing for a shift in the politics of class from inequality to unfreedom.