Cover -- Immunization: How Vaccines Became Controversial -- Imprint Page -- Contents -- 1. What Do Vaccines Do? -- 2. Technologies: The First Vaccines -- 3. Technologies: Viral Challenges -- 4. Technologies: The Commodification of Vaccines -- 5. Policies: Hesitant Beginnings -- 6. Policies: Vaccination and the Cold War -- 7. Policies: Vaccination in a Globalizing World -- 8. The Roots of Doubt -- References -- Additional Reading -- Acknowledgements -- Index
AbstractThe 1950s and 1960s were a 'golden age' of medical progress: an era of high expectations, widespread faith, and life‐saving innovations. In the 1970s, as it gradually became clear that medicine's technological advance also contributed to the rising costs of health care, policy makers began to question the ways in which new technologies diffused. Sociologists soon found that professional and institutional interests, the search for competitive advantage, and processes of 'institutional isomorphism' played major roles. By the end of the millennium, as a result of growing patient (and 'health care consumer') activism, and of globalization, the context in which new technologies were developed, introduced, and used had become politicized, and technologies had become more heterogeneous. The patient perspective offered a new vantage point from which to study medical technology in use, and one which fitted many sociologists' normative and methodological commitments. Many recent sociological studies highlight failures, contradictions, and the (often concealed) interests involved in the promotion of new drugs and other medical technologies. However, resources for studies aligned with dominant interests, perspectives, and claims are more readily available.
L'auteur critique d'abord la perspective qui a prévalu jusqu'à aujourd'hui chez les sociologues Américains des sciences et plus particulièrement chez R. K. Merton et ses étudiants qui est de considérer les sciences comme un vaste sous-système social autonome : un certain nombre d'évidences empiriques (correspondance entre valeurs et normes de la science et valeurs politiques, base " particulariste " du système de récompenses, rôles politico-scientifiques des scientifiques des pays développés, politisation et syndicalisation des scientifiques, etc) montrent en effet que la prétention à l'autonomie est par trop inappropriée et ne peut se justifier à la lumière de ce que nous connaissons aujourd'hui. Il n'est donc pas possible au sociologue des sciences, principalement lorsqu'il étudie la science aux États-Unis ou dans d'autres pays occidentaux, d'ignorer l'influence des facteurs sociaux extrinsèques : son objectif premier est d'explorer les fonctions sociales comparables et changeantes de la science et de l'homme de science.
Development of the cochlear implant, discussed in this article, depended vitally on deaf people being persuaded to undergo implantation. Media "reconstruction" of the device as the "bionic ear" was typically encouraged by implant pioneers. Unexpectedly, however, a "counter-rhetoric" based on a very different understanding of deafness emerged. With it, deaf people are slowly succeeding in gaining influence over the further deployment of the technology. The analysis suggests modifications to existing theoretical models of technological change in medicine.
The process of technological change in obstetrics must be understood as contingent on the exigencies of the professional project, rather than in terms simply of improvement or dehumanization of care. Transformation in the procedures by which the female pelvis and the fetal head have been measured illustrate this point. The development of new measurement techniques was profoundly influenced by the shifting locus of obstetric care and by changing professional concerns, including the initial demarcation of a professional practice and subsequent debates about preferred modes of intervention.
