Diversion and Globalization in Biomedical Technologies

Abstract

The intensification of transnational exchanges since the mid-twentieth century has contributed to the global diffusion of biomedical technologies and has shaped their histories in dramatic ways.These technologies became a central medium for a vast array of practices found in medical institutions worldwide, as well as a blurring agent of the boundaries between nature and culture (Lock and Nguyen 2010;Rheinberger 2000).However, technologies such as medical imaging, genetic testing, pharmaceuticals, and in vitro fertilization (IVF) are defined and embedded within normative frameworks consisting of both explicit and implicit rules, as exemplified by Bateman (2006).Manufacturers of technological devices, and their routine uses by biomedical practitioners, professional associations that take part in their conception, and national governmental and international bodies that play a role in their diffusion all draw on these frameworks.Once entangled with each other, these elements give birth to mainstream, albeit heterogeneous and fluctuating, uses of biomedical technologies.These technologies therefore recast medicine in a normative framework-or, as the articles in this issue show, a series of frameworks the norms of which vary along space and time, conditioning medical practice.This process has long been described as political, because it usually takes place in relation to central governing structures and entails remarkable transformations of therapeutic power.Not only medical knowledge and practice but also the possibility of a discourse on medicine, are thus subjected to a profound reorganization (Foucault 1963), involving the moral foundations of medicine and therapeutic power, as these concern values and the nature of right and wrong (Stengers 1997).Biomedical technologies have a normative dimension, the character of which is both political and moral (Murphy 2012).While many studies have drawn attention to the social, epistemological, and cognitive dimensions of contemporary changes in medicine, it is important to observe the moral inflection of these transformations (Fassin 2000).This is all the more true when speaking of norm-generating, ethically challenging biomedical technologies.The recent mass HIV infection in a small village area of northwestern Cambodia is a case in point (Fuller 2015).Dozens of people who were infected were treated by a village doctor who had his own take on the use and manipulation of medicines and syringes.For more than 20 years, his services were frequently sought after and he was considered a generous person.Today his nonstandard practiceinvolving the use of unsterilized syringes and sharing them amongst patients-is recognized as utterly damaging, and the 'doctor' is in jail, not only legally but also morally accused.Deviant uses and practices of biomedical technologies can heal or kill in unexpected ways and at unforeseen times.These technologies and their ambivalence have been widely studied (Bharadwaj and Glasner 2009;

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