Karen-Sue Taussig: Ordinary Genomes: Science, Citizenship and Genetic Identities
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- Leonelli, S. Acta Biotheor (2012) 60: 319. doi:10.1007/s10441-012-9150-8
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Of the many contexts in which one might research the social significance of biological and biomedical knowledge and technologies, the contemporary landscape of national identities and cultures is perhaps the most challenging and the least documented. Historians of science have crafted penetrating analyses of how science and technology have and have been shaped by the politics, economics and specific social systems of European nation states, particularly France, Great Britain, Germany and of course the United States. Such analyses become more difficult and controversial when tackling contemporary national contexts, with their volatile politics, diverse social constituencies, complex international relations and ever-shifting layering of power and class.
Few scholars have dared to confront the nation as a unit of analysis in the social studies of science and technology, and those who did—like, most recently, Jasanoff (2005)—had to bear the brunt of critique from all corners of the humanities and social sciences, including sometimes justified complaints that such work tends to reify dangerous stereotypes of national culture by oversimplifying social trends on the basis of insufficient data. And yet, addressing the notion of national culture and its significance in our globalised and pluralistic social reality is a crucial task for scholars interested in understanding the social role of science and technology. STS scholarship has long argued that the social status, role and significance of scientific knowledge and technological artefacts is situated within specific local contexts, and thus cannot be assessed in any general or universalistic fashion. What is still far from being understood is how the local worlds of groups (or, to use a more fashionable term, networks) of actors intersect, fuse together and separate within specific national and international contexts.
Reaching a better understanding of the relation between national cultures and scientific knowledge is particularly urgent given the monolithic portrayal often given of science and technology, which emphasises the ‘neutral’ and ‘objective’ nature of scientific knowledge over the specific interests, politics and values that shape its development, use and social perception. This is where the discipline of anthropology, with its long history of methods and reflection devoted to analysing cultural specificity, comes to the rescue. Scholarship in the anthropology of science has provided wonderful studies of how differently scientific knowledge and artefacts—particularly knowledge concerning genetics and personalised medicine—are understood and used across the globe. Karen-Sue Taussig’s Ordinary Genomes: Science, Citizenship and Genetic Identities is another demonstration of how anthropology can be combined with the social studies of science and technology in order to reveal “the complex processes through which local culture and scientific and medical practices mutually engage, contest, and inform each other” (p. 16).
As one comes to see how embedded genetic knowledge and practices are in everyday life in the Netherlands, one realises that genetics cannot be extracted from its national and historical context (p. 16).
Each chapter provides convincing evidence towards this thesis.
The first two chapters introduce the reader to her research methods and to the history, values, current politics and medical infrastructure of the Netherlands. Taussig’s description of Dutch clinical genetics certainly stresses its place among the most advanced clinical structures in the world, both in terms of access to the public (thanks to the Dutch combination of private and public healthcare, their services are available to virtually all citizens who can be proven to need them) and in terms of its excellent infrastructure and resources (both in terms of expertise and in terms of instruments). The high status of Dutch clinical genetics is also linked to a widespread trust in the diagnostic value of genetics, demonstrated by the presence of genetic centres at each of the eight teaching hospitals in the country.
Chapters 3 and 4 follow closely how clinicians in these centres approach and discuss their patients. What is depicted here rarely strays from a representation of ‘best practice’, with teams of doctors meeting to discuss individual cases and constantly trying to improve and update their knowledge in order to help their patients. Indeed, Taussig shows no interest in critiquing the clinicians’ efforts to treat their patients. Rather, her goal is to tease out the extent to which social, religious, biological and geographical imaginaries meet in the production and use of genetic knowledge. Thus, in Chapter Three she examines how ‘ordinariness’ is assigned in clinical practice, resulting in a striking illustration of how mundane and scientific consideration are woven together in clinical discussions to the point of becoming indistinguishable. Chapter Four shows in more detail how assumptions about religious beliefs and behaviours associated to specific places in the Netherlands, particularly the so-called Bible Belt, influence clinicians’ assessments of patients.
It was imagined as a card that could facilitate what is now called personalised medicine – the idea that genetic knowledge could facilitate physician’s ability to tailor people’s medical treatment to the specifics of their genomes. At the same time, a new identity card with detailed information about a person’s biology raised the spectre of increased surveillance and social control (p. 8).
This coupling of promise and threat comes up again and again in Taussig’s examination of how genetic knowledge is used for clinical diagnosis. Curiously, Taussig chooses to discuss this in detail in the context of animal rights activism, as instantiated by the Dierenbescherming (a well-established civic organisation devoted to animal protection). She uses this case to explore yet another sense in which genetics is embedded in national history, that is the Dutch habit to associate genetic manipulation with eugenic practices in Nazi Germany, thus taking distance from it and potentially delegitimising it. (Although whether this habit is characteristic of the Netherlands, or common to several European countries, is a question that only a comparative, cross-European study can answer—a point that holds for several other arguments made in this book.) It is in the context of medical practice, however, that the Janus-faced nature of genetic knowledge seems to take on its most complex, multi-faceted form.
Genetic counselling is presented as a vehicle for values, interests and assumptions linked to the several overlapping identities of the people involved, ranging from their professional roles (patient versus doctor, clinician versus physician) to their religious affiliations, class, origins and location. Taussig’s insistence in showing us diversity and pluralism not only across different people, but within the same person, constitutes the strength of her study. At the same time, the emphasis on pluralism challenges the very notion of ‘national culture’ that Taussig set out to analyse. Her introduction presents a bold characterisation of Dutch culture, which she draws from her encounters and detailed interviews with several Dutch citizens, as driven by two fundamental values, which she calls ‘a desire for ordinariness’ and a ‘commitment to tolerance’ (p. 5).
As an Italian national who has lived in the Netherlands for 4 years, I can sympathise with Taussig’s perception of the uniqueness and relative coherence of Dutch culture, and I would agree that these values play a key role in shaping political and social discourse in the Netherlands. However, as Taussig herself makes clear, the battle between the value of tolerance and the call to ‘ordinariness’ has acquired an increasingly ominous political significance in the Netherlands, where the government is heavily engaged in the exercise of defining what count as ‘ordinary’ identity and values in the face of rising cultural pluralism. For instance, a major example of contemporary identity politics by the Dutch state is the “inburgeringsprogramma” (“citizenshipization programme”), which is targeted to non-European immigrants and aimed to develop and verify their familiarity with and respect for basic Dutch values. Setting up this programme involves crafting a specific interpretation of what counts as normal and of the limits of tolerance, which is rather at odds with the heated debates over the meaning of these very terms that regularly flood Dutch mass media. An anthropological examination of Dutch culture and its relationship to scientific knowledge needs to take these tensions and power struggles into account, and Taussig’s analysis is one step in the right direction. This book can be enjoyed by a wide readership, ranging from scientists interested in how the popular understanding and social study of biology can be crafted to any person with an interest in the relation between genetics and society. Readers, particularly if of Dutch nationality, might find themselves disagreeing with her analysis, or be pushed to further investigation of her claims—but fostering a much needed critical debate on the relation between national cultures and politics, medical infrastructures, perceptions of biological identity and the production of biological knowledge is precisely the task that this book has successfully set for itself.