Medicine, Health Care and Philosophy

, Volume 20, Issue 1, pp 89–103

Our genes, our selves: hereditary breast cancer and biological citizenship in Norway

  • Kari Nyheim Solbrække
  • Håvard Søiland
  • Kirsten Lode
  • Birgitta Haga Gripsrud
Scientifc Contribution

DOI: 10.1007/s11019-016-9737-y

Cite this article as:
Solbrække, K.N., Søiland, H., Lode, K. et al. Med Health Care and Philos (2017) 20: 89. doi:10.1007/s11019-016-9737-y
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Abstract

In this paper we explore the rise of ‘the breast cancer gene’ as a field of medical, cultural and personal knowledge. We address its significance in the Norwegian public health care system in relation to so-called biological citizenship in this particular national context. One of our main findings is that, despite its claims as a measure for health and disease prevention, gaining access to medical knowledge of BRCA 1/2 breast cancer gene mutations can also produce severe instability in the individuals and families affected. That is, although gene testing provides modern subjects with an opportunity to foresee their biological destiny and thereby become patients in waiting, it undoubtedly also comes with difficult existential dilemmas and choices, with implications that resonate beyond the individual and into different family and love relations. By elaborating on this finding we address the question of whether the empowerment slogan, which continues to be advocated through various health, BRCA and breast cancer discourses, reinforces a naïve or an idealized notion of the actively responsible patient: resourceful enough to seek out medical expertise and gain sufficient knowledge, on which to base informed decisions, thereby reducing the future risk of developing disease. In contrast to this ideal, our Norwegian informants tell a different story, in which there is no apparent heroic mastery of genetic fates, but rather a pragmatic attitude to dealing with a dire situation over which they have little control, despite having complied with medical advice through national guidelines and follow-up procedures for BRCA 1/2 carriers. In conclusion we claim that the sense of safety that gene testing and its associated medical solutions allegedly promise to provide proved illusory. Although BRCA-testing offers the potential for protection from adverse DNA-heritage, administered through possibilities for self-monitoring and self-management of the body, the feeling of ‘being in good health’ has hardly been reinforced by the emergence of gene technology.

Keywords

Biological citizenship Genetic testing Hereditary breast cancer Subjectivity Gender Norway 

Funding information

Funder NameGrant NumberFunding Note
Folke Hermansen Cancer Research Foundation
    Inge Steensland Foundation

      Copyright information

      © Springer Science+Business Media Dordrecht 2016

      Authors and Affiliations

      • Kari Nyheim Solbrække
        • 1
      • Håvard Søiland
        • 2
        • 3
      • Kirsten Lode
        • 4
      • Birgitta Haga Gripsrud
        • 5
      1. 1.Department of Health Sciences, Institute of Health and SocietyUniversity of OsloOsloNorway
      2. 2.Department of Breast and Endocrine SurgeryStavanger University HospitalStavangerNorway
      3. 3.Department of Clinical ScienceUniversity of BergenBergenNorway
      4. 4.Department of ResearchStavanger University HospitalStavangerNorway
      5. 5.Department of Health StudiesUniversity of StavangerStavangerNorway

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