„JEG“ OG „VI“: ANTROPOLOGISK ENGAGEMENT I PERSONLIG MEDICIN Professor MSO, tiltrædelsesforelæsning, den 26. februar 2018

Ingen kan være i tvivl om den aktuelle relevans af personlig medicin i det danske samfund. Diskussionen har omhandlet regeringens forslag til den organisatoriske og etiske ramme for indhentning, opbevaring og brug af genomer i forbindelse med implementeringen af personlig medicin i det danske sundhedssystem. Omtalen af indhentning af genomer som „tyveri“ og italesættelse af projektet som „højrisikabelt“ sætter fingeren på diskussionens centrale problemstilling: at genomer både kan forstås som del af individet og del af velfærdsstaten – som en del af personens „jeg“ og kollektivets „vi“. Antropologi har meget at bidrage med, når det gælder relationen mellem person og kollektiv

Fortællinger om slægtskab i cancergenetisk rådgivning

Tilhører gener individet eller familien? Hvad betyder det at være genetisk forbundet? Der bliver stillet skarpt på forståelser af gener, krop og slægtskab, som de kommer til udtryk i forbindelse med cancergenetisk rådgivning og testning

Collaborative intimacies

Pigs and pig organs are frequently used prior to human trials in experimental transplant research into how to optimise human transplantation. But what exactly happens when transplant professionals perform experimental research on pigs? Similarly, what happens when a pig is on the surgical table? Based on ethnographic fieldwork in Danish transplant research laboratories, we investigate how pig experiments facilitate ‘collaborative intimacies’ among medical professionals. Collaborative intimacies are used here as an empirical and theoretical framework for conceptualising and re-imagining the social relationships between species and the medical disciplines that emerge in laboratory work. Collaborative intimacies in the lab provide medical training and facilitate moral reflection and social networking among transplant professionals. As such, we argue that research utilising animal models is not only about technological progress and ethical dilemmas; rather, collaborative intimacies make us understand how intimate relations among medical professionals in translational research unfold and how such relations matter for professional and technological futures

Patient-derived Organoids in Precision Oncology – Towards a Science of and for the Individual?

An interesting question for philosophy of science is how the “personal” gets constituted, scientifically as well as socially, through new technologies and practices in personalized medicine. A novel approach to better account for patient variation is to develop so-called tumor organoids based on tumor samples from individual cancer patients. Given their ability to recapitulate tumor heterogeneity, patient-derived models have been highlighted as breaking way for a “science of the individual” or a “one patient paradigm” in medicine. But to what extent is it possible – and desirable – for in vitro models to become “substitutes” for patients or patient types? To explore such questions, we combine philosophical and ethnographic analysis of laboratory research and clinical research practice. We analyze how epistemic uncertainties about the evidential status of organoids relate to ontological uncertainties about the nature of cancer itself, and document challenges of determining what level of variation is scientifically and clinically meaningful in personalized medicine. Moreover, we show how epistemic and ethical implications intersect when tumor organoids are attempted used for patient-specific drug screening. In this context, researchers and clinicians become stretched between the hopes of patients and epistemic uncertainty

Patient-derived Organoids in Precision Oncology – Towards a Science of and for the Individual?

An interesting question for philosophy of science is how the “personal” gets constituted, scientifically as well as socially, through new technologies and practices in personalized medicine. A novel approach to better account for patient variation is to develop so-called tumor organoids based on tumor samples from individual cancer patients. Given their ability to recapitulate tumor heterogeneity, patient-derived models have been highlighted as breaking way for a “science of the individual” or a “one patient paradigm” in medicine. But to what extent is it possible – and desirable – for in vitro models to become “substitutes” for patients or patient types? To explore such questions, we combine philosophical and ethnographic analysis of laboratory research and clinical research practice. We analyze how epistemic uncertainties about the evidential status of organoids relate to ontological uncertainties about the nature of cancer itself, and document challenges of determining what level of variation is scientifically and clinically meaningful in personalized medicine. Moreover, we show how epistemic and ethical implications intersect when tumor organoids are attempted used for patient-specific drug screening. In this context, researchers and clinicians become stretched between the hopes of patients and epistemic uncertainty

Postnatal consultations with an obstetrician after critical perinatal events:a qualitative study of what women and their partners experience

Objective The objective of this study was to explore women’s and their partners’ experiences with attending postnatal consultations with an obstetrician after critical perinatal events.Design Qualitative interview study. We did semi-structured individual narrative interviews exploring the lived experiences. Interviews were analysed using a phenomenological approach and the thematic analysis was validated by a transdisciplinary group of anthropologists, obstetricians and a midwife.Setting Department of obstetrics at a large hospital in Denmark.Participants We did a qualitative study with 17 participants (10 women and 7 partners) who had experienced critical perinatal events.Results Five major themes were identified: (1) a need to gain understanding and make sense of the critical perinatal events, (2) a need for relational continuity, (3) the importance of discussing emotional effects as well as physical aspects of occurred events, (4) preparing for future pregnancies and (5) closure of the story.Most of the participants emphasised the importance of knowing the obstetrician undertaking the postnatal consultation. The majority of the participants described a need to discuss the emotional effects of the experience as well as the physical aspects of occurred events. The postnatal consultation served as an approach to obtain a positive closure of their birth story and to feel confident about potential future pregnancies.Conclusions This interview-based study suggests that postnatal consultation with an obstetrician might be an important tool for women and their partners in understanding the course of events during the critical birth experience and in processing it and preparing for future pregnancies. It appears to be important to assign an obstetrician whom they already know and to encourage them to discuss not only physical aspects of what happened but also the emotional effects of the experience

Fra modermælk til donormælk: Forhandlinger af mælk, individ og velfærdskollektiv

Denne artikel udforsker de socio-materielle praksisser, der etablerer donormælk som en sikker substans, der kan cirkulere inden for det danske velfærdssamfund. Studiet tager afsæt i etnografisk feltarbejde i Kvindemælkcentralen på Hvidovre Hospital, hvor arbejdet med donormælk til danske neonatalafdelinger foregår. Det er en arbejdsplads med få ansatte, men med et slutprodukt, som er af livsvigtig karakter for præmature børn, hvis mødre ofte har svært ved at etablere en mælkeproduktion, særligt de første dage efter fødsel. Med inspiration fra ideen om multipel topologi samt antropologiske studier af forbundethed analyserer artiklen hvilke forhold, der gør udvekslingen af mælk fra donormødre til præmature børn mulig. På baggrund af interviews med personale, donormødre og mødre til for tidligt fødte børn viser vi, hvordan de ansatte i Kvindemælkcentralen arbejder med at præsentere donormælk som både en naturlig kropslig substans og et standardiseret produkt uden spor af donorens krop. Artiklen giver indsigt i donernes placering i et forpligtende fællesskab forvaltet af Kvindemælkcentralen og demonstrerer samtidig Kvindemælkcentralens centrale position i arbejdet med at hjælpe præmature og syge børn. Vi argumenterer for, at Kvindemælkcentralens ansatte forvalter, balancerer og afgrænser kontakten mellem donor og modtager - et arbejde, som gør det muligt for modermælk at cirkulere og forbinde nyfødte borgere til velfærdskollektivet

Interviewsamtale: Medicinsk Antropologi: Fra kanon til blæksprutte

Interviewsamtale om medicinsk antropolog