Looking back on the future of genetic counselling in Canada

This article focuses on how occupational roles and work relationships have changed over time for genetic counselling activities in Canada. It begins with a review of the stages of consensus that were reached about a role for geneticists and genetic counselling in clinical settings and, second, the formation of medical genetics as a service specialism. Interviews conducted by the author and survey data collected by the Canadian Association of Genetic Counsellors/L’Association Canadienne des Conseillers en Genetique are then used to examine role divarication in genetic counselling and the boundary realignment in inter-professional relations between physician and non-physician personnel involved in counselling activities. This leads, in a final step, to summarize what the research shows about the changing face of genetic counselling in Canada and directions for future historical investigation

Tracing the shifting sands of ‘medical genetics’: what’s in a name?

This paper focuses on the structural development of institution-based interest in genetics in Anglo-North American medicine after 1930 concomitantly with an analysis of the changes through which ideas about heredity and the hereditary transmission of diseases in families have passed. It maintains that the unfolding relationship between medicine and genetics can best be understood against the background of the shift in emphasis in conceptualisations of recurring patterns of disease in families from ‘biological relatedness’ to ‘related to chromosomes and genes.’ The paper begins with brief considerations of the historical confluences of, first, heredity and medicine and, second, genetics and medicine which, in a third section, leads to a discussion about a uniquely ‘genetics-based approach’ to medicine in the second half of the twentieth-century

The early history of medical genetics in Canada

This article shows that the intellectual and specialist movements that supported the growth of medical genetics in Canada between 1947 and 1990 were emergent phenomena, created, split, and reattached to different groups of actors, and reconfigured numerous times over the course of four decades. In each instance, new kinds of working relationships appeared; sets of diverse actors in local university-hospital settings coalesced into a new collectivity; and, as a collectivity, actors defined and/or redefined occupational roles and work rules. In its beginnings, medical genetics appears to be the object of a serious institutional manoeuver: a movement in support of the creation of examining and teaching positions in human genetics in North American medical schools. With time, the institutionalization of ‘medical genetics’ took hold, spurred on by changes in the rate and direction of service delivery associated with genetic consultation and laboratory services in clinical settings. Medical genetics in Canada consequently gained a semblance of unanimity over its basic reference points and arrived at a meaning directly tributary to current acceptance of the term

Professionalization theory, medical specialists and the concept of "national patterns of specialization"

Studies comparing particular medical specialties in different national settings have not appeared in the sociology of the professions literature. Consequently, little is known about how local contexts actually affect the professionalization process and medical specialization. Are certain determinants of specialization active in some countries and not in others? Can some determinants be said to be always active? Two recent independent studies of medical geneticists in, respectively, the UK and Canada present a unique opportunity to reflect on earlier social-theoretical discussions concerning the determinants of medical specialization in the context of country-specific organizational frameworks. Placed side-by-side, the two studies lend support to earlier research that emphasize, first, conceptual and technological innovations in medicine as driving specialty formation, and, second, the dominant position of physicians in the resulting division of medical labour. Beyond this, however, each study throws highlight on local influences as being important with respect to particular courses of action or inaction at the national and regional level. In the end, what appear to be coherent sets of diagnostic and counselling services from a unitary, global perspective can also be viewed as loose networks of resource dependencies, personnel, and organizations which can be re-configured within local health care delivery systems

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Ideas about heredity, genetics, and ‘medical genetics’ in Britain, 1900–1982

The aim of this paper is to understand how evolving ideas about heredity and genetics influenced new medical interests and practices and, eventually, the formation of ‘medical genetics’ as a medical specialism in Britain. I begin the paper by throwing highlight on the social and institutional changes through which these ideas passed. I argue that, with time, there was a decisive convergence in thought that combined ideas about the familial aspects of heredity and the health needs of populations with an omnibus ‘genetic’ approach to health and illness that focused on the structures and activities of chromosomes and genes in individuals. I show how this convergence in thought was spurred on, first, by innovations in genetic science and technology in the after 1960, and, second, by negotiated protocols and standards of medical practice worked out by bodies such as the relevant royal colleges, the linked associations and societies for medical professionals, affected training and research authorities, and the state. The notion of ‘medical genetics’ in Britain consequently gained a semblance of unanimity over its basic reference points and arrived at a meaning directly tributary to current acceptance of the term in the context of a medical specialism

Graphical and computationally intensive techniques for presenting and disseminating information about the genetics of disease: Possibilities, limitations, and additions

Exactly how genetic factors contribute to the onset of disease is not fully understood. All the same, information and images pertaining to genetics and disease remain arguably serviceable when they produce agreeable diagnostic, prognostic, and, ultimately, therapeutic results. This article begins with a historical survey of graphical techniques concerning hereditary disease. The article then goes on to show how information gathering and representation broadened steadily to accommodate genetic diagnostic tests. This leads, in a final step, to an examination of the capacity of computational genetics and genomics to generate working models of what causes disease. [PUBLICATION ABSTRACT

Synthesis, convergence, and differences in the entangled histories of cytogenetics in medicine: A comparative study of Canada and Mexico

Most historians of science and medicine agree that medical interest in genetics intensified after 1930, and interest in the relationship of radiation damage and genetics continued and expanded after World War II. Moreover, they maintain that the synthesis and convergence of human genetics and cytological techniques in European centers resulted in their dissemination to centers in the United States, resulting in a new field of expertise focused on medicine and clinical research, known as cytogenetics. In this article, we broaden the scope of the inquiry by showing how the early histories of cytogenetics in Canada and Mexico unfolded against strikingly different backgrounds in clinical research and the delivery of health care. We thus argue that the field of cytogenetics did not emerge in a straightforward manner and develop in the same way in all countries. The article provides a brief background to the history of human cytogenetics, and then outlines key developments related to the early adoption of cytogenetics in Canada and Mexico. Conclusions are then drawn using comparisons of the different ways in which local determinants affected adoption. We then propose directions for future study focused on the ways in which circuits of practices, collaborative research, and transfers of knowledge have shaped how cytogenetics has come to be organised in medicine around the world