Book Review by Isobel Newby
Hansson, Kristofer and Rachel Irwin, editors. Movement of Knowledge: Medical Humanities Perspectives on Medicine, Science, and Experience. Nordic Academic Press, 2020.
Movement of Knowledge, edited by Kristofer Hansson and Rachel Irwin, is the result of a collaborative effort by the Cultural Studies Group of Neuroscience at Lund University. Indeed, multidisciplinary collaboration is an enduring thread throughout the book. Rooted in influential theories in the history of science, such as James Secord’s ‘knowledge in transit’ and Sheila Jasanoff’s ‘co-production of knowledge’, the essays in Movement of Knowledge find coherence through major cross-disciplinary themes such as communication, negotiation and, of course, collaboration. Each chapter successfully expands upon these central themes. Though its authors’ experiences in Swedish clinical contexts inform their reflections, the book presents a substantial contribution to international scholarship as similar knowledge transfers between practitioners, patients, publics and medias take place across much of the western world.
The book was published with the support of Bagadilico, a research consortium exploring new therapies for Parkinson’s disease, as well as Lund’s Child-Centred Care programme, which investigates the best support options for children with long-term illnesses. It is no coincidence, then, that two of the most compelling chapters consider ethical dilemmas within these two contexts: Markus Idvall advocates for patients living with Parkinson’s disease by discussing the dangers of reducing them to research subjects; Kristofer Hansson warns of the pitfalls of applying standardised knowledge to the lives of children diagnosed with diabetes through haemoglobin testing.
In keeping with its multidisciplinary perspective, Movement of Knowledge has a four-part structure and features contributions from eleven scholars representing diverse disciplines such as ethnology, anthropology, clinical practice, history of science – even art history. Part one, ‘Medical Knowledge and the Political’, introduces readers to the historical context behind prenatal diagnostic technologies, emphasizing the power of technologies and objects to explore the political and social ramifications of translating specialist medical knowledge into lay understandings. The field of neuroscience connects the essays in part two, ‘Circulating and Sharing Medical Knowledge’. Through interviews with researchers, they explore the “movement of knowledge” theme through various neuroscience experts and illuminate the media’s role both in translating the knowledge produced by neuroscientists and in stoking the public’s fascination with brain research. Part three, ‘Co-Creation of Medical Knowledge’, demonstrates the ways in which objective knowledge can be transformed into therapeutic methods and – crucially – how this knowledge is interpreted by patients. Specifically, the two essays cover the topics of informed consent and diabetes care, taking readers though the complex journey and negotiations involved in informed consent as well as the difficult process of translating scientific evidence into home-based diabetes care. Finally, part four, ‘Knowledge in Everyday Experience’, considers the impact of standardisation on home-based treatment, the utility of aesthetics as therapy and the exploitation of patient ‘empowerment’ on patients’ conceptions of their own health and illnesses. These are explored in turn through a demonstration of the power of 52mmol/mol as a blood-sugar goal for diabetic patients; ideas about reciprocity whilst experiencing art; and, finally, the too often harmful forms of alternative medicine.
Movement of Knowledge will best serve clinical practitioners interested in science communication because it opens up opportunities for self-reflection during dialogues with patients and their families. The final chapter by Rui Liu and Susanne Lundin has immediate relevance, with opportunities to ponder the role of digitalisation on knowledge transfer and the rise of alternative facts. Crucially, however, the authors succeed in their effort to understand rather than criticise the perspectives of different actors . Importantly, the book has the potential to improve patient outcomes because it offers useful evaluations on the ways in which medical knowledge can be translated and applied by various stakeholders, including patients themselves. Kristofer Hansson, Gabriella Nilsson and Irén Tiberg’s chapter on the complexities of implementing hospital homecare seems particularly pertinent to today’s global health context.
As the title suggests, my fellow scholars of medical humanities, sociologists of scientific knowledge, philosophers of science, and certainly ethnographers, will likely discover a chapter fit for their research needs. Although the book does not need to be read cover-to-cover, the richness of detail and expertise evident in each chapter might make the experience worthwhile. Ethnographic studies receive the most space. However, as an historian of science, I believe Movement of Knowledge is at its best when diving into the historical context surrounding important medical developments. Using Jasanoff’s theory of co-production, Anna Tunlid writes a compelling chapter, which shows how research, clinical and policy contexts interpreted prenatal diagnostic practice. Her discussion deals with societal themes that have persisted throughout history and still affect clinical practices today, including how medical genetics spawned eugenic ideas. She covers moral debates around disability and gender as well as how society defines ‘normal’ and ‘healthy’ individuals. For interdisciplinary researchers such as myself, Movement of Knowledge reaffirms the value of studying medical contexts that escape established academic classifications. More importantly, its essays demonstrate the potential role all stakeholders can have in improving care practices, handling clinical encounters, and the movement of medical knowledge itself.
Isobel Newby is a PhD candidate at the University of Leeds, in a Collaborative Doctoral Partnership with The National Archives. Her doctoral project explores the role of expertise in science policymaking during the BSE episode of the late 20th century.