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Biomedical Ambiguity

Race, Asthma, and the Contested Meaning of Genetic Research in the Caribbean

Ian Whitmarsh

Publication Year: 2008

Steadily increasing numbers of Americans have been diagnosed with asthma in recent years, attracting the attention of biomedical researchers, including those searching for a genetic link to the disease. The high rate of asthma among African American children has made race significant to this search for genetic predisposition. One of the primary sites for this research today is Barbados. The Caribbean nation is considered optimal because of its predominantly black population. At the same time, the government of Barbados has promoted the country for such research in an attempt to take part in the biomedical future.

In Biomedical Ambiguity, Ian Whitmarsh describes how he followed a team of genetic researchers to Barbados, where he did fieldwork among not only the researchers but also government officials, medical professionals, and the families being tested. Whitmarsh reveals how state officials and medical professionals make the international biomedical research part of state care, bundling together categories of disease populations, biological race, and asthma. He points to state and industry perceptions of mothers as medical caretakers in genetic research that proves to be inextricable from contested practices around nation, race, and family.

The reader's attention is drawn to the ambiguity in these practices, as researchers turn the plurality of ethnic identities and illness meanings into a science of asthma and race at the same time that medical practitioners and families make the opaque science significant to patient experience. Whitmarsh shows that the contradictions introduced by this "misunderstanding" paradoxically enable the research to move forward.

Published by: Cornell University Press


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pp. 1-2

Title Page, Copyright

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pp. 3-6


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pp. 7-8

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pp. vii-x

...I am deeply indebted to the families in Barbados who welcomed me into their homes and lives. I thank these mothers and fathers for our interactions. Unfortunately, in order to retain their anonymity I cannot provide names or specify further the families and medical workers who helped me, but I will express particular appreciation to Michael, Suzanne, Harold, ...

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Introduction: Vernaculars in Race and Disease Science

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pp. 1-14

...The current search for a genetic basis for common illnesses—for example, diabetes, asthma, cancers, depression—is a focus on hereditary susceptibilities. The concept of “biological predispositions” competes with, and draws on, other ways of explaining disease, some more closely related (e.g., characteristics of the blood, “family history,” fate) than others (e.g., melancholia, ...

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1. Contestations of Race

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pp. 15-32

...Race is a thorny topic in American biomedicine today. As Morris Foster and Richard Sharp (2002) have argued, the Human Genome Project created interest in new applications of the relationship between genetic predispositions and race. A growing body of research attempts to link racial disparities in the prevalence and severity of diseases—for example, cancer, heart...

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2. The Nation as Biomedical Site

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pp. 33-55

...Barbados is a center of international genetics-of-disease research. The various studies have been conducted by academic and industry research teams based in the United Kingdom and United States, including, in particular, teams from Johns Hopkins University and State University of New York (SUNY) Stony Brook. The current research includes searching for genetic ...

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3. Asthma Variations

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pp. 56-68

...Asthma in Barbados has only recently taken shape as a diagnostic category through the focused attention of the pharmaceutical industry, bio-medical research, and the state. This (re)categorization has drawn on the multiple techniques and deep disagreements that have characterized American and British medical meanings of “asthma.” Before turning to the ways ...

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4. (Re)Categorizing Asthma and the Rational Pharmaceutical

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pp. 69-97

...Barbados has one of the highest levels of asthma of any country in the world, at 18–20 percent of the population, a number thought to be increasing sharply. The following is a story about what these numbers mean. Asthma diagnosis, treatment, and prevalence estimates all vary widely as different criteria—some traditional, some more recent as a result of...

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5. Biomedical Partnerships: Making Genetics Significant

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pp. 98-117

...The asthma genetics study is now one of several genetics projects in preparation or being conducted in Barbados by teams from Johns Hopkins University. The genetics of acute lung injury is being researched by a multisited U.S. collaborative effort that now involves a Barbadian researcher. A project on the genetics of obstructive sleep apnea is being conducted by a ...

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6. Misgivings in Medical Participation

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pp. 118-144

...Participation in the asthma genetics study involves allowing the genetics team or facilitators into the home to draw blood from all family members, collect dust samples, and conduct questionnaires, allergen skin prick tests, and a spirometry test. Because the study is longitudinal and extends into other areas (e.g., asthma severity), this process is repeated over the course ...

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7. Participant Mothers

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pp. 145-156

...Women are effectively the focal point for the genetics study: when children have an attack, the mother is usually the family member who takes them to the Accident and Emergency Department at the hospital for care, where recruitment into the study occurs. During subsequent enrollment, these women are also the primary source of getting extended family...

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8. Home Visit Translations

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pp. 157-182

...The following is a home visit experience reproduced from my field notes:We walk up to a house made of wood and concrete, resting on cement blocks, with sheets draped over the windows as window shades. As we enter the home, a woman in her mid-thirties greets us kindly but with watchful eyes—“Good morning,” she says. There are four of us: two Barbadian ...

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9. Biomedical and Anthropological Excesses

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pp. 183-190

...In the extensive conversations I had with families about dust, the category had a particularly vague valence. Early in my fieldwork, I continually tried to reduce this ambiguity by asking people to tell me the one or several components that make up this dust. I failed, and only belatedly came to realize that this vagueness was integral to the concept. Asthma specialists and ...


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pp. 191-204


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pp. 205-220


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pp. 221-226

E-ISBN-13: 9780801459931
Print-ISBN-13: 9780801446863

Page Count: 240
Publication Year: 2008

Edition: 1