Among bioethicists and members of the public, genetics is often regarded as unique in its ethical challenges. As medical researchers and clinicians increasingly combine genetic information with a range of non-genetic information in the study and clinical management of patients with common diseases, the unique ethical challenges attributed to genetics must be re-examined. A process of genetic routinisation that will have implications for research and clinical ethics, as well as for public conceptions of genetic information, is constituted by the (...) emergence of new forms of genetic medicine, in which genetic information is interpreted in a multifactorial frame of reference. Although the integration of genetics in medical research and treatment may be a helpful corrective to the mistaken assumptions of genetic essentialism or determinism, the routinisation of genetics may have unintended consequences for the protection of genetic information, perceptions of non-genetic information and the loss of genetic research as a laboratory for exploring issues in research and clinical ethics. Consequently, new ethical challenges are presented by the increasing routinisation of genetic information in both biomedical and public spheres. (shrink)

This article introduces the notion of ‘routinisation’ into discussions of informed consent. It is argued that the routinisation of informed consent poses a threat to the protection of the personal autonomy of a patient through the negotiation of informed consent. On the basis of a large survey, we provide evidence of the routinisation of informed consent in various types of interaction on the internet; among these, the routinisation of consent to the exchange of health related information. (...) We also provide evidence that the extent of the routinisation of informed consent is dependent on the character of the information exchanged, and we uncover a range of causes of routinisation. Finally, the article discusses possible ways of countering the problem of routinisation of informed consent. (shrink)

In this paper, the historical development of the clitic systems of Standard Modern, Cypriot and Pontic Greek is discussed. These three varieties not only present the whole range of variation one can find across clitic systems in Greek but, furthermore, derive from a common linguistic ancestor, i.e. Koine Greek. This paper argues that the transition from Koine Greek to the Medieval varieties and from the Medieval varieties to the respective modern ones can be explained by making the assumption that (...) class='Hi'>routinisation and parsing/hearer assymetries are two important factors behind syntactic change. The claim is that the transition from Koine to the Medieval Greek varieties involves the emergence of a clitic system with encoded syntactic constraints out of a freer one, where clitic positioning was regulated by pragmatic preferences rather than syntactic constraints. Then, the transition to the modern varieties from the respective medieval ones is explained, at least partly, on the assumption that production/parsing mismatches are capable of triggering syntactic change. This last assumption combined with: the tendency to obtain more generalised parsing triggers for parsing the individual clitics and the fact that the Medieval varieties in question differ in minimal but crucial ways, provides us an explanation for the transition to the modern varieties. (shrink)

Many ICT services require that users explicitly consent to conditions of use and policies for the protection of personal information. This consent may become ‘routinised’. We define the concept of routinisation and investigate to what extent routinisation occurs as well as the factors influencing routinisation in a survey study of internet use. We show that routinisation is common and that it is influenced by factors including gender, age, educational level and average daily internet use. We further (...) explore the reasons users provide for not reading conditions and policies and show that they can be grouped in meaningful ways that may delineate different types of routinsation. (shrink)

In the debate surrounding the introduction of non-invasive prenatal testing in prenatal screening programmes, the concept of routinisation is often used to refer to concerns and potential negative consequences of the test. A literature analysis shows that routinisation has many different meanings, which can be distinguished in three major versions of the concept. Each of these versions comprises several inter-related fears and concerns regarding prenatal screening and particularly regarding NIPT in three areas: informed choice, freedom to choose and (...) consequences for people with a disability. Three of the strongest arguments raised under the flag of routinisation are assessed for their validity: the threat that NIPT poses to informed choice, the potential increase in uptake of first-trimester prenatal screening and its consequences for social pressure to participate in screening or terminate affected pregnancies, and the negative consequences for disabled people. These routinisation arguments lack empirical or normative ground. However, the results of this analysis do not imply that no attention should be paid to possible problems surrounding the introduction of NIPT. At least two problems remain and should be addressed: there should be an ongoing debate about the requirements of informed choice, particularly related to an expanded scope of prenatal screening. Also, reproductive autonomy can only be achieved when expecting parents’ options are variegated, real and valuable, so that they can continue to choose whether or not to screen or to terminate a pregnancy. (shrink)

Genetic testing practices are increasingly advancing clinical medicine. This process of ‘routinisation of genetics’ has been conceived as a medical and ethical problem mainly because of the assumption that non-geneticists might lack the necessary skills to provide these services. In particular, the relevant theoretical knowledge in clinical genetics is viewed as insufficient in general practitioners and physicians from other specialities. Empirical findings seem to indicate significant variations not only in theoretical but also in practical knowledge between geneticists and non-geneticists. (...) Several fields of practical knowledge—regarding for example the focus of clinical action, the relevance of therapeutic action or the normative framework—can be identified that are or could be areas of conflict when the routinisation of genetic services proceeds. From an ethical point of view, these variations in know how and background are especially relevant whenever the respective genetic service is concerned with medical information of exceptional normative quality, such as, for example, in prenatal genetic screening and diagnosis of untreatable conditions. Here, the clinically acquired practical knowledge of the non-geneticist could be particularly misleading insofar as there is no relation to therapy and—in a narrow sense—no clinical utility to be assessed. Non-geneticists need a chance to acquire the relevant theoretical and practical knowledge in order to understand and fulfil their own duties in the respective situations in a way that secures the important rights at stake of their patients and clients. (shrink)

Cet article explore les voies par lesquelles le pourcentage s’est imposé dans les sciences du politique. D’abord utilisé dans le domaine financier, le pourcentage est incorporé, en 1662, par Graunt dans le champ des études de mortalité; au début du xix e siècle, il migre vers les études de croissance de la population, puis il gagne d’autres territoires pour devenir un outil d’application générale. Chaque migration s’inscrit dans le cadre de l’émergence d’une nouvelle problématique: « naissance de la mortalité » (...) dans un cas; « naissance de la population » dans l’autre. Le recours aux pourcentages apparaît ainsi comme un des éléments de la fondation de l’objectivisme statistique. (shrink)

Background Denmark has implemented a comprehensive, nationwide pharmaceutical information system, and this system has been evaluated by the Danish Council of Ethics. The system can be seen as an exemplar of a comprehensive health information system for clinical use. Analysis The paper analyses 1) how informed consent can be implemented in the system and how different implementations create different impacts on autonomy and control of information, and 2) arguments directed towards justifying not seeking informed consent in this context. Results and (...) Conclusion Based on the analysis a heuristic is provided which enables a ranking and estimation of the impact on autonomy and control of information of different options for consent to entry of data into the system and use of data from the system. The danger of routinisation of consent is identified. The Danish pharmaceutical information system raises issues in relation to autonomy and control of information, issues that will also occur in relation to other similar comprehensive health information systems. Some of these issues are well understood and their impact can be judged using the heuristic which is provided. More research is, however needed in relation to routinisation of consent. (shrink)

Notant d’un côté que la variabilité de la matière première empêche la routinisation et de l’autre, que les organisations imposent des protocoles de routine afin de contrôler le flux du travail, cet article explore deux questions liées : comment une organisation peut-elle traiter de manière routinière des événements inattendus? Comment les journalistes d’actualité font-ils décroître la variabilité des événements qui forment la matière première de l’information? L’article examine cinq classifications utilisées par les journalistes pour faire le tri parmi les (...) événements qui font l’actualité. En premier lieu, l’article analyse ces classifications en tant que « catégories » qui définissent ces événements. Cette approche se soldant par un échec, pour des raisons qui seront précisées, l’article examine ces mêmes classifications en tant que typifications. Cette dernière analyse montre à quel point la typification de la matière première est constituée par les exigences de la structure organisationnelle du travail d’information. Une attention particulière est prêtée aux problèmes pratiques liés au contrôle du travail. Les conséquences, pour les organisations produisant de l’information, de la manière dont un événement se produit sont également analysées. Certaines conséquences de l’analyse sont débattues. (shrink)

In highly routinised service encounter interactions, communication is often guided by service scripts that are the material embodiment of institutional expectations of how the service interaction is to be conducted. However, counter to common belief that scripted communication is well-controlled and homogeneous in its execution, observation of actual talk reveals interesting patterns and variations that reflect the ways in which participants make meaning of and perform their respective roles within the interaction towards achieving the overall goal of the service communication. (...) Applying the analysis of speech functions and sequential order of talk in audio-recorded verbal exchanges between servers and customers at the service counter of a fast-food restaurant, acts in the fast-food service interaction are interpreted and explained in relation to management-prescribed service script, servers’ script-in-use and customers’ script within an institutional discourse framework. Findings from the study have important implications for service management and training as it addresses the tension between the practices on the ground and those sanctioned by the organisation. (shrink)

In transformation research of late, accounts on the relation between intentionality and agency on the one hand, and the more routinised and structured side of social co-existence on the other, are increasingly nuanced. However, we observe a deficiency in the way arguments are set up by the interlocutors: both, scholars who grant intentionality a central role and those who emphasise its limitations generally do so at the level of ontology – debating degrees of human capacity for conscious planning versus a (...) largely unconscious reproduction. We wish to shift this question from an ontological to a pedagogical one, exploring possibilities to cultivate and learn intentionality. We do so by developing the concept of consciousness-in-nature that we derive from, and contextualise in, the traditions of deep ecology and (Westernised) Buddhism which both view human beings as inseparable from nature and one another. With consciousness-in-nature we refer to an understanding of humans as a part of nature that has developed the capacity for (self-) reflection and deliberation – a capacity that is not static or firm but can be nurtured and cultivated or clouded over and subdued. From this standpoint, we lay out an understanding of the role of (re)learning consciousness for processes of social change and explore potentials for its nurturing. (shrink)

Research ethics committees and institutional review boards spend considerable time developing, scrutinising, and revising specific consent processes and materials for survey-based studies conducted on crowdsourcing and online recruitment platforms such as MTurk and Prolific. However, there is evidence to suggest that many users of ICT services do not read the information provided as part of the consent process and they habitually provide or refuse their consent without adequate reflection. In principle, these practices call into question the validity of their consent. (...) In this paper we argue that although the ‘no read problem’ and the routinisation of consent may apply to research participants’ consent practices for studies on crowdsourcing platforms, this is not a serious problem. Furthermore, given that the informational requirements for informed consent in these contexts are minimal, we argue that these participants are, nevertheless, sufficiently informed to give valid consent. We conclude that research ethics committees and institutional review boards should only agonise over the precise details of the informed consent process and materials in those rare cases where appreciable risks to research participants need to be managed. (shrink)

Prenatal screening pathways, as nowadays offered in most Western countries consist of similar tests. First, a risk‐assessment test for major aneuploides is offered to pregnant women. In case of an increased risk, invasive diagnostic tests, entailing a miscarriage risk, are offered. For decades, only conventional karyotyping was used for final diagnosis. Moreover, several foetal ultrasound scans are offered to detect major congenital anomalies, but the same scans also provide relevant information for optimal support of the pregnancy and the delivery.Recent developments (...) in prenatal screening include the application of microarrays that allow for identifying a much broader range of abnomalities than karyotyping, and non‐invasive prenatal testing (NIPT) that enables reducing the number of invasive tests for aneuploidies considerably. In the future, broad NIPT may become possible and affordable.This article will briefly address the ethical issues raised by these technological developments. First, a safe NIPT may lead to routinisation and as such challenge the central issue of informed consent and the aim of prenatal screening: to offer opportunity for autonomous reproductive choice. Widening the scope of prenatal screening also raises the question to what extent ‘reproductive autonomy’ is meant to expand. Finally, if the same test is used for two different aims, namely detection of foetal anomalies and pregnancy‐related problems, non‐directive counselling can no longer be taken as a standard. Our broad outline of the ethical issues is meant as an introduction into the more detailed ethical discussions about prenatal screening in the other articles of this special issue. (shrink)

Newborn screening is the programme through which newborn babies are screened for a variety of conditions shortly after birth. Programmes such as this are individually oriented but resemble traditional public health programmes because they are targeted at large groups of the population and they are offered as preventive interventions to a population considered healthy. As such, an ethical tension exists between the goals of promoting the high uptake of supposedly ‘effective’ population-oriented programmes and the goal of promoting genuinely informed decision-making. (...) There is, however, a lack of understanding with regard to how parents experience the tension between promoting uptake and facilitating informed choice. This paper addresses this issue, and data are presented to show how aspects of the timing, presentation of information and procedural routinisation of newborn screening serves to impact on the decisions made by parents. (shrink)

Confucianism has attracted some attention in business ethics, in particular as a form of virtue ethics. This paper develops ideas about Confucianism in business ethics by extending discussion about Confucian ideas of ritual. Ritual has figured in literature about organisational culture, but Confucian accounts can offer additional ideas about developing ethically desirable organisational cultures. Confucian ritual practice has diverged from doctrine and from the classical emphasis on requirements for concern and respect as parts of ritual. Despite some differences of emphasis (...) amongst early writers, classical texts like the Analects and Mencius allow for the importance of ritual as opportunity for interpersonal encounter. These are texts that bring out the flexibility and context-sensitivity of ritual, with associated implications about the need for care and attention to other individuals. They eschew ritual as unthinking repetition, in favour of ritual as meaningful expression. The mutual awareness such ritual can engender is an important part of human existence. Such ritual is a means to solving coordination problems through common knowledge, as opposed to unthinking routine. Undue routinisation can be one problem with organisational ritual, while another can be use of ritual as a means of oppressive control. In organisations, ritual should satisfy general requirements of concern and respect, and should maintain opportunities for mutual encounter. The difference between arrangements which do or do not offer such opportunities may suggest lines of development for virtue ethics in business. (shrink)

In this paper, I approach the power of digital platforms by using the republican concept of domination. More specifically, I argue that the traditional, agent-relative interpretation of domination, in the case of digital domination, is best supplemented by a more radical version, on which republicans ought to give priority to structural elements. I show how radical republicanism draws attention to (1) the economic rationales and the socio-technical infrastructures that underlie and support digital platforms and to (2) the forms of influence (...) that are directed at cognitive dimensions, such as habituation and routinisation, which are particularly relevant for the power of digital platforms. These insights also imply that republicans have reason to favour a more structural response to digital platforms over more direct and individualised forms of control that fit with a ‘standard’ republican approach, such as securing exit options and requiring user consent. (shrink)

This article undertakes a critical analysis of the work of Gisèle Sapiro, with reference to sociology of literature. From 1999 (Sapiro, 2014a), Sapiro has developed the Bourdieusian research tradition, amplifying especially Bourdieu’s theory of crisis. Focusing on the antagonisms between literary “prophets” and “priests”, she has drawn on a rich sample of 184 writers to elucidate the struggles inherent in World War II between writers from different field positions and literary habitus. Further, her historical analyses of the ethical commitments of (...) nineteenth century writers via a fresh microsociology of literary trials (Sapiro, 2011) has reminded us of the importance of popular poets in articulating the suffering of the subordinate classes. Her most recent book (Sapiro, 2018) has expanded on her earlier themes, whilst identifying the recuperation of certain 1930s’ fascist worldviews within contemporary literature. This article notes that there is a telling divergence between Bourdieu and Sapiro on the issue of interests behind disinterestedness, exemplified in the case of Zola. On this issue, Sapiro’s reading (Sapiro, 2011) is found convincing. Finally, the dialectic of avant-garde consecration and routinisation is questioned as a universal structure. It is suggested that certain avant-garde – the Harlem Renaissance, for example – did not undergo swift consecration or routinisation, although this contention deserves greater research. The paper concludes by showing that Sapiro’s conception of writers’ responsibility owes its origins less to Sartre than to the Durkheimian/ Bourdieusian notion of the expertise of the “specific intellectual”. It welcomes Sapiro’s concern for literature as a potential force for social change. (shrink)

Prenatal screening pathways, as nowadays offered in most Western countries consist of similar tests. First, a risk-assessment test for major aneuploides is offered to pregnant women. In case of an increased risk, invasive diagnostic tests, entailing a miscarriage risk, are offered. For decades, only conventional karyotyping was used for final diagnosis. Moreover, several foetal ultrasound scans are offered to detect major congenital anomalies, but the same scans also provide relevant information for optimal support of the pregnancy and the delivery. Recent (...) developments in prenatal screening include the application of microarrays that allow for identifying a much broader range of abnomalities than karyotyping, and non-invasive prenatal testing that enables reducing the number of invasive tests for aneuploidies considerably. In the future, broad NIPT may become possible and affordable. This article will briefly address the ethical issues raised by these technological developments. First, a safe NIPT may lead to routinisation and as such challenge the central issue of informed consent and the aim of prenatal screening: to offer opportunity for autonomous reproductive choice. Widening the scope of prenatal screening also raises the question to what extent ‘reproductive autonomy’ is meant to expand. Finally, if the same test is used for two different aims, namely detection of foetal anomalies and pregnancy-related problems, non-directive counselling can no longer be taken as a standard. Our broad outline of the ethical issues is meant as an introduction into the more detailed ethical discussions about prenatal screening in the other articles of this special issue. (shrink)

On 17 May 2016 Lucy Welsh interviewed Annelise Riles about her work on the relationship between law and time as part of Welsh’s involvement with the AHRC Regulating Time network. Annelise Riles is the Jack G. Clarke Professor of Law in Far East Legal Studies and Professor of Anthropology at Cornell, and is Director of the Clarke Program in East Asian Law and Culture. Her work examines the transnational dimensions of laws, markets and culture across the fields of comparative law, (...) conflict of laws, the anthropology of law, public international law and international financial regulation. Most recently Professor Riles has been examining the nature and meaning of the settlement made on the so-called Comfort Women, and what impact that has for locating events in the past. The Comfort Women were Korean women who were essentially captured and forced to work as sexual slaves for the Japanese army during World War Two. In 2015, Japanese and South Korean ministers agreed a settlement in what they regarded as an irreversible and final settlement of the issue. Welsh and Riles exchange over their mutual interests in time and routinisation in this interview as they discuss what the story of the Comfort Women has to tell us. (shrink)

We examine pregnant women's experiences with routinised obstetric ultrasound as entailed in their antenatal care during planned pregnancies. This paper highlights the ambiguity of ultrasound technology in the constitution of maternal–foetal connections. Our analysis focusses on Australian women's experiences of the ontological, aesthetic and epistemological ambiguities afforded by ultrasound. We argue that these ambiguities offer possibilities for connecting to the foetus in ways that maintain a kind of unknowability; they afford an openness and ethical responsiveness irrespective of the future of (...) the foetus. This suggests that elucidating women's experience has implications for theorising ethics across maternal–foetal relations and, more specifically, for the ‘moral pioneering’ (Rapp, 2000) that reproductive technologies can demand of women. Moral pioneering cannot be reduced to moments or processes of decision-making; it must allow for greater recognition of the affective commitments entailed in and incited by ultrasound. Furthermore, focussing on experiences of the ambiguity of ultrasound allows for understanding the ways in which affectivity circulates across domains commonly understood as medical or social, public or private. In doing so, it contributes to undermining a series of tensions that currently shape feminist analysis of obstetric ultrasound, often at the expense of the experience of women. (shrink)

Background Non-invasive prenatal testing (NIPT), which can screen for aneuploidies such as trisomy 21, is being implemented in several public healthcare systems across Europe. Comprehensive communication and information have been highlighted in the literature as important elements in supporting women’s reproductive decision-making and addressing relevant ethical concerns such as routinisation. Countries such as England and France are adopting broadly similar implementation models, offering NIPT for pregnancies with high aneuploidy probability. However, we do not have a deeper understanding of how (...) professionals’ counselling values and practices may differ between these contexts. Methods In this paper, we explore how professionals in England and France support patient decision-making in the provision of NIPT and critically compare professional practices and values. We draw on data from semi-structured interviews with healthcare professionals. Results Both English and French professionals emphasised values relating to patient choice and consent. However, understandings and application of these values into the practice of NIPT provision differed. English interviewees placed a stronger emphasis on interpreting and describing the process of counselling patients and clinical care through a “principle” lens. Their focus was on non-directiveness, standardisation, and the healthcare professional as “decision-facilitator” for patients. French interviewees described their approach through a “procedural” lens. Their focus was on formal consent, information, and the healthcare professional as “information-giver”. Both English and French professionals indicated that insufficient resources were a key barrier in effectively translating their values into practice. Conclusion Our findings illustrate that supporting patient choice in the provision of NIPT may be held as an important value in common on a surface level, but can be understood and translated into practice in different ways. Our findings can guide further research and beneficially inform practice and policy around NIPT provision. (shrink)

Étudier les actes de requête dans les discours prononcés aux Nations Unies s’avère d’une utilité certaine dans le travail de caractérisation de ce sous-genre diplomatique. La formulation indirecte des actes de langage et les procédés linguistiques qui éloignent les sources potentielles de confrontation révèle des discours contraints par l’exercice de la « politesse », au service de l’impératif institutionnel de valorisation du consensus. Ces discours qui s’éloignent du fonctionnement du langage ordinaire transfèrent la prise en charge de l’énonciation aux États-membres (...) qui sont ici de véritables locuteurs et qui partant parlent en leur propre nom. L’on observe alors l’impact d’un contexte socio-discursif sur le fonctionnement de langue. Les requêtes formulées dans ces discours reflètent les problématiques qui préoccupent les États membres, puisque dans bien des cas, une requête peut être l’aveu d’un manque. Les verbes illocutoires donnent un bon aperçu des « façons de parler » et témoignent d’ores-et-déjà d’une routinisation des pratiques langagières. (shrink)

An expanding policy framework aimed at monitoring alcohol consumption during pregnancy has emerged. The primary justification is prevention of harm from what is termed ‘prenatal alcohol exposure’ (PAE), by enabling more extensive diagnosis of the disability labelled fetal alcohol spectrum disorder (FASD). Here we focus on proposals to include biomarkers as a PAE ‘screening tool’, specifically those found in meconium (the first newborn excrement), which are discussed as an ‘objective’ measure of PAE.We ask the overarching question, ‘Can routine screening of (...) meconium to establish PAE be ethically or legally justified’, and we answer, ‘No’. To reach this conclusion, we discuss three areas. First, we consider the reasons why meconium screening should not be deemed ‘typical’ within the scope of accepted screening tools. We argue that given the aim and necessary timing of the screen, it cannot achieve what it promises. Second, we outline why patient autonomy and consent are not properly accounted for and cannot be reconciled with the ‘routinisation’ of the proposed ‘screening’. Last, we outline why the benefit of such a screen is not clear, focusing on the significance of trust in healthcare professionals (HCP) for the best interests of the future child and pregnant woman.While recognising the adverse effects of heavy alcohol consumption during pregnancy, we emphasise the case for robust ethical, legal and social considerations and the central need for trust between HCP and patients in maternity care. We conclude the permissibility of meconium screening has not been proven, and it is not justified. (shrink)

Nous nous intéressons au dispositif d’écoute par webchat d’une association d’accompagnement de personnes en détresse. On se focalise sur certaines régularités du corpus, retenues en raison de leur fréquence, mais également, en raison de leur contribution à la compréhension du fonctionnement de cette pratique numérique et des enjeux de l’expression et de la co-construction de la souffrance dans ce dispositif. Ce webchat est analysé comme un dispositif spécifique de dévoilement de soi laissé à l’initiative de l’appelant mais alimenté par l’empathie (...) et l’humanité de l’écoutant. L’expression de cette empathie passe par une objectivité montrée fonctionnant comme forme de respect de la liberté de penser et d’agir de l’autre et par la routinisation, notamment l’analyse d’un patron discursif, qui amene le locuteur à quitter le champ des valeurs sociales collectives morales pour ce qui est bien, utile ou bon pour lui, individuellement. (shrink)

Admitting hospital patients: a qualitative study of an everyday nursing task In recent years new modes of nursing work have been introduced globally in response to radical changes in healthcare policies, technology and new ideologies of citizenship. These transformations have redefined orthodox nurse–patient relationships and further complicated the division of labour within health‐care. One distinctive feature of the work of registered nurses has been their initial assessment of patients being admitted to hospital, and it is of interest that this area (...) of nursing practice remains central to the registered nurse's role at a time where other areas of practice have been relinquished to other occupational groups. This qualitative study, drawing on conversation analysis and ethnographic techniques, explores this area of everyday nursing work. Initial nursing assessments have attracted considerable interest in the nursing literature, where it is clearly stated that assessments should be patient centred and seen as the important first step on the road to a therapeutic nurse–patient relationship. Results from this study lead to the conclusion that the actual nursing practice of patient assessment on admission to hospital is at odds with the recommendations of the literature and that a more routinised, bureaucratic form of work is devised by nurses as a means of expediting the process of admission. (shrink)

PurposeThe purpose of this paper is to profile everyday management and business strategies of 30 cyber cafés in Mumbai and contextualize them in the broader and pervasive culture of non‐formal economy.Design/methodology/approachThe paper conducts an ethnographic study of open‐ended interviews of cyber café owner/managers to understand everyday patterns of managing a cyber café. The field observations and literature review aid an understanding of non‐formal economy in Mumbai.FindingsThe paper finds three important insights: business with internet technologies, even at the level of a (...) small café, is expensive, requiring reasonable computing skills to maintain or expand business potential; in order to survive expense management several unauthorized practices are routinised and merge with the broader structures of non‐formal economy; and the non‐formality of business practices influence an open, liberal atmosphere to browse the internet and turn in a predominantly youth clientele.Research limitations/implicationsWith regulatory discourse on information and communication technologies centered on piracy and ill‐legality, informality of business practices in emerging economies provide an alternate premise to understand its nature and function. These challenge received notions of visualizing ICT as simply piracy and coming to terms with markets shaped and structured by non‐formal processes.Originality/valueThe study is one of the first on cyber cafés in Mumbai using the framework of non‐formal economy to analyse data. This paper presents the connections between a small ICT‐enabled business and the pervasive culture of non‐formal business relations in Mumbai. It also reports on the everyday organizational practices and client usages of internet cafés in India. (shrink)

In this paper we comment on the changes in the provision of fertility care in Australia, New Zealand and the UK to illustrate how different funding arrangements of assisted reproductive technologies (ART) shape the delivery of patient care and the position of fertility nursing. We suggest that the routinisation of in vitro fertilisation technology has introduced a new way of managing the fertility patient at a distance, the distal fertility patient. This has resulted in new forms of organisational routines (...) in ART which challenge both traditional forms of nursing and advanced nursing roles. We discuss the consequences of this increasingly globalised approach to infertility through the lens of three national contexts, Australia, New Zealand and the UK to unpack the position of nursing within the new forms of organisational routines. (shrink)

Developments in medical big data analytics may bring societal benefits but are also challenging privacy and other ethical values. At the same time, an overly restrictive data protection regime can form a serious threat to valuable observational studies. Discussions about whether data privacy or data solidarity should be the foundational value of research policies, have remained unresolved. We add to this debate with an empirically informed ethical analysis. First, experiences with the implementation of the General Data Protection Regulation (GDPR) within (...) a European research consortium demonstrate a gap between the aims of the regulation and its effects in practice. Namely, strictly formalised data protection requirements may cause routinisation among researchers instead of substantive ethical reflection, and may crowd out trust between actors in the health data research ecosystem; while harmonisation across Europe and data sharing between countries is hampered by different interpretations of the law, which partly stem from different views about ethical values. Then, building on these observations, we use theory to argue that the concept of trust provides an escape from the privacy-solidarity debate. Lastly, the paper details three aspects of trust that can help to create a responsible research environment and to mitigate the encountered challenges: trust as multi-agent concept; trust as a rational and democratic value; and trust as method for priority setting. Mutual cooperation in research—among researchers and with data subjects—is grounded in trust, which should be more explicitly recognised in the governance of health data research. (shrink)

Public debate around cultural diversity has been dominated by a focus on ‘panicked multiculturalism’ – those spaces which have been subject to social anxieties because of perceived conflicts around ethnicity. This article attempts to address the habitual ways cultural differences are transacted and reconciled in the daily conduct of people in culturally diverse settings. Although habit has been a central category for understanding racial prejudice, it has rarely impacted on an understanding of the practices and capacities which people develop for (...) living with difference, the routinised ‘civic virtues’ of intercultural life. Cosmopolitanism and conviviality have become significant tools in framing this enquiry, though not without problems. The issue for this article is whether these terms are methodologically useful for the analysis of the habits of ‘civic virtues’. This article, drawing on the everyday interactions in and around a school, argues that we need to conceptualise conviviality as an object of empirical research. This requires that we think about habit as a pedagogical process, and the temporal and spatial elements through which ‘cosmopolitan’ behaviours are habituated. (shrink)

À partir d’une approche anthropologique des prises en charge médicales de la tuberculose et du paludisme, ainsi que des conceptions et usages de la prévention dans des milieux urbains d’Afrique de l’Ouest , ce texte interroge la nature du métier de soignant. Après nous être penchés sur les spécificités de ce type d’étude anthropologique en milieu médical, nous nous attachons à décrypter les processus d’occultations des singularités du malade qui caractérisent les messages et discours de prévention. Dans les structures de (...) santé, sont étudiées les négociations des normes de diagnostic et de traitement à l’œuvre ; les attitudes des soignants qui oscillent entre sur- et sous-estimations des risques sanitaires ; et le hiatus entre la demande et les besoins réels de formations continues. Enfin, nous nous penchons sur la rencontre entre les soignants et les malades qui peut se trouver transformée par les spécificités de la maladie et de son traitement. On constate alors que les fondements de la professionnalisation tendent à disparaître au profit d’un mode de régulation du rapport au malade, au collègue et plus largement au savoir médical qui témoigne de l’émergence d’une culture soignante qui est, de fait, une culture organisationnelle. Elle se caractérise à la fois par la délégation des tâches à des non-professionnels, la production et la résolution des conflits mettant en évidence des réseaux clientélistes ainsi que par une routinisation des gestes.Drawing on an anthropological approach of tuberculosis and malaria care in West African cities , and on an analysis of prevention modes, this paper examines the characteristics of medical work. We first examined the conditions of an anthropological field study in health care centres. The concealment of both patients’ singularities and populations’ specificities targeted in the prevention messages were then studied. The negotiation of diagnosis and treatment standards, and the under- and over-estimations of nosocomial risks were also analysed. We also focused on the gap between demands and actual needs for training, and on the relationships between health care providers and patients, which can be modified by the specificities of the disease. We noticed a decay of professionalization, a kind of regulation of relationships between health care workers and patients, and among medical staff, which expresses an emerging medical culture, which is also an organizational culture. Its main features are the delegation of tasks to non-professionals workers, a strategy of conflict management based on clientelism, and the development of routine action. (shrink)

Radical innovations and practices frequentlyfind themselves in an inhospitable environment,struggling against the gravitational force ofdominant norms, practices and relations. Thispaper explores the problems radical changeconfronts in its attempts to become sustainable.Against the postmodern valorisation of thetransient and ephemeral, the paper argues forthe importance of routinisation and repetitionin the process of creating and sustainingchange. A metaphor of social pathways isdeveloped to explore how new routines arecreated through de jure (governance) andde facto (usage) means. The paper arguesthat, in contrast to governance, (...) the emergentdurability generated by usage enables routinesto outlive their conditions of existence.At the same time, routines at odds with theirsocial and institutional environment tend overtime to disappear. The second half of the paperdraws on four British attempts to introduce newpathways: lesbian and gay local governmentinitiatives, Conservative education reforms,Greenham Common Women's Peace Camp and LocalExchange Trading Systems (LETS). Through theseexamples, the paper reflects on attempts tocreate more conducive environments, and some ofthe difficulties this generates. (shrink)

This article explores the normative nature of institutions. The starting point of my investigation is Kahneman, Knetsch and Thaler's notion of the reference transaction from which I derive a recursive relationship between normative judgements and social practices (i. e. regular, routinised actions in a social group), an implication of which I call the "self-justification of practices". Drawing on John Dewey, I demonstrate how prevailing practices influence normative standards and thus how institutions become normative entities. I then show how, despite the (...) conservative bias of normative standards, institutional change comes about. Finally, I enquire into the possibility of normative critique of prevailing practices and institutions. (shrink)