Tinkered care: Assembling Medicine Consumption in Grey Zones
Liu, Rui LU
(2023)
- Abstract
- The aim of this dissertation is to advance knowledge about care as situated practices within and beyond medical institutional settings. It addresses the phenomenon of substandard and falsified medical products, an issue that concerns state governments globally and organisations including the World Health Organization. While legal sanctions and technological innovation are strongly advocated to protect legal pharmaceutical markets, this study looks at ambivalences and ambiguities in the provision and experiences of health services.
By drawing on the concepts of assembling and tinkering, and using empirical data collected from care seekers, physicians and pharmacy staff, the analysis suggests that the individual agency of care... (More) - The aim of this dissertation is to advance knowledge about care as situated practices within and beyond medical institutional settings. It addresses the phenomenon of substandard and falsified medical products, an issue that concerns state governments globally and organisations including the World Health Organization. While legal sanctions and technological innovation are strongly advocated to protect legal pharmaceutical markets, this study looks at ambivalences and ambiguities in the provision and experiences of health services.
By drawing on the concepts of assembling and tinkering, and using empirical data collected from care seekers, physicians and pharmacy staff, the analysis suggests that the individual agency of care seekers is enacted and enabled in a context where an ability to adapt to a changing environment increasingly becomes a social norm. Medical professionals are well aware of people’s evolving medicine consumption, but find it challenging to respond to these changes. Furthermore, observations conducted at pharmacies suggest that, in this semi-institutional and semi-retail setting, medical authority is carefully managed through embodied and routinised engagement with store environments and by attuning to customers’ emotions. All these findings lead to a conceptualisation of care as a tinkered practice, with attentiveness and flexibility being two essential characteristics. However, tinkered care involves risks, especially in relation to medicine access and use.
Tinkered care: Assembling medicine consumption in grey zones provides an empirical account of health services as a multi-actor network. It adds knowledge to the spatial-temporal dimension of care practices and offers a conceptualisation of care as tinkered practices. It argues for a need for alternative understandings of care and health services other than institutionally scripted ones. (Less) - Abstract (Swedish)
- Avhandlingens syfte är att utveckla kunskapen om vård som en situerad praktik såväl inom som utanför den medicinska miljön. Avhandlingen problematiserar fenomenet med förfalskade och illegitima medicinska produkter, vilket är ett problem som angår mellanstatliga organisationer, som exempelvis WHO (Världshälsoorganisationen). Samtidigt som rättsliga sanktioner och teknologisk innovation förespråkas för att skydda den legala medicinska marknaden, visar studien på den ambivalens och tvetydighet som är inbegripna i olika hälsotjänster.
För att förstå en medicinsk verksamhet som en situerad och förhandlad praktik utvecklar jag begreppen ”assembling” och ”tinkering”. Det empiriska materialet för avhandlingen är insamlat med hjälp av... (More) - Avhandlingens syfte är att utveckla kunskapen om vård som en situerad praktik såväl inom som utanför den medicinska miljön. Avhandlingen problematiserar fenomenet med förfalskade och illegitima medicinska produkter, vilket är ett problem som angår mellanstatliga organisationer, som exempelvis WHO (Världshälsoorganisationen). Samtidigt som rättsliga sanktioner och teknologisk innovation förespråkas för att skydda den legala medicinska marknaden, visar studien på den ambivalens och tvetydighet som är inbegripna i olika hälsotjänster.
För att förstå en medicinsk verksamhet som en situerad och förhandlad praktik utvecklar jag begreppen ”assembling” och ”tinkering”. Det empiriska materialet för avhandlingen är insamlat med hjälp av etnografiska metoder och enkäter. För att besvara mina frågeställningar har jag befunnit mig hos tullen på Arlanda, på sjukhus och i apotek, jag har också träffat vårdsökande, läkare och apotekspersonal. I analysen visar jag att den individuella vårdtagaren befinner sig i ett komplext socialt sammanhang där förmågan att anpassa sig efter en föränderlig miljö mer och mer är betingat av sociala normer. Jag visar att flexibilitet och medvetenhet är två viktiga egenskaper för en ”tinkered practice”, vilket innebär risker i relation till tillgång och bruk av läkemedel.
Avhandlingen ger en empirisk inblick i hur vårdtjänster i dag formeras i ett nätverk av multipla aktörer. Avhandlingen bidrar med kunskap om den rumsliga och tidsliga dimensionen av vårdtjänster, den visar också hur vård är en ”tinkered practice”. Avhandlingen argumenterar för ett behov av alternativ förståelse av vård- och hälsotjänster utanför de traditionella institutionerna. (Less)
Please use this url to cite or link to this publication:
https://lup.lub.lu.se/record/c26b6478-76ee-4801-9af5-f94cf18e3135
- author
- Liu, Rui
LU
- supervisor
- opponent
-
- Professor Lindgaard Høyer, Klaus, University of Copenhagen
- organization
- publishing date
- 2023
- type
- Thesis
- publication status
- published
- subject
- keywords
- care practices, medicine consumption, tinkering,, grey zones, health services, medical professionals, substandard and falsified medical products, Sweden
- publisher
- Lund University (Media-Tryck)
- defense location
- U 203, Universitetsplatsen 2, 252 25 Campus Helsingborg
- defense date
- 2023-03-24 10:15:00
- ISBN
- 978-91-8039-549-6
- 978-91-8039-548-9
- project
- Service Studies Consumption
- language
- English
- LU publication?
- yes
- id
- c26b6478-76ee-4801-9af5-f94cf18e3135
- date added to LUP
- 2023-02-15 13:07:22
- date last changed
- 2023-12-05 02:44:10
@phdthesis{c26b6478-76ee-4801-9af5-f94cf18e3135,
abstract = {{The aim of this dissertation is to advance knowledge about care as situated practices within and beyond medical institutional settings. It addresses the phenomenon of substandard and falsified medical products, an issue that concerns state governments globally and organisations including the World Health Organization. While legal sanctions and technological innovation are strongly advocated to protect legal pharmaceutical markets, this study looks at ambivalences and ambiguities in the provision and experiences of health services. <br/><br/>By drawing on the concepts of assembling and tinkering, and using empirical data collected from care seekers, physicians and pharmacy staff, the analysis suggests that the individual agency of care seekers is enacted and enabled in a context where an ability to adapt to a changing environment increasingly becomes a social norm. Medical professionals are well aware of people’s evolving medicine consumption, but find it challenging to respond to these changes. Furthermore, observations conducted at pharmacies suggest that, in this semi-institutional and semi-retail setting, medical authority is carefully managed through embodied and routinised engagement with store environments and by attuning to customers’ emotions. All these findings lead to a conceptualisation of care as a tinkered practice, with attentiveness and flexibility being two essential characteristics. However, tinkered care involves risks, especially in relation to medicine access and use.<br/><br/>Tinkered care: Assembling medicine consumption in grey zones provides an empirical account of health services as a multi-actor network. It adds knowledge to the spatial-temporal dimension of care practices and offers a conceptualisation of care as tinkered practices. It argues for a need for alternative understandings of care and health services other than institutionally scripted ones.}},
author = {{Liu, Rui}},
isbn = {{978-91-8039-549-6}},
keywords = {{care practices; medicine consumption; tinkering,; grey zones; health services; medical professionals; substandard and falsified medical products; Sweden}},
language = {{eng}},
publisher = {{Lund University (Media-Tryck)}},
school = {{Lund University}},
title = {{Tinkered care: Assembling Medicine Consumption in Grey Zones}},
url = {{https://lup.lub.lu.se/search/files/137938560/Rui_Liu_WEBB.pdf}},
year = {{2023}},
}