Exploring and Supporting Articulation Work in the Molecularization of Cancer Care

• In Event: The Interpretive, Affective, and Ethical Work of Big Data in Health Care and Medicine - I

Abstract

As cancer diagnosis, monitoring and treatment becomes “datafied” with molecular information, practitioners and patients face new challenges of interpretation and decision-making. This, in turn, requires a range of articulation work (encompassing uncertainty-, boundary-, care- and body-work) in the clinic, the laboratory and beyond to make meaning and manage expectations. Drawing on a four-year ethnographic study of genomic medicine for cancer, this paper explores the nature of this work and its implications for patient and practitioner identities and responsibilities. We focus in particular on the gender and class dynamics of these practices in our analysis of how this work was performed in a series of case studies of patient and practitioner engagement with molecular profiling and targeted treatments for cancer. This raises a range of ethical questions about the intensification of articulation work required of researchers, patients and carers operating in conditions of precarity and limited resources which sit at odds with the more promissory discourses of precision medicine. We end by reflecting on what recognising and making time for this kind of work would means for efforts to transform healthcare institutions and mainstream big data in everyday health care.

Authors

• Anne Kerr, University of Leeds

• Julia Swallow, University of Leeds

• Choon Key Chekar, University of Leeds

• Sarah Cunningham-Burley, University of Edinburgh

• Emily Ross, University of Edinburgh

• Chowdhry Sue, University of Edinburgh