HomeTreating the risk society?

Treating the risk society?

Soigner la société du risque ?

Clinical treatments, politics and the biomedicalization of prevention

Traitements, politiques et biomédicalisation de la prévention

*  *  *

Published on Friday, November 29, 2013 by Julie Abbou

Summary

This conference will explore the issues and practices of what might be called a clinical approach to risk in a diversity of medical situations. With this expression we refer to the new preventive management of populations that has emerged over the last thirty years, in which the clinic has been reestablished as center of practices and as obligatory point of passage for the policies targeting populations, aiming at the collective management of risks and at the preservation of public health. Participants will address the question of risk objectification, the tools, assemblages and means of interventions mobilized, the articulation between targeting individuals and managing populations, issues of biopolitics and biological citizenship.

Announcement

Argument

Historically, the concept of risk has been a central issue for health policies, as diseases have in industrial societies been among those hazards of life covered by insurances since the late 19th century. After World War II, managing health by way of risk has however become synonymous of epidemiological studies, identification of risk factors, and educational campaigns aimed at reducing exposure to risks. In this perspective, statistical objectification led to constitution of “at risk” populations, which were subjected to surveillance at a distance and were deemed responsible for their conducts. From the 1960s on, risk also took hold in medicine in another way: as a consequence of sanitary crises and of the growing attention paid to the sanitary effects of techno-industrial risks, from nuclear energy to polluting substances and pharmaceuticals. Risks were then objectified through new technologies such as cost-benefit-risk calculus. As health risks contributed to weakening traditional patterns of social stratification relying on classes and to the emergence of new ways of governing contemporary societies calling for increased reflexivity, health has become a privileged field for observers of the “risk society”.

However, the government of health through risk is no longer limited to these issues. Over the last twenty years, a new biomedicalization of prevention has emerged, targeting “embodied” risks. Control has been extended over biological entities – genetic predispositions, biochemical variations, cellular or morphological alterations – which are considered to be precursors of pathology or to be themselves a pre-disorder condition. In both cases, risk has been turned into a lesion or a condition, which become the targets of clinical intervention including biological tests, individual consultation, pharmacological or surgical treatments, and injunction to be autonomous. We may thus speak of a new preventive management of populations, in which the clinic has been reestablished as center of practices and as obligatory point of passage for the policies targeting populations, aiming at the collective management of risks and at the preservation of public health. The goal is thus not only the government of society through risk, or the government of the risk society, but also its treatment.

This situation has been well described and analyzed in the case of medical genetics. It has thus been demonstrated how embodied risks are now treated as diseases, creating among patients new relationships to medical interventions, to their own body and to their biographies, while health professionals face new uncertainties. But other segments of medicine are also concerned with the management of risk by way of treatment. It is the case of highly heterogeneous domains with attempts to control HIV or tuberculosis transmission by way of pharmacological therapies, to treat the risks of cardio-vascular pathologies or of addictive behaviors, or to design ways of “living with” exposures to environmental pollutions. More generally, the biomedicalization of risk might be at play in a diversity of situations where restorative interventions replace prevention over surveillance, such as preparedness in the management of infectious threats or in occupational health.

This conference will explore the issues and practices of what might be called a clinical approach to risk in a diversity of medical situations. Participants may address the question of risk objectification, the tools, assemblages and means of interventions mobilized, the articulation between targeting individuals and managing populations, issues of biopolitics and biological citizenship. Proposals dealing with one of the three following problems are especially welcome: treating risk as a disease; organizing the clinics of risk; population prevention through individual treatments.

Programme

Thursday, December 5th – Morning

  • 9.30 - Jean-Paul Gaudillière & Nicolas Henckes (CERMES3). Welcome and general introduction.

Keynote

  • 10.00 - Nikolas Rose (Department of Social Science, Health and Medicine - King’s College London) . Predictive, Preventive, Personalized – and Participatory? Psychiatry and the new rationality of medicine.

11.00-11.15 – Coffee

Risk as Pre-disease

  • 11.15 - Baptiste Moutaud (CERMES3). Constructing and intervening on patient risk: Controversies in the field of early psychosis
  • 12.00 - Isabelle Ville (CERMES3). Un arbitrage clinique : la gestion des risques en médecine fœtale

12.45-14.00 Lunch

Thursday, December 5th – Afternoon

Treating risks

  • 14.00 - Janina Kehr (Institute and Museum of the History of Medicine – University of Zurich). Risky treatments? Multiresistance and sacrificial populations in 21st Century Tuberculosis Control
  • 14.45 - Vinh-Kim Nguyen (Département de Médecine Sociale et Préventive de l’Université de Montréal). Exploring clinical reason today: the population-laboratory and the rise of the algorithm

15.30-15.45 – Coffee

  • 15.45 - Christoph Gradmann (Institute of Health and Society – University of Oslo). Stalking microbes : Infectious risks, hospital hygiene and the natural history of infectious diseases in the late 20th century.
  • 16.30-17.30 General discussion introduced by Soraya Boudia (LATTS – Université Paris-Est)

Friday, December 6th –Morning

Keynote

  • 10.00 - Robert Aronowitz (Department of History and Sociology of Science – University of Pennsylvania). The social and psychological efficacy of risk interventions

Managing risk, managing cancer

  • 11.00 - Carsten Timmermann (Centre for the History of Science, Technology and Medicine- The University of Manchester). Lung Cancer. Risk management and the making of a recalcitrant disease.
  • 11.45 - Ilana Lowy (CERMES3 – INSERM). A risky prevention: Tamoxifen and the reduction of breast cancer risk

Friday, December 6th – Afternoon

The clinic of risk

  • 14.00 - Marie-Jauffret (CERMES3 – INSERM). La gestion du risque dans le champ des addictions : Enjeux et tensions autour de la place du médicament.
  • 14.45 - Anne Lovell (CERMES3 – INSERM). Chronic risk and leaky treatments: Risks and stakes in biomedicalizing addiction

15.30-15.45 – Coffee

  • 15.45 - Adam Hedgecoe (School of Social Sciences – University of Cardiff). From risk to uncertainty. Genome sequencing and the clinic.
  • 16.30-17.30 – General discussion introduced by George Weisz (Department for the Social Study of Medicine – McGill University)

Places

  • Université Paris Descartes, salle Leduc - 45 rue des Saints Pères
    Paris, France (75006)

Date(s)

  • Thursday, December 05, 2013
  • Friday, December 06, 2013

Keywords

  • biomédicalisation, risque, XXe siècle, médecine préventive, biopolitique

Contact(s)

  • Nicolas Henckes
    courriel : henckes [at] vjf [dot] cnrs [dot] fr

Information source

  • Nicolas Henckes
    courriel : henckes [at] vjf [dot] cnrs [dot] fr

To cite this announcement

« Treating the risk society? », Colloquium, Calenda, Published on Friday, November 29, 2013, https://calenda.org/265841

Archive this announcement

  • Google Agenda
  • iCal