Publications

NEW BOOK JUST OUT!

EDITED BY PROFESSOR SUSI GEIGER

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Chapter 1 – Geiger, Susi (2021) Healthcare Activism, Marketization, and the Collective Good.

Chapter 2 – Galasso, Ilaria and Geiger, Susi (2021): Preventing “Exit,” Eliciting “Voice”: Patient, Participant, and Public Involvement as Invited Activism in Precision Medicine and Genomics Initiatives

Prof Susi Geiger, Principal Investigator

Gross, Nicole and Susi Geiger (forthcoming): Choreographing for Public Value in Digital Health? Big Data & Society (UCD Highly Prestigious Journal, Impact Factor 8.5).

Epistemic and Institutional Recognition Work in Changing Conditions of Social Visibility: Anosmia’s Journey from the Shadows to the Spotlight.

Social Science & Medicine (ABS4, IF 5.4).

Bojovic, Neva and Susi Geiger (2023)

Abstract

This paper explores the complex relationships between recognition, collective action, and social (in)visibility of health conditions. We trace how collective action for recognition changes as conditions of visibility shift. We investigate how the Covid-19 global pandemic thrust one health condition (anosmia) and collective efforts around its recognition from almost complete public invisibility into a sudden spotlight. We show how ‘prepared’ movement actors leveraged this sudden hypervisibility to mobilize resources and change cultural values, noting how prior ‘recognition work’ becomes a resource for new ways to advocate for their condition’s recognition, toward epistemic and institutional recognition: from building a shared epistemic ground and improving relatability, toward resource distribution and finally, creating and institutionalizing new cultural values through policy change. Our findings highlight organizational efforts to mitigate community tensions and dispersions related to hypervisibility, through boundary and integration work.

Vulnerability and response-ability in the pandemic marketplace: Developing an ethic of care for provisioning in crisis

Geigers, Susi; Galasso, Ilaria; Hangel, Nora; Lucivero, Federica and Watts, Gemma (2023)

Journal of Business Ethics (FT50 Journal)

Abstract

This paper draws on the ethics of care to investigate how citizens grappled with ethical tensions in the mundane practice of grocery shopping at the height of the Covid-19 pandemic. We use this case to address the broader question of what it means ‘to care’ in the context of a crisis. Based on a qualitative longitudinal cross-country interview study, we find that the pandemic transformed ordinary shopping spaces into places fraught with a sense of fear and vulnerability. Being forced to face one’s own vulnerability created an opportunity for individuals to relate to one another as significant others through a sense of “response-ability”, or the capacity of people to respond to ethical demands through situated ethical reasoning. We argue for a practical ethos of care in which seemingly small decisions such as how often to go shopping and how much to buy of a particular product serve as a means to relate to both specified and generalized others—and through this, ‘care with’ society. Our study contributes to displacing the continuing prevalence of an abstract and prescriptive morality in consumption ethics with a situated and affective politics of care. This vocabulary seems better suited to reflect on the myriad of small and unheroic care acts in times of crisis and beyond.

Genetic research and the collective good: participants as leaders to reconcile individual and public interests

Galasso, Ilaria and Susi Geiger (2023)

Journal of Medical Ethics (UCD Highly Prestigious Journal)

Abstract

This paper problematises the notions of public or common good as weighed against individual sovereignty in the context of medical research by focusing on genetic research. We propose the notion of collective good as the good of the particular collective in which the research was conducted. We conducted documentary and interview-based research with participant representatives and research leaders concerned with participant involvement in leading genetic research projects and around two recent genetic data controversies: the case of the UK Wellcome Sanger Institute, accused of planning unauthorised commercialisation of African DNA samples, and the case of the company Genuity Science, which planned genetic research on brain tumour samples in Ireland with no explicit patient consent. We advocate for greater specificity in circumscribing the collective to which genetic research relates and for greater efforts in including representatives of this collective as research coleaders in order to enable a more inclusive framing of the good arising from such research. Such community-based participant cogovernance and coleadership in genetic research is vital especially when minorities or vulnerable groups are involved, and it centrally requires community capacity building to help collectives articulate their own notions of the collective good.

Affective resonance and durability in political organizing: The case of patients who hack

Vidolov, Simeon, Susi Geiger and Emma Stendahl (online first 2023)

Organization Studies, (AJG4 FT50 journal).

Abstract

We explore the role of affect in fuelling and sustaining political organizing in the case of an online type-1 diabetes community. Analysing this community’s interactions, we show that the drive towards political transformation is triggered by affective dissonance, but that this dissonance needs to be recurrently enacted through the balanced circulation of objects of pain and hope. We propose the notion of affective resonance to illuminate the dynamic interplay that collectively moderates and fosters this circulation and that keeps bodies invested and reverberating together around shared political goals. Affective resonance points researchers toward the fragile and complex accomplishment that affective politics represents. Focusing particularly on the community’s interactions on Twitter, we also reflect on the role of (digital) resonance spaces in how affects circulate. By adopting and transposing concepts from affect theories into the context of patient communities, we further add important insights into the unique embodied challenges that patients with chronic illness face. Highlighting the hope induced by techno-bodily emancipation that intertwine into a particular form of political organizing in such healthcare movements, we give emphasis to patient communities’ deeply embodied affects as important engines for political, social and economic change.

Covid-19, global solidarity, and the case for equitable vaccine distribution through technology transfers

Public Policy Paper on recent article in the journal Organisation

Nicole Gross & Susi Geiger (2023)

Abstract

The Covid-19 pandemic has highlighted the importance of health technologies to mitigate against the spread of the disease, but it has also demonstrated that the current biopharmaceutical business model, based on patented medicines and other technologies, leads to vast inequalities in healthcare particularly in low- and middle-income countries. We believe that the pharmaceutical industry has a duty to enable and enact global solidarity through technology sharing, but judging by current technology transfer practices, we question their willingness to assume their role in organizing healthcare markets through solidaristic principles. In the absence of a voluntary adoption of solidaristic practices by pharmaceutical firms, solidarity needs to be institutionalized as a fundamental organizing principle for global healthcare markets, particularly in times of health emergencies.

Breaching, Bridging, and Bonding: Interweaving Pathways of Social-symbolic Work in a Flanked Healthcare Movement.

Journal of Management Studies (FT50, AJG4*, IF 9.720)

Geiger, Susi and Emma Stendahl (2023)

Abstract

This article explores how heterogeneous and distributed forms of social-symbolic work combine over time to yield synergistic relationships that precipitate institutional change. We study a collective effort by patient activists to change the technological and regulatory standards of Type 1 diabetes care. We offer contributions to radical flank theory by conceptualizing radical and moderate flanks as dynamic and overlapping pathways of action rather than fixed actor positions, and we show how a medial ‘bonding’ pathway can provide important social glue to connect the radical and moderate flanks. While in our case the material and discursive ‘hacking’ work in the breaching pathway disrupted institutions, triggered technology innovation, and created momentum for change, material and relational ‘bridging’ embedded these efforts into existing institutional structures and longer-term innovation trajectories. Values and amplification work in the bonding pathway served to keep the two other pathways aligned over time. By addressing how a complex social problem – patient-centric innovation – may be affected through heterogeneous social-symbolic work that leads to institutional accommodation, our study holds considerable policy and societal relevance.

In the name of transparency: Organizing European pharmaceutical markets through struggles over transparency devices.

Organization Studies (AJG4 FT50 journal, IF 6.859)

Geiger, Susi and Theo Bourgeron (2023)

Abstract

The controversies surrounding the heavily redacted contracts between the European Commission and Covid-19 vaccine producers have highlighted ‘transparency’ as a hotly debated concept in the pharmaceutical market. We combine research on transparency with literature on the organization of markets to investigate how such struggles over competing visions of transparency end up shaping markets and their politics. Focusing on the case of the European pharmaceutical market, we demonstrate how market transparency was implemented through devices that enacted specific visions of transparency and produced distinct market organizations over time: transparency for states (until about 1990), transparency for corporations (ca. 1990 to 2010) and transparency for state coalitions (since 2010). We discuss how the specific instrumentations and materializations of such visions of transparency play a crucial role in market politics. This debate also highlights why engaging in controversies over transparency has become increasingly important for those contesting the market status quo – in pharmaceutical markets and beyond.

Emplaced Partnerships and the Ethics of Care, Recognition and Resilience.

Journal of Business Ethics (FT50 journal)

Ryan, A., Geiger, S., Haugh, H., Branzei, O., Gray, B., Lawrence, T., Creswell, T., Anderson, A., Jack, S., McKeever, E. (2023)

Abstract

The aim of the SI is to bring to the fore the places in which cross-sector partnerships (CSPs) are formed; how place shapes the dynamics of CSPs, and how CSPs shape the specific settings in which they develop. The papers demonstrate that partnerships and place are intrinsically reciprocal: the morality and materiality inherent in places repeatedly reset the reference points for partners, trigger epiphanies, shift identities, and redistribute capacities to act. Place thus becomes generative of partnerships in the most profound sense: by developing an awareness of their emplacement, CSPs commit to place, and through their place-based commitments produce three intertwined modalities of place-specific ethics that bind CSPs and place: ethic of recognition, an ethic of care, and an ethic of resilience. Our authors have found vivid examples of how emplaced CSPs embody these ethics, signaling hope for the sustainability of our (always hyper-local) life-worlds.

Tech sharing, not tech hoarding: Covid-19, global solidarity, and the failed responsibility of the pharmaceutical industry

Geiger, Susi & Gross, Nicole (2022)

Organization

Abstract

The Covid-19 pandemic has highlighted the importance of health technologies to mitigate against the spread of the disease and improve care, dominantly including life-saving vaccines. But the pandemic has also highlighted that the current biopharmaceutical business model, based on the enclosure of these technologies and on the immense accumulation of capital it enables, leads to vast inequalities in healthcare particularly in low and middle-income countries. We believe that the pharmaceutical industry has a moral duty to enable and enact global solidarity through tech sharing instead of tech hoarding, but judging by current technology transfer practices we question their willingness to assume their role in organizing healthcare markets through solidaristic principles. In the absence of a voluntary adoption of solidaristic principles and practices by biopharmaceutical firms, the institutionalization of global solidarity as a fundamental organizing principle for healthcare markets is necessary to strengthen resilience and know-how globally. With this call, we add to existing conceptualizations of solidarity by (a) introducing a global level of solidarity and (b) thinking through the concept not as an abstract humanistic stance but as a concrete organizing principle for global healthcare markets.

Global Access to Medicines and the Legacies of Coloniality in COVID-19 Vaccine Inequity

Geiger, Susi and Ciara Conlan (2022)

Policy & Practice, Vol. 34.

Abstract

This article, written by two members of the advocacy organisation Access to Medicines Ireland, analyses current discourses and practices around global COVID-19 vaccine distribution.  As vast imbalances in vaccination coverage continue to characterise global vaccine distribution, we argue that some of the public discourses and distribution mechanisms are coloured by a colonial legacy, which substitutes local capacity building in low and middle-income countries with donations, and substitutes a transparent public debate around how to tackle these inequalities with a discourse that explains them away through perpetuating such tropes as ‘vaccine hesitancy’ or ‘wastage’.  Even though such claims have been continually refuted by scientific evidence, the pharmaceutical industry and many high-income country governments keep reiterating them.  By dismantling such myths, we point to the legacies from which they have emerged.  Flagging the possibility of alternative discourses and practices in global health, we trace the recent history of the access to medicines movement.  We argue for a need to suspend intellectual property rights rules around COVID-19 health technologies through the so-called Trade-Related Aspects of Intellectual Property Rights (TRIPS) waiver, citing positive exemplars of vaccines developed through an open science paradigm as a counterpoint to the pharmaceutical industry’s claims that such a waiver would have chilling effects on the global pharmaceutical innovation system.  We close by highlighting development education opportunities around global access to medicines and universal healthcare.

Organizing the sharing economy through experiments: framing and taming as onto-epistemological work

Chimenti, Gianluca and Susi Geiger (2022)

Organization Studies

Prior work on performativity has illustrated how theories intervene in economic organizing. We expand this body of research by studying how concepts, and particularly those that are loosely defined and/or not widely understood, provoke their own realities through experiments. We examine how different experimental set-ups allow these concepts to be seized by a multitude of actors all wishing to instantiate worlds in their own interests, and how they potentially open up multiple competing realities as a result. We follow the concept of Mobility-as-a-Service as it mobilizes various experiments across public and private realms in Stockholm and Dublin, and we analyse how specific types of experiments co-produce epistemic and ontological work. Our results illustrate how different experimental designs can be conducive in taming and/or framing ambiguous concepts through interconnected processes of such onto-epistemological work. This highlights the distributed and relational but also the ‘provocative’ facets of performing ambiguous concepts through experiments. We discuss the consequences of these insights for how we think about scaling from experiments to broader socio-economic realities.

Anticipating hopes, fears and expectations towards COVID-19 vaccines: A qualitative interview study in seven European countries

Katharina Paul, Bettina Zimmermann, Paolo Corsico, Amelia Fiske, Susi Geiger, Stephanie Johnson, Janneke Kuiper, Elisa Lievevrouw, Luca Marelli, Barbara Prainsack, Wanda Spahl, IneVan Hoyweghen (2022)

Social Science and Medicine – Qualitative Research in Health

Abstract

Vaccine uptake is essential to managing the ongoing COVID-19 pandemic, and vaccine hesitancy is a persistent concern. At the same time, both decision-makers and the general population have high hopes for COVID-19 vaccination. Drawing from qualitative interview data collected in October 2020 as part of the pan-European SolPan study, this study explores early and anticipatory expectations, hopes and fears regarding COVID-19 vaccination across seven European countries. We find that stances towards COVID-19 vaccines were shaped by personal lived experiences, but participants also aligned personal and communal interests in their considerations. Trust, particularly in expert institutions, was an important prerequisite for vaccine acceptance, but participants also expressed doubts about the rapid vaccine development process. Our findings emphasise the need to move beyond the study of factors driving vaccine hesitancy, and instead to focus on how people personally perceive vaccination in their particular social and political context.

COVID-19 and techno-solutionism: responsibilization without contextualization?

Luca Marelli, Katharina Kieslich & Susi Geiger (2022)

Critical Public Health

We are delighted to act as the Special Section Editors for a subsection of the papers in this Special Issue on public health and COVID-19. The three papers in question emanate from the same large, multinational research project – Solidarity in Times of Pandemics or SolPan – a project that has sought to study the motivations and values underpinning people’s practices as they cope with and reflect on the political, economic, and sociocultural impacts of the pandemic. Putting the participants’ voices at the centre, the three papers in this Special Section highlight different and complementary citizens’ perspectives on the implementation of technologies to alleviate the spread of COVID-19….

 

Democratic research: Setting up a qualitative, comparative and longitudinal interview study during the COVID-19 pandemic

Zimmermann B., Wagenaar H., Kieslich K….Galasso Ilaria, Geiger, Susi, Vidolov, Simeon et al. (2022) Social Science and Medicine – Qualitative Research in Health.

Abstract

The sudden and dramatic advent of the COVID-19 pandemic led to urgent demands for timely, relevant, yet rigorous research. This paper discusses the origin, design, and execution of the SolPan research commons, a large-scale, international, comparative, qualitative research project that sought to respond to the need for knowledge among researchers and policymakers in times of crisis. The form of organization as a research commons is characterized by an underlying solidaristic attitude of its members and its intrinsic organizational features in which research data and knowledge in the study is shared and jointly owned. As such, the project is peer-governed, rooted in (idealist) social values of academia, and aims at providing tools and benefits for its members. In this paper, we discuss challenges and solutions for qualitative studies that seek to operate as research commons.

Leaning in or falling over? Epistemological liminality and the knowledges that make a market

Geiger, Susi & Gross, Nicole (2022)

Journal of Cultural Economy

Abstract

This article describes the experiences of two market studies scholars who became involved in an Applied Research Centre aimed at developing a societally valuable market in digital health – an experience that ended in failure. We introduce the concept of epistemological liminality as a theoretical tool to problematise our own positionality as ‘market experts’ in this failed academic-industry-government collaboration around a concerned market. Liminality involved entering a transitional space–time in which our academic knowledge as market studies scholars was suspended, but where we failed to successfully move into a new epistemic space of ‘applied market studies’. This state of suspension – and frustration – is a cautionary tale for the difficulties of linking different (and often contradictory) epistemic communities that meet in applied research. We stop short of providing a moral to this market (non)performance tale, but we do highlight the need for openness and debate on the knowledges that come together to make a market in such collaborations.

An analysis of the institutional landscape and proliferation of proposals for Global Vaccine Equity for COVID-19:Too Many Cooks or too many Recipes?

Geiger, Susi & McMahon, Aisling (2021)

Journal of Medical Ethics.

Abstract

This article outlines and compares current and proposed global institutional mechanisms to increase equitable access to COVID-19 vaccines, focusing on their institutional and operational complementarities and overlaps. It specifically considers the World Health Organisation’s (WHO) COVAX model as part of the ACT-A initiative, the WHO’s COVID-19 Technology Access Pool (C-TAP) initiative, the proposed TRIPS intellectual property waiver, and other proposed WHO and World Trade Organisation (WTO) technology transfer proposals. We argue that while various individual mechanisms each have their specific merits – and in some cases weaknesses – overall, many of these current and proposed mechanisms could be highly complementary if used together to deliver equitable global access to vaccines. Nonetheless, we also argue that there are risks posed by the proliferation of proposals in this context, including the potential to disperse stakeholder attention or to delay decisive action. Therefore, we argue that the relevant institutions and in particular the WHO and the WTO must be clearer in how various proposed mechanisms could interlink and work together to achieve global vaccine equity. Alongside this, there is now also a clear need for concerted global multilateral action to recognise the complementarities of specific individual models proposed and to provide a pathway for collaboration in attaining global equitable access to vaccines. The institutional infrastructure or proposals to achieve this amply exists at this point in time – but much greater co-operation from industry and clear, decisive and co-ordinated action from States and international organisations is urgently needed.

 

Markets and institutional fields: foundational concepts and a research agenda

Mountford, Nicola & Geiger, Susi (2021)

Springer

Abstract

We borrow the notion of field from institutional theory to think through how markets and their ‘outsides’–or at least one particular manifestation of an ‘outside’–stand in a dynamic and interactive relationship. We distinguish the field and the market in terms of issues versus exchange and identity versus position. We argue that the lack of clarity as to how fields and markets differ, relate, overlap, and are bounded, jeopardizes our ability to address important societal debates concerning the roles of markets within and across other areas of social life. It also hinders a consolidation of insights across different approaches to studying markets, even though researchers from different disciplines often address similar concerns. Key questions for which both conceptual and analytical clarity are essential include how markets and their ‘outsides’ (here: fields) intersect; whether and how diverse sets of actors interact, work, and migrate between fields and markets; and what dynamics may be observable between field and market. We provide four illustrative examples of field/market relationships and a theoretical, methodological, and empirical research agenda for future research into markets and their ‘outsides’.

Market mash ups: The process of combinatorial market innovation

Geiger, Susi & Kjellberg, Hans. (2020)

Journal of Business Research

Abstract

This paper investigates market innovation that takes place at the intersection of previously weakly connected markets. Based on a longitudinal study of the development of the digital therapeutics market, we delineate the concept of combinatorial market innovation as a market innovation process that is characterized by the deliberate synthesis of market subprocesses from two (or more) existing markets. We develop a conceptualization of combinatorial market innovation related to five market subprocesses (configuring exchange agents, qualifying offerings, fashioning modes of exchange, generating market representations, and establishing market norms). Focusing on how these processes interact, we identify three distinct types of intertwinement – sequential interrelationmutual reinforcement, and interference. We also reflect on the need for market innovation studies to more strongly consider overlaps and adjacencies between markets and market systems.

Duos and duels in field evolution: How governments and interorganizational networks relate

Mountford, Nicola., & Geiger, Susi. (2020)

Organization Studies41(4), 499-522

Abstract

We live in an era where models of governing are changing rapidly under multifaceted evolutionary pressures and where, at the same time, organizational fields are becoming increasingly networked. With this paper, we add to the field dynamics literature, focusing on the space where these evolutionary pressures coincide – the interactions of Governments and interorganizational networks. We examine the roles that interorganizational networks play in relation to Government actors under particular long- and short-term institutional and governance conditions. We articulate four roles that networks may play in relation to Government: advocate, technology, judge and ruler. We argue that long-term institutional logics, combined with short-term Government action in response to a particular field evolution, may predict the role that the interorganizational network will assume in relation to Government in that particular field scenario. We discuss flows through the typology as conditions change and we conclude by presenting an agenda for future research in the field dynamics and interorganizational networks research domains that leverages our proposed network role typology.

Silicon Valley, Disruption and the End of Uncertainty

Geiger, Susi. (2020)

Journal of Cultural Economy 13:2, 169-184,

Abstract

This paper reflects on the relationship between high-tech disruption narratives and uncertainty. My main argument is that an economic sociology of the future is incomplete without addressing the ‘demonic’ or rather eschatological elements apparent in the promissory twin rhetoric of disruption and inevitability that a number of contemporary technology firms employ. The conjuring up of liberatory high-tech futures implicates a political-philosophical perspective of the end game. It utilizes at once the productive power of uncertainty to create visions of ‘absolute riches’ and societal gain but at the same time narrows these futures down to one inevitable alternative to the status quo. Through the examples of two Silicon Valley disruptor firms, I argue that these eschatological narratives need to be opened to social scientific critique in order to examine their potential societal consequences above and beyond the narrow geographic confines of ‘the Valley.’

A tidal wave of inevitable data?
Assetization in the consumer genomics testing industry

Geiger, Susi – University College Dublin, 
Gross,Nicole – National College of Ireland
(2020)

Business & Society

Abstract

We bring together recent discussions on data capitalism and bio-capitalization by studying value flows in consumer genomics firms – an industry at the intersection between healthcare and technology realms. Consumer genomics companies market genomic testing services to consumers as a source of fun, altruism, belonging and knowledge. But by maintaining a multisided or platform business model, these firms also engage in digital capitalism, creating financial profit from data brokerage. This is a precarious balance to strike: If these companies’ business models consist of assetizing the pool of genomic data that they assemble, then part of their work has to revolve around obscuring to consumers any uncertainties that would potentially impinge on these processes of assembly. We reflect on the nature of these practices and the market relationships that enable them, and we relate this reflection to debates around alternative market arrangements that would potentially mitigate the extractive tendencies of these and other digital health firms.

Market Failures and Market Framings:  Can a Market be transformed from the inside?

Geiger, Susi and Gross, Nicole (2018):   
Organization Studies v39 (10) pp 1357 – 1376.

Abstract

How do actors innovate markets in cases of perceived market failures? This paper’s aim is to examine what happens when a market is innovated or, as we call it, ‘redevised’ in situations where public and commercial interests significantly diverge. Market devices can serve an important function in such attempts to innovate markets: they are material and/or social arrangements that are put into place to shape the market in question in certain ways. But can such devices really transform a market from within? To examine this question we trace the history of the Geneva Medicines Patent Pool, a civil society initiative introduced to change pharmaceutical firms’ licensing and collaboration practices in the market for HIV/AIDS medicines. Our empirical results indicate that redevising a market in response to market failures can shift the market’s frames and contribute to altering its practices, but that this is a pragmatic and often lengthy process that is never fully predictable in advance. By attending to the intended and unintended consequences – or misfires – of redevising a market, our study raises important questions around acting in and on the market, market innovation’s’ ontological impact, zooming in and zooming out when studying redevising, and attending to the temporality of market innovation.

Concerned Markets
Economic Ordering for Multiple Values

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Edited by Susi Geiger, Associate Professor of Marketing, University College Dublin, Ireland, Debbie Harrison, Associate Professor, BI Norwegian Business School, Norway, Hans Kjellberg, Associate Professor, Stockholm School of Economics, Sweden and Alexandre Mallard, Director of the Centre de Sociologie de l’Innovation, Ecole des Mines ParisTech, France

When political, social, technological and economic interests, values, and perspectives interact, market order and performance become contentious issues of debate. Such ‘hot’ situations are becoming increasingly common and make for rich sites of research. With expert empirical contributions investigating the organization of such ‘concerned’ markets, this book is positioned at the centre of the rapidly growing area of interdisciplinary market studies. Markets investigated include those for palm oil, primary health care and functional foods. The authors also examine markets and environmental concerns as well as better market design for those at the bottom of the pyramid.

Dr Théo Bourgeron and Prof Susi Geiger

Building the weak hand of the state: tracing the market boundaries of high pharmaceutical prices in France

Théo Bourgeron and Susi Geiger (2022)

New Political Economy

Abstract:

Prices for new medications have strongly increased over the last decades, reaching levels that could endanger healthcare insurance systems. Focusing on the French case, this article builds on the structural approach of business power and investigates how this situation results from the construction of market boundaries that created unassailable spaces for high pricing. Starting from the 1990s, it traces how high drug prices relied on the construction of a market setting first designed to increase pharmaceutical prices, in which the negotiating position of the state was deliberately weakened. But the politics of maintaining such high drug pricing quickly required reshaping the boundaries of the pharmaceutical market and concentrating the favourable negotiation framework on a small number of innovative medicines. Most recently, the spiralling of prices for these medicines have necessitated yet another revisiting of these market boundaries. High drug prices do not result from direct business power by the pharmaceutical sector; rather, the pharmaceutical sector depends on boundary-work performed in cooperation with state institutions to carve out domains for favourable market pricing. Emphasising the politics of this boundary-work thus ultimately also signals its potential reversibility.

(De-)Assetising pharmaceutical patents: Patent contestations behind a blockbuster drug.

Théo Bourgeron and Susi Geiger (2021)

Economy & Society

Abstract:

Recent debates in public health and social sciences have shown how biofinancialization has been fuelled by patents’ transformation into ‘patent-as-assets’. This paper traces the historical construction of one such patent-as-asset bundle: the multi-billion worth architecture of patents behind the hepatitis C blockbuster drug sofosbuvir. Following this process from the late 1980s to present times, we highlight the ontological entanglements of pharmaceutical patents and the scientific, legal, commercial and political contestations that result from the focal firms’ assetization projects. By shining a light on these entanglements, our paper points to the extraordinary historical conditions required for the assetization of drug patents as well as to their vulnerability to contestations. In particular, we highlight new forms of patent activism that threaten the ‘asset condition’ of high-priced pharmaceuticals.

Dr Théo Bourgeron – Post Doctoral Research Fellow

‘Let the virus spread’.
A doctrine of pandemic management for the libertarian-authoritarian capital accumulation regime

Bourgeron, Théo (2021)

DOI 10.1177/1350508421995741

Abstract:

Debates have grown around the initial COVID-19 response of radical right-wing governments such as those of the UK, the US and Brazil. These governments initially let the virus spread among the population and delayed the enforcement of strong social distancing measures such as a lockdown. Focusing on the UK’s early response to COVID-19, this article builds on Nicos Poulantzas’ Marxist theory of the state to highlight how this pandemic management doctrine stemmed from changes in the UK’s capitalist class. It traces the ideological grounding of this doctrine, relating it to the rise of libertarian think tanks in British conservative circles and shifts in the policy committees in charge of pandemic preparedness. It suggests that this pandemic response is an episode of the ongoing replacement of the dominant neoliberal accumulation regime with a new libertarian-authoritarian one and examines how this latter materialises the interests of an emerging group of ‘disaster capitalists’. Therefore, it takes the COVID-19 crisis as an example of how the reconfiguration of capitalist accumulation regimes articulates a new doctrine of catastrophe management, radical right-wing ideologies, libertarian-authoritarian institutions and the growing power of capitalist actors able to profit from extreme events.

Constructing the Double Circulation of Capital & “Social Impact.”

An Ethnographic Study of a French Impact Investment Fund.

Bourgeron, Théo (2020)
Historical Social Research 45 (3): 117-139.
doi: 10.12759/hsr.45.2020.3.117-139.

Abstract:

»Die Konstruktion der doppelten Zirkulation von Kapital und ,sozialem Impact‘. Eine ethnographische Studie über einen französischen Impact- Investitionsfond«.

Elaborating on a three-month ethnography of an impact investing fund called Impact Equity, this article aims to understand the mechanisms at work in the emergence of the impact investing sector. After presenting the case of Impact Equity (section 1), the article details the norms and devices through which impact investing is constructed in everyday financial work (sections 2 and 3) and investigates how impact investors mobilise moral beliefs and strategic motivations to navigate competing definitions of “social impact” (section 4). In doing so, this article outlines how the construction of the sector has involved the creation of channels enabling capital and “social impact” to circulate between institutional investors, impact investment funds, and “impactful businesses,” and it highlights the historical tensions that this process has involved.


Dr Ilaria Galasso – Post Doctoral Research Fellow

Narratives about distributed health literacy during the COVID-19 pandemic

Susana Silva, Helena Machado, Ilaria Galasso, Bettina M Zimmermann, and Carlo Botrugno

Health

Abstract

The promotion of health literacy was a key public health strategy during the COVID-19 pandemic. However, the role of social networks and relationships for support with health literacy-related tasks in the context of the COVID-19 pandemic is scarcely understood. Moving beyond traditional notions of health literacy, which focus on individual skills and knowledge, this study uses the concept of distributed health literacy to explore how individuals make meaning of and respond to health literacy and make their literacy skills available to others through their relational and socially situated and lived experiences of the COVID-19 pandemic. Drawing on 89 semi-structured interviews conducted in three European countries (Italy, Portugal, and Switzerland) between October and December 2021, we found narratives of stabilization, hybridization, and disruption that show how health literacy concerning COVID-19 is a complex social construct intertwined with emotional, cognitive, and behavioral responses distributed among individuals, communities, and institutions within socioeconomic and political contexts that affect their existence. This paper opens new empirical directions to understand the critical engagement of individuals and communities toward health information aimed at making sense of a complex and prolonged situation of uncertainty in a pandemic.

The second pandemic: Examining structural inequality through reverberations of COVID-19 in Europe

Amelia Fiske, Ilaria Galasso, Johanna Eichinger, Stuart McLennan, Isabella Radhuber, Bettina Zimmermann, Barbara Prainsack (2022)

Social Science and Medicine

Abstract

While everyone has been impacted directly or indirectly by the COVID-19 pandemic and the measures to contain it, not everyone has been impacted in the same way and certainly not to the same degree. Media coverage in early 2020 emphasized the “unprecedented” nature of the pandemic, and some even predicted that the virus could be a global “equalizer.” Ensuing debates over how the pandemic should be handled have often hinged on oppositions between protecting health and healthcare systems versus saving livelihoods and the economy, a dichotomy that we argue is false. Drawing on 482 interviews conducted in Germany, Italy, Ireland, Austria, German-speaking Switzerland and the UK over two points in a 6-month period as part of the ‘Solidarity in times of Pandemics Research Consortium’ (SolPan), we illustrate the ways that oppositions posed between saving lives or saving livelihoods fail to capture the entangled, long-standing nature of structural inequalities that have been revealed through the pandemic. Health- and wealth-related inequalities intersect to produce the “second pandemic,” a term used by a research participant to explain the other forms of devastation that run in parallel with virus. Our findings thus complicate such dichotomies through a qualitative understanding of the pandemic as a lived experience. The pandemic emerges as a critical juncture which, in exacerbating these existing structural inequalities, also poses an opportunity to work to better resolve them.

Ongolly Fernandos – PhD Student

The social meanings of artefacts: Face masks in the COVID-19 pandemic

Franziska B. Schönweitz, Johanna Eichinger, Janneke M.L. Kuiper, Fernandos Ongolly, Wanda Spahl, Barbara Prainsack, Bettina M. Zimmermann

Frontiers in Public Health, section Public Health Policy

Abstract

Since the beginning of the COVID-19 pandemic, research has explored various aspects of face mask use. While most of the research explores their effectiveness to prevent the spread of the virus, a growing body of literature has found that using face masks also has social meaning. But what social meaning does it have, and how does this meaning express itself in people’s practice? Based on 413 qualitative interviews with residents in five European countries (Austria, Belgium, Germany, Ireland, and Switzerland), we found that the meanings of face masks have changed drastically during the first months of the pandemic. While in spring 2020 people wearing them had to fear stigmatization, in autumn of 2020 not wearing masks was more likely to be stigmatized. Throughout the first year of the pandemic, we found that mask wearing had multiple and partly seemingly contradictory meanings for people. They were perceived as obstacles for non-verbal communication, but also a way to affirm friendships and maintain social contacts. They also signaled specific moral or political stances on the side of face mask wearers and non-wearers alike, expressed their belonging to certain communities, or articulated concern. In sum, our findings show how face masks serve as scripts for people to navigate their lives during the COVID-19 pandemic. We conclude that public and political discussions concerning face masks should include not only evidence on the epidemiological and infectiological effects of face masks, but also on their social meanings and their social effects.

Dr Simeon Vidolov – Research Scientist

Vidolov, S. (2022), “Uncovering the affective affordances of videoconference technologies“, Information Technology & People, Vol. 35 No. 6, pp. 1782-1803 (in Special Issue ‘Emotions in the Digitalised Workplace’)

Abstract

Purpose – The purpose of this study is to examine the role of videoconferencing technologies for mediating and transforming emotional experiences in virtual context.

Design/methodology/approach – Drawingonempiricaldataofvideoconferencingexperiences, this study identifies different constitutive relations with technology through which actors cope with actual or potential anxieties in virtual meetings. It draws on the phenomenological-existential tradition (Sartre and MerleauPonty) and on an interpretive phenomenological analysis (IPA) to conceptualize and illustrate the role of affective affordances in virtual settings.

Findings – The study identifies four different body–technology–other relations that provide different action possibilities, both disclosing and concealing, for navigating emotional experiences in virtual encounters of mutual gazing.These findings offer insights into the anatomy of virtual emotions and provide explanations on the nature of Zoom fatigue (interactive exhaustion) and heightened feelings of self-consciousness resulting from video conferencing interactions.

Originality/value – This paper builds on and extends current scholarship on technological affordances, as well as emotions, to suggest that technologies also afford different tactics for navigating emotional experiences. Thus, this paper proposes the notion of affective affordance that can expand current information system (IS) and organization studies(OS)scholarship in important ways.The focus is on video conference technologies and meetings that have received little research attention and even less so from a perspective on emotions. Importantly, the paper offers nuanced insights that can advance current research discourse on the relationships between technology, human body and emotions.

MISFIRES’ TEAM

Vulnerability and response-ability in the pandemic marketplace: Developing an ethic of care for provisioning in crisis

Geigers, Susi; Galasso, Ilaria; Hangel, Nora; Lucivero, Federica and Watts, Gemma (2023)

Journal of Business Ethics (FT50 Journal)

Abstract

This paper draws on the ethics of care to investigate how citizens grappled with ethical tensions in the mundane practice of grocery shopping at the height of the Covid-19 pandemic. We use this case to address the broader question of what it means ‘to care’ in the context of a crisis. Based on a qualitative longitudinal cross-country interview study, we find that the pandemic transformed ordinary shopping spaces into places fraught with a sense of fear and vulnerability. Being forced to face one’s own vulnerability created an opportunity for individuals to relate to one another as significant others through a sense of “response-ability”, or the capacity of people to respond to ethical demands through situated ethical reasoning. We argue for a practical ethos of care in which seemingly small decisions such as how often to go shopping and how much to buy of a particular product serve as a means to relate to both specified and generalized others—and through this, ‘care with’ society. Our study contributes to displacing the continuing prevalence of an abstract and prescriptive morality in consumption ethics with a situated and affective politics of care. This vocabulary seems better suited to reflect on the myriad of small and unheroic care acts in times of crisis and beyond.

Genetic research and the collective good: participants as leaders to reconcile individual and public interests

Galasso, Ilaria and Susi Geiger (2023)

Accepted at Journal of Medical Ethics (UCD Highly Prestigious Journal)

Abstract

This paper problematises the notions of public or common good as weighed against individual sovereignty in the context of medical research by focusing on genetic research. We propose the notion of collective good as the good of the particular collective in which the research was conducted. We conducted documentary and interview-based research with participant representatives and research leaders concerned with participant involvement in leading genetic research projects and around two recent genetic data controversies: the case of the UK Wellcome Sanger Institute, accused of planning unauthorised commercialisation of African DNA samples, and the case of the company Genuity Science, which planned genetic research on brain tumour samples in Ireland with no explicit patient consent. We advocate for greater specificity in circumscribing the collective to which genetic research relates and for greater efforts in including representatives of this collective as research coleaders in order to enable a more inclusive framing of the good arising from such research. Such community-based participant cogovernance and coleadership in genetic research is vital especially when minorities or vulnerable groups are involved, and it centrally requires community capacity building to help collectives articulate their own notions of the collective good.

Inequalities in the Challenges Affecting Children and their Families during COVID-19 with School Closures and Reopenings: A Qualitative Study 

Galasso, Ilaria & Gemma Watts (2023)

Public Policy paper based on recent article in the journal Public Health Ethics

This paper seeks to illuminate the policy implications of Covid-19 school closures and reopenings in Ireland through the voices and experiences of households, which reveals inequalities in terms of access to education and within home settings during school closures.[i] Using these insights, this paper identifies strategies and policy recommendations to mitigate inequalities throughout and beyond public health crises, including flexible working policies, parental access to external expertise, government supports to enhance school adaptability, dedicated stakeholder consultation during decision-making processes, and the regular use of qualitative interviews within school settings to better determine needs and inequalities requiring policy attention.

Affective resonance and durability in political organizing: The case of patients who hack

Vidolov, Simeon, Susi Geiger and Emma Stendahl (online first 2023)

Organization Studies, (AJG4 FT50 journal).

Abstract

We explore the role of affect in fuelling and sustaining political organizing in the case of an online type-1 diabetes community. Analysing this community’s interactions, we show that the drive towards political transformation is triggered by affective dissonance, but that this dissonance needs to be recurrently enacted through the balanced circulation of objects of pain and hope. We propose the notion of affective resonance to illuminate the dynamic interplay that collectively moderates and fosters this circulation and that keeps bodies invested and reverberating together around shared political goals. Affective resonance points researchers toward the fragile and complex accomplishment that affective politics represents. Focusing particularly on the community’s interactions on Twitter, we also reflect on the role of (digital) resonance spaces in how affects circulate. By adopting and transposing concepts from affect theories into the context of patient communities, we further add important insights into the unique embodied challenges that patients with chronic illness face. Highlighting the hope induced by techno-bodily emancipation that intertwine into a particular form of political organizing in such healthcare movements, we give emphasis to patient communities’ deeply embodied affects as important engines for political, social and economic change.

Inequalities in the Challenges Affecting Children and their Families during COVID-19 with School Closures and Reopenings: a Qualitative Study

Galasso; Ilaria and Watts; Gemma. (2022)

Public Health Ethics

Abstract

School closure is one of the most debated measures undertaken to contain the spread of the Coronavirus disease (COVID-19) pandemic. The pandemic has devastating health and socio-economic effects and must be contained, but schools play a vital role in present and future well-being, capabilities and health of children. We examine the detrimental consequences of both the closure and reopening of schools, by focusing on inequalities in the challenges affecting children and their families. This paper is grounded on Irish and Italian data from a multi-national longitudinal qualitative interview study. Research participants articulated a variety of issues and challenges that highlight inequalities in access to education during school closures, in the supportiveness of home setting, and in school preparedness to reopen, often mirroring or exacerbating pre-existing inequalities. The reported unequal lived experiences indicate that some harms are actionable, and already suggest some potential harm mitigation strategies. We conclude by advocating for enhanced public consultation to help mitigate the consequences of public dilemmas in general, and to help detect and tackle inadequacies and inequalities for school children through and beyond the pandemic, by learning from the experience of the concerned actors.

Democratic research: Setting up a qualitative, comparative and longitudinal interview study during the COVID-19 pandemic

Zimmermann B., Wagenaar H., Kieslich K….Galasso Ilaria, Geiger, Susi, Vidolov, Simeon et al. (2022) Social Science and Medicine – Qualitative Research in Health.

Abstract

The sudden and dramatic advent of the COVID-19 pandemic led to urgent demands for timely, relevant, yet rigorous research. This paper discusses the origin, design, and execution of the SolPan research commons, a large-scale, international, comparative, qualitative research project that sought to respond to the need for knowledge among researchers and policymakers in times of crisis. The form of organization as a research commons is characterized by an underlying solidaristic attitude of its members and its intrinsic organizational features in which research data and knowledge in the study is shared and jointly owned. As such, the project is peer-governed, rooted in (idealist) social values of academia, and aims at providing tools and benefits for its members. In this paper, we discuss challenges and solutions for qualitative studies that seek to operate as research commons.

Normative positions towards COVID-19 contact-tracing apps: findings from a large-scale qualitative study in nine European countries

Federica Lucivero, …Ilaria Galasso,Fernandos Ongolly, … Emma Stendahl & Ine Van Hoyweghen (2021)

Critical Public Health

Abstract

Mobile applications for digital contact tracing have been developed and introduced around the world in response to the COVID-19 pandemic. Proposed as a tool to support ‘traditional’ forms of contact-tracing carried out to monitor contagion, these apps have triggered an intense debate with respect to their legal and ethical permissibility, social desirability and general feasibility. Based on a large-scale study including qualitative data from 349 interviews conducted in nine European countries (Austria, Belgium, France, Germany, Ireland, Italy, the Netherlands, German-speaking Switzerland, the United Kingdom), this paper shows that the binary framing often found in surveys and polls, which contrasts privacy concerns with the usefulness of these interventions for public health, does not capture the depth, breadth, and nuances of people’s positions towards COVID-19 contact-tracing apps. The paper provides a detailed account of how people arrive at certain normative positions by analysing the argumentative patterns, tropes and (moral) repertoires underpinning people’s perspectives on digital contact-tracing. Specifically, we identified a spectrum comprising five normative positions towards the use of COVID-19 contact-tracing apps: opposition, scepticism of feasibility, pondered deliberation, resignation, and support. We describe these stances and analyse the diversity of assumptions and values that underlie the normative orientations of our interviewees. We conclude by arguing that policy attempts to develop and implement these and other digital responses to the pandemic should move beyond the reiteration of binary framings, and instead cater to the variety of values, concerns and expectations that citizens voice in discussions about these types of public health interventions.

Ethical Reasoning During a Pandemic: Results of a Five Country European Study

S. B. Johnson….. E. Stendahl……& N. Hangel (2022)

AJOB Empirical Bioethics

Abstract

Introduction: There has been no work that identifies the hidden or implicit normative assumptions on which participants base their views during the COVID-19 pandemic, and their reasoning and how they reach moral or ethical judgements. Our analysis focused on participants’ moral values, ethical reasoning and normative positions around the transmission of SARS-CoV-2.Methods: We analyzed data from 177 semi-structured interviews across five European countries (Germany, Ireland, Italy, Switzerland and the United Kingdom) conducted in April 2020.Results: Findings are structured in four themes: ethical contention in the context of normative uncertainty; patterns of ethical deliberation when contemplating restrictions and measures to reduce viral transmission; moral judgements regarding “good” and “bad” people; using existing structures of meaning for moral reasoning and ethical judgement.Discussion: Moral tools are an integral part of people’s reaction to and experience of a pandemic. ‘Moral preparedness’ for the next phases of this pandemic and for future pandemics will require an understanding of the moral values and normative concepts citizens use in their own decision-making. Three important elements of this preparedness are: conceptual clarity over what responsibility or respect mean in practice; better understanding of collective mindsets and how to encourage them; and a situated, rather than universalist, approach to the development of normative standards.