Beyond The Anticipatory Corpse: Medicine, Power, and the Care of the Dying: A Theoretical and Methodological Intervention into the Sociology of Brain Implant Surgery

J Med Philos. 2016 Dec;41(6):659-678. doi: 10.1093/jmp/jhw024. Epub 2016 Sep 22.

Abstract

Drawing on and extending the Foucaultian philosophical framework that Jeffrey Bishop develops in his masterful book, The Anticipatory Corpse: Medicine, Power, and the Care of the Dying, we undertake a sociological analysis of the neurological procedure-deep brain stimulation (DBS)-which implants electrodes in the brain, powered by a pacemaker-like device, for the treatment of movement disorders. Following Bishop's work, we carry out this analysis through a two-fold strategy. First, we examine how a multidisciplinary team evaluates candidates for this implant at a major medical center. We present excerpts from an ethnographic study of the "case conference" where disease entities are presented, contested, ratified, and made objects for intervention with this technology. The case conference becomes the key site in the transition from "person-with-illness" to "person-with-brain-implant" as a team of health professionals determines a plan of action by interpreting both statistical and "quality of life" data regarding their patients. Second, this article explores these decision-making processes through Bishop's conceptualization of evidence-based medicine, which relies on statistical approaches as the ultimate authority in knowledge production and medical decisions. We then reflect on Bishop's critique of the social sciences and the methodological, analytical, and substantive ramifications that The Anticipatory Corpse can offer future sociological work.

Keywords: The Anticipatory Corpse; Foucault; case conferences; deep brain stimulation; sociology of medicine.

MeSH terms

  • Attitude of Health Personnel
  • Cadaver
  • Clinical Decision-Making / ethics*
  • Clinical Decision-Making / methods*
  • Deep Brain Stimulation / ethics*
  • Deep Brain Stimulation / methods*
  • Human Body
  • Humans
  • Movement Disorders / therapy*
  • Philosophy, Medical
  • Sociology